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Osteosarcoma Treatment in Pune Experts
At Sancheti Hospital’s Ortho Onco Department, we offer advanced osteosarcoma treatment in Pune with expert oncologists providing precise diagnosis and personalized care.
Overview
Osteosarcoma is the most common type of primary bone cancer, mainly affecting children, teenagers, and young adults. This aggressive cancer begins in the bone-forming cells and creates malignant tumors that produce abnormal bone tissue.
While osteosarcoma can develop in any bone, it most often occurs in the long bones of the arms and legs, particularly near major joints like the knees, hips, and shoulders.
Although relatively rare, with only 3-5 cases per million people each year, osteosarcoma can be serious and life-threatening, especially when it spreads to other parts of the body.
The good news is that advances in osteosarcoma treatment have significantly improved survival rates for patients with localized disease. Modern treatment combines chemotherapy with advanced surgical techniques, offering hope for better outcomes.
Symptoms
The symptoms of osteosarcoma often start gradually and can sometimes be mistaken for common conditions like growing pains or sports injuries. Many patients experience symptoms for weeks or months before seeking medical help.
The most common signs include:
- Bone pain or tenderness, usually near a joint that may come and go at first but becomes persistent and intense over time
- Pain that worsens at night or after physical activity
- Swelling in one area on or near a bone, or a noticeable lump
- Warmth around the affected area
- Limited movement in nearby joints
- Limping or difficulty walking if the tumor is in the leg
- Bone fractures that happen suddenly or from minor injuries that normally wouldn’t cause breaks
- Unexplained fever (rarely)
- Skin discoloration over the affected area (rarely)
If osteosarcoma has spread to the lungs, patients might experience breathing problems or persistent cough, though this is uncommon at the time of initial diagnosis.
Causes
The exact causes of osteosarcoma are not fully understood. Scientists believe it develops when DNA changes occur in bone-forming cells, leading to uncontrolled cell growth and division. These genetic changes cause cells to form tumors that can invade healthy tissue and potentially spread to other parts of the body.
While the precise cause remains unknown, researchers have identified several factors that may contribute to its development:
- Rapid bone growth during adolescent growth spurts
- Previous radiation exposure for treating other cancers
- Genetic factors and inherited mutations
- Bone infarction (lack of blood supply to bone tissue)
- Certain viruses in animal studies
- Exposure to specific chemicals
Risk Factors
While most people diagnosed with osteosarcoma have no known risk factors, certain elements can increase a person’s chances of developing this bone cancer:
Age and Gender:
- Most common in children and teenagers between 10-24 years old
- Peak incidence around age 15
- Slightly more common in males, especially teenage boys
- A smaller group of cases occurs in older adults
Medical History:
- Previous chemotherapy or radiation therapy for other cancers
- Certain bone conditions like Paget’s disease or fibrous dysplasia
- Taller height in children may increase risk
Genetic Conditions:
- Hereditary retinoblastoma (eye cancer linked to RB1 gene mutations)
- Li-Fraumeni syndrome (caused by TP53 gene mutations)
- Rothmund-Thomson syndrome (RECQL4 gene mutations)
- Bloom syndrome (BLM gene mutations)
- Werner syndrome (WRN gene mutations)
- Diamond-Blackfan anemia
Other Factors:
- Family history of bone cancers
Diagnosis
Diagnosing osteosarcoma involves a comprehensive evaluation that includes medical history, physical examination, and specialized tests.
Physical Examination: Healthcare providers look for lumps, swelling, or tenderness around bones and check for limited joint movement.
Imaging Tests:
- X-rays: Often the first test, showing bone destruction and new bone formation
- MRI scans: The gold standard for defining tumor extent and relationship to surrounding tissues
- CT scans: Used for biopsy planning and detecting lung spread
- Bone scans: Help detect cancer cells in other bones
- PET scans: Identify highly active cancer cells and assess tumor extent
Blood Tests: While no specific blood tests exist for osteosarcoma, doctors monitor levels of:
- Alkaline phosphatase (ALP)
- Lactate dehydrogenase (LDH)
High levels may indicate heavier tumor burden and help track treatment response.
Biopsy: A definitive diagnosis of osteosarcoma requires examining tumor tissue under a microscope. A core needle biopsy is typically preferred and must be performed by an experienced orthopedic oncologist.
Types
Osteosarcoma includes several types based on location, appearance, and how quickly they grow:
High-Grade Osteosarcoma:
- Fast-growing tumors with abnormal-looking cells
- Most common type in children and teenagers
- Includes osteoblastic, chondroblastic, and fibroblastic variants
Intermediate-Grade Osteosarcoma:
- Less common
- Periosteal type is the main form
- Often treated similarly to low-grade tumors
Low-Grade Osteosarcoma:
- Slow-growing tumors
- Cells look more similar to normal bone cells
- Includes low-grade central and parosteal types
Secondary Osteosarcoma:
- Develops in abnormal bone
- Often linked to Paget’s disease or radiation exposure
Stages
After diagnosis of osteosarcoma, staging determines if the cancer has spread. This information is crucial for planning the most effective treatment strategy.
AJCC TNM System:
- Stage IA: Low grade, less than 8 cm, no spread
- Stage IB: Low grade, larger than 8 cm, no spread
- Stage IIA: High grade, less than 8 cm, no spread
- Stage IIB: High grade, larger than 8 cm, no spread
- Stage III: High grade with skip lesions, no spread
- Stage IVA: Any grade, lung spread only
- Stage IVB: Any grade, spread to lymph nodes or distant sites
SEER Categories:
- Localized: No spread beyond the original bone
- Regional: Spread to nearby structures or lymph nodes
- Distant: Spread to lungs or other distant sites
Treatment
Osteosarcoma treatment typically involves a team approach combining different therapies for the best possible outcomes.
