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Treatment Option Overview
How osteosarcoma is treated
How osteosarcoma is treated
If it is suspected that the problem is osteosarcoma, before the first biopsy,
your doctor may recommend a specialist called an orthopedic oncologist.
There are treatments for all patients with osteosarcoma. Three kinds of
treatment are used:
In addition to these standard therapies, a treatment called biologic therapy is being tested for localized and metastatic osteosarcoma. Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
All patients with localized osteosarcoma should have surgery to remove the tumor, if possible. The doctor may remove only the
cancer and some of the healthy tissue around the cancer (limb-sparing surgery). When the tumor is in a weight-bearing bone, the bone should be protected during activity to avoid fractures that could prevent limb-sparing surgery. Sometimes all or part
of an arm or leg may have to be removed (amputated) to make sure that all of
the cancer is taken out. If cancer has spread to lymph nodes, the lymph nodes
will be removed (lymph node dissection).
In patients with osteosarcoma that has not spread beyond the bone, researchers
have found no difference in overall survival whether patients have limb-sparing surgery or whether they have surgery with amputation. When the cancer
can be taken out without amputation, artificial devices or bones from other
places in the body can be used to replace the bone that was removed.
The process of rebuilding (reconstructing) a part of the body changed by previous surgery is called reconstructive surgery. Options for reconstructive surgery in patients with osteosarcoma depend on many factors, including where the tumor is, how large it is, the age of the patient, and how much the patient will continue to grow.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill or put into the body by a needle in a vein or muscle. Chemotherapy is
called systemic treatment because the drug enters the blood stream, travels
through the body, and can kill cancer cells throughout the body. Chemotherapy
with more than one drug is called combination chemotherapy.
Sometimes chemotherapy is injected directly into the area where the cancer is
found (regional chemotherapy). In osteosarcoma, surgery is often used to
remove the local tumor and chemotherapy is then given to kill any cancer cells
that remain in the body. Chemotherapy given after surgery has removed the
cancer is called adjuvant chemotherapy. Chemotherapy can also be given before
surgery to shrink the cancer so that it can be removed during surgery; this is
called neoadjuvant chemotherapy.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation for osteosarcoma usually comes from a machine
outside the body (external radiation therapy).
A patient may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or may choose to go into
a clinical trial. Not all patients are cured with standard therapy, and some
standard treatments may have unwanted side effects. For these
reasons, clinical trials are designed to find better ways to treat cancer
patients and are based on the most up-to-date information. Clinical trials for
osteosarcoma are ongoing in many parts of the country. If you want more
information, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237); TTY at 1-800-332-8615.
Some cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include physical problems; changes in mood, feelings, thinking, learning or memory; and having second cancers (new types of cancer). Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.
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