Ask The Expert/FAQs

Frequently Asked Questions Regarding Osteogenic Sarcoma

	Q.	What is osteogenic sarcoma?
	Q.	What causes osteogenic sarcoma?
	Q.	What are the symptoms of osteogenic sarcoma?
	Q.	How is it diagnosed?
	Q.	How is it treated?
	Q.	How long is the treatment?
	Q.	How effective is the treatment?

Q: What is osteogenic sarcoma?

A. Osteogenic sarcoma is a type of cancer that affects the bone. It is primarily in individuals between the ages of 10 and 25, with 900 new patients diagnosed each year. Osteogenic sarcoma is usually present in the legs and knees, with 60 percent of cases being diagnosed in these regions. However, osteogenic sarcoma can show up in other bones, such as the shoulders and the jaw, where it is harder to treat.

Q:  What causes osteogenic sarcoma?

A. To this day, researchers aren’t sure what causes osteogenic sarcoma. Some theories postulate that repeated trauma to a specific area causes increased presence of osteoid tissue to repair the area, leading to malignancy. Another theory is that the cause is genetic, being linked with the same gene that causes retinoblastoma. Osteogenic sarcoma may also result from continued irradiation exposure from treatment of other cancers.

Q:  What are the symptoms of osteogenic sarcoma?

A. People with osteogenic sarcoma often complain of a bruising or swelling of the area, with a feeling of a bump. Pain is constant all the time, but becomes worse during the night. The bone in question is very weak, and thus very easy to break. The bone affected will also be more difficult to move.

Q:  How is it diagnosed?

A.  X-rays, bone scans, MRIs, and CT scans are all used to diagnose osteogenic sarcoma. A biopsy, or removal of a small portion of the questionable tissue, will confirm the existence of osteogenic sarcoma. After being diagnosed, the cancer is then ”staged” to determine how far it has spread, and how much it has advanced. If detected early enough, it may not have metastasized and may be prevalent only in the surrounding tissue. However, in many cases (due to the symptoms associated with bone breaks and common injuries), the cancer may not be diagnosed early and may have metastasized to the lungs. If this has happened, it will be more difficult to treat, and the survival rate diminishes.

Q:  How is it treated?

A.  Treatment for osteogenic sarcoma involves a three-step process:

Neoadjuvant chemotherapy – this means that chemotherapy is given to the patient before surgery. This is meant as an attempt to reduce the size of the tumor before it is resected (surgically removed). Treatment usually involves drugs such as methotrexate, cisplatin, doxorubicin, etoposide, ifosfamide, and pegylated interferon alfa 2b.

Surgery – surgery involves either complete amputation (in cases that are rare), or a procedure known as limb-salvage surgery. Limb-salvage surgery involves removing the affected tissue and part of the surrounding tissue. A follow-up treatment may involve endoprosthesis, where the lost bone tissue is replaced by either a bone graft, or a piece of plastic-metal alloy. After limb-salvage surgery, patients are required to undergo a recovery regimen that lasts from six to 12 months (amputees require longer recovery time, and must cope with the psychological effects of amputation), usually involving a CPM (continuous motion machine) that bends and straightens the limb.

Follow-up chemotherapy – a biopsy is performed to determine the size of the tumor after the surgery. If less than 10 percent is present, then the surgery is considered to be a success and a lighter treatment of methotrexate is administered. However, if more than 10 percent is present within the body then a more concentrated dose of chemotherapy is administered.

Q:  How long is the treatment?

A. Treatment for osteogenic sarcoma can last anywhere from 26 weeks to two years, depending on how late/early the cancer was diagnosed, and how effective the treatment is.

Q:  How effective is the treatment?

A. Osteogenic sarcoma has one of the lower survival rates among young adults/children afflicted with cancer. The five-year survival rate is around 65-70 percent.

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