Osteosarcoma or osteogenic sarcoma (also known as OS or osteo) is an aggressive malignant primary bone cancer. When OS metastasizes (spreads) it is often to the lungs but metastases to other bones may occur. With about 800+ cases a year diagnosed in the United States, OS is the most prevalent bone cancer affecting children and adolescent/young adults.
Osteosarcoma can occur at any age but the most common age for diagnosis is in children and young adults during growth spurt times . It often begins near the ends of leg or arm bones near joints. Osteosarcoma is rarer in other bones like the pelvis, shoulder, and jaw but unusual sites are increasingly seen in older adults. Given its rarity and time of usual diagnosis, it is common to be misdiagnosed as a benign tumor or dismissed as growing pains
Most cancer risk factors are identified by epidemiology studies. Scientists may look at large groups of people and compare those that have developed cancer with those that haven’t. When analyzing the differences in behaviors and exposure to certain substances, scientists are able to determine possible risk factors. When scientists can link multiple studies to the same outcome, the potential risk factor to the increase in cancer risk, and have a possible mechanism that shows how the risk factor causes cancer, then they have more reason to believe the validity behind the causes of that cancer.
However, these studies really can’t be the final determination to prove that a certain substance or behavior leads to cancer. They can be misleading because the findings could be due to chance or the suspected risk factor may be completely different from the true risk factor. Although looking at potential risk factors can guide you in the right direction to avoid development of cancer, it is important to understand that all risk factors cannot be avoided - such as growing older.
According to the American Cancer Society most known risk factors for osteosarcoma are unavoidable. Other than radiation therapy, there are no known lifestyle-related or environmental causes of osteosarcoma. Most osteosarcoma cases are thought to be somatic gene mutations; these are acquired gene changes that just randomly occur without apparent cause during life. The somatic gene changes are only present in the tumor cells. Known risk factors are:
Risk is highest between 10 and 30 especially during growth spurt years, which indicates it may be related to rapid bone growth
Children who are tall for their age which suggests it may be related to rapid bone growth.
More common in males and in African Americans and Hispanic/Latino people
Hereditary Retinoblastoma: rare eye cancer which has a mutation in the RB1 gene
◦ Li-Fraumeni Syndrome: usually caused by abnormal changes in the TP53 gene
◦ Bloom syndrome, Werner Syndrome and Diamond-Blackfan Anemia, etc.
B’s Mom says, “Act quickly. Keep a positive attitude for your child. There are NO dumb questions, stay informed on your level of understanding. If you don’t understand or know... ASK! Guessing is worse than knowing.”
If you are concerned about having osteosarcoma after understanding the risk factors, it may be a good time to talk to your doctor, or find one that you trust and feel you can develop a relationship with.
Many doctors are pressed to see as many patients in a day which results in quick visits that can feel unfulfilling or rushed being only 15-20 minutes. When approaching your doctor, it is important to come with a plan so you can get the most out of the visit. These are four key tips given by Dr. Debra Roter, PhD at Johns Hopkins Bloomberg School of Public Health on how to maximize the time you have with your doctor.
Come to the office ready with a few topics and questions you want to address and bring them up at the very beginning of the visit. This does not have to be complex, it can just be simple concerns, worries, or fears along with any health symptoms you have been experiencing.
Be honest about those worries and concerns. Don’t be afraid to tell your doctor about your lifestyle and personal life with the assumption that they don't care. All of this helps the doctor understand the big picture of your health and wellbeing in the short time. They are there to help you and make you feel comfortable.
Again, the doctor is there to give you information and help you feel better. If the information they are giving you is too complex, ask questions! It is better to ask then leave wishing you had. Another way to understand all of the advice and information is to repeat back to the doctor what they are saying, as well as repeat a concern you have that they maybe had not addressed when you brought it up before. Emphasize your concerns so the doctor understands how deeply affected you are by this.
Lastly, it’s important to work together with your doctor to gain the most impact. And again with addressing concerts; if your doctor offers a treatment plan, make sure to address your concerns about side effects or questions about other options. More importantly, try to calm your anxiety before the appointment starts by thinking positively about the outcome of your visit. Have mindfulness and know that you are there to work together with your doctor to find the best option.
Michelle from Virginia suggests, “My first thought when my daughter was diagnosed was “How did I miss this?” She had complained of leg pain for a couple of months and I thought it was growing pains. I felt really guilty for not knowing and for delaying in taking her to the doctor. These thoughts are common but are not productive. You are not at fault in any way. You have a diagnosis now and you will have a great team of doctors, nurses, social workers, nursing care partners, and child life workers who will walk this road with you.”
*No two osteosarcoma patients are the same, therefore there is no substitute for the expert care of your medical team. This is not meant to replace the guidance of your oncology team. It is meant to share resources, information and support.