Osteosarcoma Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Osteosarcoma is a type of cancer that develops in the bones. This cancer belongs to the category of musculoskeletal cancer which is quite serious and can cause death. Osteosarcoma can metastasize or spread to the lungs.
This cancer usually affects children and young adults, ages 10–30 years. Among these age ranges, it is adolescents who are most commonly affected by osteosarcoma.
According to WHO, the incidence of osteosarcoma is around 4–5 per 1,000,000 population. Osteosarcoma is also more common in men than women with a ratio of 3:2.
Symptom
Those who suffer from osteosarcoma may complain of lumps that feel painful in certain parts of their body. Other symptoms of osteosarcoma are:
- The mass on the part of the body that is getting bigger
- Pain in tumors
- A fracture occurs in the area of the tumor (pathological fracture)
- Limited body movement
- Weight loss
- Anemia
Reason
Osteosarcoma is a malignant condition with multifactorial causes. This type of cancer can be caused by several factors, such as:
- Chemical compound. There are several types of chemical compounds that are associated with the occurrence of osteosarcoma, such as anthracyclines and alkyl compounds. These compounds are thought to cause genetic changes.
- Virus. Rous sarcoma virus containing the V-Src gene is a type of proto-oncogene virus or virus that can cause malignancy.
- Radiation. This cause is associated with an increased incidence of secondary sarcoma in those who have received radiation for cancer therapy.
- Molecular. This is an event of loss of the tumor suppressor gene (or retinoblastoma /RB gene). Mutations of this P53 (tumor suppressor gene) are also associated with osteosarcoma.
Diagnosis
The diagnosis of osteosarcoma is determined based on medical interviews, physical examinations, and supporting examinations. On physical examination, it is likely to find severe local pain, lumps in certain areas, easy fractures (pathological fractures), and weight loss.
The initial investigation that can be done is a radiological examination. On plain photo examination, bones can be seen that have moth-eaten lytic lesions or lesions, blastic lesions, cortex destruction, an aggressive type of periosteal reaction (Codman triangle, sunburst, hair on end ), soft tissue masses, and matrix formation.
CT scans and MRI examinations can also be done to provide a more detailed picture of the tissue around the bones. A biopsy is a step in the diagnosis of osteosarcoma to determine the type of osteosarcoma cell.
Treatment
Treatment of osteosarcoma can be in the form of surgical therapy, as well as chemotherapy with or without radiotherapy. The right choice of therapy for this disease also requires discussion from multi-disciplinary doctors for the most optimal therapy.
Chemotherapy is generally intended to control the spread and facilitate surgery (amputation). Surgery is the main therapy for osteosarcoma through the principle of resection while maintaining maximum body function.
Surgery can be performed preceded by chemotherapy methods (neoadjuvant chemotherapy). Neoadjuvant chemotherapy may be used to reduce tumor size and make surgery easier. Several chemotherapy regimen options are with cisplatin and doxorubicin, or docetaxel and gemcitabine.
Surgical therapy is performed on tumors without neurovascular involvement. After surgery, the patient can undergo chemotherapy again. In osteosarcoma, radiotherapy plays a relatively small role because this type of cancer is not sensitive to radiotherapy. However, radiotherapy may be considered for certain types of tumors or for bone tumors with locations that are difficult to reach with surgery.
Prevention
Until now there has not been found any effective prevention of osteosarcoma.