Sunday, January 13, 2008

How to Treat Osteosarcoma


Osteosarcoma is a bone tumor thought to originate from mesenchymal bone-forming cells. It is the most common bone cancer and the production of malignant bone establishes the diagnosis as osteosarcoma. This is a deadly cancer that usually begins in the long bones of children. Death from osteosarcoma usually results from metastasis to the lungs. The following steps will show how to treat osteosarcoma.


Difficulty: Challenging



Step One

Begin preoperative chemotherapy to facilitate surgical removal. The osteosarcoma can be reduced by more than 95 percent in responsive patients and they have a better prognosis than patients who do not respond as favorably. Recommended medication includes cisplatin, doxorubicin, and ifosfamide and methotrexate.

Step Two

Use surgery as the only option for tumor removal because osteosarcomas are not very responsive to radiotherapy. A complex bone reconstruction or a total joint prosthesis may be required after the surgical resection so an orthopedic surgeon must be closely involved with this treatment.

Step Three

Continue postoperative chemotherapy. This is critical because most osteosarcoma patients have some metastasis by the time they are diagnosed and the recurrence rate is high.

Step Four

Perform a definitive resection with patient survival as the primary goal. All sides of the tumor must therefore contain a wide margin with 5 to 7 cm considered adequate. Amputation may be required in some cases.

Step Five

Consider some of the limb-saving options that are available with osteosarcoma. A bone graft from the patient's own body or another donor may be performed. Other options include a rotationplasty where the ankle is used as a knee joint.

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