Osteosarcoma

Diagnosis

Osteosarcoma diagnosis usually begins with a physical examination. Based on the results, your healthcare provider may recommend additional tests and procedures to confirm the presence of cancer and determine its extent.

Imaging tests
Imaging tests create detailed pictures of the body to show the size, location, and spread of the tumor. Common imaging tests for osteosarcoma include:

• X-ray

• MRI

• CT scan

• Bone scan

• Positron emission tomography (PET) scan

Biopsy
A biopsy is the most definitive test for diagnosing osteosarcoma. It involves removing a sample of tissue from the affected area for laboratory testing. The biopsy may be done in one of two ways:

• Needle biopsy, where a needle is inserted through the skin into the tumor.

• Surgical biopsy, where a surgeon removes a piece of tissue during an operation.

The sample is examined under a microscope to determine whether it is cancerous and to identify the specific type of osteosarcoma. The results help doctors create an effective treatment plan.

The biopsy must be carefully planned to avoid complications that could affect future surgery. It’s important to have the procedure performed by a team experienced in treating osteosarcoma.

Treatment

Treatment for osteosarcoma typically includes surgery and chemotherapy. In rare cases, radiation therapy may also be used if surgery is not an option.

Surgery
The main goal of surgery is to remove all cancerous tissue while preserving as much function as possible. The type of surgery depends on the tumor’s size, location, and how much tissue is affected.

Common surgical procedures include:

• Limb-sparing surgery – Removes the tumor while saving the affected arm or leg. The removed bone may be reconstructed using metal implants or bone grafts.

• Amputation – In rare cases, the entire limb may need to be removed to eliminate the cancer completely. After amputation, a prosthetic limb can help restore mobility.

• Rotationplasty – Used mainly for osteosarcoma near the knee in children. The lower part of the leg, including the foot and ankle, is rotated and reattached to the thigh bone. The ankle joint then functions as a knee joint, allowing the use of a prosthesis for walking and sports activities.

Chemotherapy
Chemotherapy uses strong medicines to destroy cancer cells. It is often given before surgery to shrink the tumor and make removal easier. After surgery, chemotherapy continues to kill any remaining cancer cells and reduce the risk of recurrence.

In cases where osteosarcoma spreads or returns, chemotherapy can help slow the cancer’s progression and relieve symptoms such as pain.

Radiation therapy
Radiation therapy uses powerful energy beams, such as X-rays or protons, to target and destroy cancer cells. It’s typically reserved for situations where surgery cannot remove all of the cancer. The treatment is delivered externally using a machine that directs radiation precisely at the affected area.

Clinical trials
Clinical trials test new and experimental treatments for osteosarcoma. These studies can offer access to advanced therapies not yet widely available. Participation in a clinical trial should be discussed with your healthcare team to understand potential benefits and risks.