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Osteosarcoma is the most common type of bone cancer that is usually found in the ends of long bones, such as the shin, femur (thigh bone) and humerus (upper arm bone). It is a type of sarcoma, which is a cancer that develops from the cells in bone and/or soft tissue.
Osteosarcoma is more common in males, and is generally diagnosed in children, teens, and young adults. However, anyone can develop this disease.
There are three primary types of osteosarcomas, which are classified by how the cancer cells look under the microscope.
High-grade osteosarcomas are the most common subtype of this disease and are the most aggressive. The cells analysed under the microscope do not look like normal bone, and many cancer cells are seen dividing into new cells. Some common types of high-grade osteosarcomas include:
Intermediate-grade osteosarcomas are uncommon and are often treated the same as low-grade osteosarcomas. These tumours are defined by being not as extensive as high-grade tumours, but more advanced than low-grade tumours. The most notable type of intermediate osteosarcoma is juxtacortical intermediate-grade osteosarcoma.
Low-grade osteosarcomas are the slowest growing subtype of osteosarcoma. The cells analysed under the microscope mostly resemble normal bone cells, with few replicating cancer cells observed. The most common types of low-grade osteosarcomas include:
If an osteosarcoma is detected, it will be staged and graded based on size, metastasis (whether the cancer has spread to other parts of the body) and how the cancer cells look under the microscope. Staging and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
This system can also be used in combination with a numerical value, from stage 0-IV:
Cancers can also be graded based on the rate of growth and how likely they are to spread:
Once your tumour has been staged and graded, your doctor may recommend genetic testing, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for osteosarcoma may include:
For more information on the treatment options, please refer to the Rare Cancers Australia Treatment Options page.
While the cause of osteosarcomas remain unknown, the following factors may increase your risk of developing the disease:
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
The symptoms of osteosarcoma may include:
Not everyone with the symptoms above will have cancer, but see your general practitioner (GP) if you are concerned.
If your doctor suspects you have an osteosarcoma, they may order the following tests to confirm the diagnosis and refer you to a specialist for treatment.
Your doctor will collect your overall medical history, as well as your current symptoms. Following this, they may examine your body to check for any abnormalities.
The doctor will take images of your body using magnetic resonance imaging (MRI), a computed tomography scan (CT scan), x-rays, bone scan and/or positron emission tomography (PET scan), depending on where it is suspected the cancer is. The doctor may also look at other parts of the body and looks for signs of metastasis. Additionally, a blood test may be taken to assess your overall health and help guide treatment decisions.
Once the location of the cancer has been identified, the doctor will perform a biopsy to remove a section of tissue using a needle. This is often done by a fine needle aspiration (FNA), a core needle biopsy (CNB), or by surgical means (excisional or incisional biopsy). These samples will then be analysed for cancer cells.
While it is not possible to predict the exact course of the disease, your doctor may be able to give you a general idea based on the rate and depth of tumour growth, susceptibility to treatment, age, overall fitness, and medical history. Generally, early-stage osteosarcomas have a better prognosis and survival rates. However, if the cancer is advanced and has spread, the prognosis may not be as good and there may be a higher risk of cancer recurrence. It is very important to discuss your individual circumstances with your doctor to better understand your prognosis.
Page last updated: 19/04/2022