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Once osteosarcoma has been found, more tests may be done to find out
if cancer cells have spread to other parts of the body. This is called staging. At
present, there is no staging system for osteosarcoma. Instead, most patients are
grouped depending on whether cancer is founding only one part of the body
(localized disease) or whether the cancer has spread from one part of the body to
another (metastatic disease). The following groups are used for osteosarcoma:
1. Localized osteosarcoma: the cancer cells have not spread beyond
the bone or nearby tissue in which cancer began.
2. Metastatic osteosarcoma: The cancer cells have spread from the
bone in which the cancer began to other parts of the body. The
cancer most often spreads to the lungs. It may also spread to other
bones. In multifocal osteosarcoma, tumor appears in 2 or more
bones, but has not spread to the lungs.
3. Recurrent osteosarcoma: Recurrent diseases mean that the
cancer has come back after it has been treated. It may come back in
tissues where it first started or it may come back in another part of
the body. When osteosarcoma recurs, it is usually within 2 to 3
years after treatment is completed. Later recurrence is possible, but
rare.
Some DNA mutations cause syndromes that are linked with an increased risk of
osteosarcoma:
a. The Li-Frauman syndrome it turns off the TP53 tumor suppresor gene.
These mutations give a person a very high risk of developing one or more
types of cancer, including breast cancer, brain tumors, osteosarcoma,
and other cancers.
b. Inherited changes in Retinoblastoma (RB1) tumor suppressor gene-
increases risk of developing retinoblastoma, and also osteosarcoma.
However, most osteosarcomas are not caused by inherited DNA mutations.
They result from gene changes acquired during the persons lifetime. These
changes are present only in the cancer cells and not on to children.
For example: Although radiation therapy is very useful in treating some forms
of cancer, it can also cause cancer by damaging DNA. This is why people who
get radiation therapy to treat another cancer are more likely to later develop
osteosarcoma in the treated site.
Other DNA changes have no clear cause. Other than radiation, there are no
known lifestyle-related or environmental causes of osteosarcoma. Researchers
now understand some of the gene changes that occur in osteosarcomas, but its
not always clear what causes these changes
Patients who have osteosarcoma may have a history of pain in the affected
area and may have developed a limp (depending on which bone affected). Often
the pain is thought to be related to muscle soreness or growing pains, but it
does not go away with rest.
Some patients may also experience a dull ache or have pain that keeps them
awake at night. In some cases of osteosarcoma, it is also advisable to examine
or assess the muscles in the cancerous leg or arm because it may appear
smaller than those of the opposite limb.
X-ray
Often the first diagnostic test to be done, and an experience radiologist may
recognize immediately that bone cancer is the likely diagnosis.
Additional tests:
MRI MRI of the entire bone where the primary tumor is located. The test can
rule out skip metastases or the spread of the tumor to other areas of the bone.
Chest X ray and CT Scan it is done to detect lung metastases
Bone Scan to rule out distant spread of the disease
Biopsy provides a definite diagnosis based on the characteristics of tumor
tissue seen under a microscope. This will also show the grade level of the tumor.
a. Needle aspiration
b. Surgical biopsy
OSTEOSARCOMA
OSTEOBLAST
DNA MUTATION
MALIGNANT
OSTEOBLAST
PROLIFERATION
OF ABNORMAL
OSTEOBLAST
FORMATION OF OSTEOID
OR IMMATURE BONE
VIII. References:
https://www.cancer.org/cancer/osteosarcoma.html
http://sarcomahelp.org/osteosarcoma.html
https://www.cancer.org/cancer/osteosarcoma/causes-risks-prevention/what-
causes.html
http://sarcomahelp.org/osteosarcoma.html
http://www.cancer.net/cancer-types/osteosarcoma-childhood/symptoms-and-
signs
https://www.scribd.com/doc/17647444/OSTEOSARCOMA
http://careplannursing.blogspot.com/2015/01/nursing-care-plan-for-
osteosarcoma.html
http://nursingcrib.com/nursing-notes-reviewer/medical-surgical-
nursing/osteosarcoma/
https://www.slideshare.net/abbirr/case-presentationosteosarcomab