Chemotherapy: Chemotherapy for osteosarcoma uses powerful medications to kill cancer cells and is given in different phases:
- Neoadjuvant chemotherapy: Given before surgery to shrink tumors and treat hidden cancer cells
- Adjuvant chemotherapy: Given after surgery to eliminate remaining cancer cells
- Common drugs include cisplatin, doxorubicin, methotrexate, ifosfamide, and carboplatin
Surgery: The main goal is to completely remove the tumor while preserving limb function:
- Limb-sparing surgery: Standard treatment in over 90% of cases, removing the tumor and reconstructing with metal prosthetics or bone grafts
- Amputation: Rarely necessary, reserved for cases where limb-sparing isn’t possible
- Rotationplasty: Option for knee tumors, where the lower leg is rotated and reattached
Radiation Therapy: While osteosarcoma cells are generally resistant to radiation, it may be used when:
- Surgery isn’t possible
- Surgical margins are close or positive
- For pain relief in advanced cases
Immunotherapy: Immunotherapy for osteosarcoma is an emerging treatment approach currently being researched:
- CAR-T therapy: Engineering immune cells to attack cancer
- Immune checkpoint inhibitors
- Combination strategies to overcome cancer’s immune resistance
Rehabilitation
Rehabilitation is essential after osteosarcoma treatment, especially following surgery. Physical and occupational therapy help:
- Restore function to affected limbs
- Improve strength and mobility
- Learn to use prosthetic devices
- Enhance quality of life
- Manage pain and complications
Working with rehabilitation specialists experienced in cancer care is crucial for optimal recovery.
Complications
Both osteosarcoma and its treatment can cause various complications:
Disease-Related:
- Metastatic disease: Cancer spread, most commonly to lungs
- Pathological fractures: Bone breaks due to tumor weakness
Treatment-Related:
- Chemotherapy side effects: Nausea, low blood counts, heart problems, hearing loss, infertility
- Radiation effects: Skin changes, organ damage in treated areas
- Surgical complications: Infection, implant failure, non-healing
Long-term Issues:
- Secondary cancers: Small risk of developing new cancers later
- Functional limitations
- Psychological impacts
Prevention
Currently, there is no known way to prevent osteosarcoma because its exact causes aren’t fully understood. However, for individuals with family history or genetic conditions that increase risk, genetic counseling may be helpful.
Living With Osteosarcoma
Receiving an osteosarcoma diagnosis can be overwhelming, especially for young patients and their families. Maintaining quality of life throughout treatment is essential:
Physical Care:
- Learn pain management strategies
- Follow rehabilitation programs
- Maintain nutrition and fitness when possible
- Manage treatment side effects
Follow-up Care:
- Regular medical checkups
- Imaging tests to monitor for recurrence
- Blood tests to check organ function
- Long-term survivorship care
Team Approach: Optimal care requires collaboration between oncologists, orthopedic surgeons, radiation specialists, rehabilitation experts, nurses, and mental health professionals.
Key Takeaways
- Osteosarcoma is the most common primary bone cancer, primarily affecting children and young adults during periods of rapid bone growth
- Early recognition of persistent bone pain, swelling, or unexplained fractures is crucial for prompt diagnosis
- Osteosarcoma treatment combines intensive chemotherapy with surgical resection, with limb-sparing surgery being the preferred approach when possible
- Survival rates have improved significantly with modern multimodal treatment approaches
- Rehabilitation plays a vital role in recovery and long-term quality of life
- Regular follow-up care is essential for monitoring recurrence and managing late effects of treatment
- Research into immunotherapy for osteosarcoma and CAR-T therapy offers hope for future treatment advances
Sancheti Hospital stands at the forefront of comprehensive osteosarcoma treatment, offering patients access to cutting-edge medical care and a multidisciplinary approach to bone cancer management.
Our experienced team of orthopedic oncologists, medical oncologists, radiation specialists, and rehabilitation experts work collaboratively to provide personalized treatment plans for each patient.
With state-of-the-art surgical facilities, advanced chemotherapy protocols, and comprehensive rehabilitation services, Sancheti Hospital is committed to achieving the best possible outcomes while focusing on preserving limb function and maintaining quality of life.
Our dedication to patient-centered care extends beyond treatment, offering psychological support, family counseling, and long-term survivorship programs to ensure holistic healing throughout the cancer journey.
Meet Our Ortho Onco Specialist
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
How long does osteosarcoma treatment take?
Osteosarcoma treatment typically takes 8-12 months. This includes 10-12 weeks of chemotherapy before surgery, followed by the surgical procedure, recovery time, and then another 18-24 weeks of chemotherapy after surgery.
Can my child play sports after osteosarcoma treatment?
Most children can return to sports after limb-sparing surgery and complete recovery. However, contact sports and high-impact activities may be restricted depending on the type of reconstruction used. Your doctor will provide specific guidelines based on your child’s individual case.
Will osteosarcoma affect my child's growth?
Osteosarcoma and its treatment can affect growth, especially if it occurs near growth plates. Modern expandable prosthetics can be adjusted as children grow. Your medical team will monitor growth closely and make necessary adjustments to maintain proper limb length.
How often will my child need follow-up appointments after treatment?
Follow-up visits are frequent initially – every 2-3 months for the first two years, then every 4-6 months for the next three years. These visits include physical exams, chest X-rays or CT scans, and blood tests to monitor for any cancer recurrence.
What should I expect during chemotherapy for osteosarcoma?
Chemotherapy for osteosarcoma involves strong medications that may cause nausea, hair loss, fatigue, and temporary low blood counts. Treatment typically requires hospital stays every 2-3 weeks. Your medical team will provide medications to manage side effects and monitor your child’s response closely.
