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Osteosarcoma Overview

Osteosarcoma is a relatively uncommon bone cancer, and treatment can be complex. It is therefore imperative to choose a medical facility that is experienced with treating osteosarcoma in children. At Sheba Medical Center in Israel, our multidisciplinary doctors offer progressive therapies and techniques against this cancer. We have a premier team of pediatric oncologists, orthopedic surgeons, radiation oncologists, and other specialists who have undergone training at internationally renowned cancer centers. Our physicians use frontline expertise to custom-tailor every child’s treatment program.

Holistic healthcare is a foundation of cancer treatment at Sheba, especially when caring for our young patients. We make personalized medical decisions that consider the individual child’s comfort and overall well-being. Our compassionate team believes in open communication between the doctors, child, and family, so that you know what to expect throughout every step of your child’s treatment.

Recently, diagnosis and treatment has progressed to combine testing in the field of molecular biology along with conventional methods. At Sheba, we use these advanced tests to aid in both diagnosing the disease and directing the drug therapies so they are custom tailored for each individual patient – and for each stage of the disease.

    Molecular biology testing includes methods such as:

  • FISH
  • PCR
  • Next generation sequencing, such as gene panel sequencing (DNA and RNA), mutation profile characterization, methylation profile and response markers for immunotherapies.

Altogether, our approach is one of precision medicine (also called personalized medicine), based on a deep understanding of the biological responses underlying the disease. We interpret all test results cautiously and stringently in order to enable a highly informed selection of innovative treatments.

Our Hemato-Oncology Division is characterized by a specialized interest in applying precision medicine for bone and soft tissue sarcomas. As a rule, we strive to customize the most effective treatment program for each individual patient.

Osteosarcoma - Sheba Medical Center

About Osteosarcoma

Although osteosarcoma (also known as osteogenic sarcoma) is not a common cancer, it is the most common type of bone cancer among children, adolescents and young adults. Approximately 800 to 900 new cases of osteosarcoma are diagnosed annually in the United States, half of which are in children and teens. In general, osteosarcoma occurs most frequently in teens, when bone grows at a rapid rate, although it can happen at any age.

What is osteosarcoma?

Osteosarcoma, a bone cancer, typically originates in the marrow cavity of the long bones, such as near the ends of the legs and arms (where the bone is growing quickly). Most tumors develop in the bones surrounding the knee or in the upper arm bone close to the shoulder. However, this cancer can also occur in the spine and pelvis, or more rarely in the jaw or other locations. Osteosarcoma can metastasize to other parts of the body, generally to the lungs or other bones.

Osteosarcoma cancer cells resemble young bone cells that normally produce new, healthy bone tissue, yet the bone tissue in an osteosarcoma tumor is weaker than that of normal bones.

What are the risk factors for osteosarcoma?

In the vast majority of osteosarcomas, there is no clear cause. In general, lifestyle-related risk factors have not been identified, however there are a few factors that may affect the risk for osteosarcoma, such as:
  • Age – the risk is highest between the ages of 10 to 30, particularly during adolescent growth spurts
  • Height – children who are tall for their age may be at an increased risk
  • Gender – it is more common in males than females
  • Race/ethnicity – it is slightly more common in Hispanic/Latinos and African Americans
  • Radiation exposure to bones – people who received radiation therapy for another cancer may be at an increased risk, especially if they were treated with high doses at a young age
  • Specific bone diseases – people with particular types of non-cancerous bone diseases may be at a higher risk, such as
  • Paget’s disease, Ollier disease, polyostotic fibrous dysplasia, and hereditary multiple osteochondromas.
  • Inherited cancer syndromes – specific rare genetic cancer syndromes are linked to a higher risk, such as:
  • - Retinoblastoma
  • - Li-Fraumeni syndrome
  • - Rothmund-Thomson syndrome
  • - Bloom syndrome
  • - Werner syndrome
  • - Diamond-Blackfan anemia

Whatare the symptoms of osteosarcoma?

The symptoms of osteosarcoma are associated strongly with the size and specific location of the tumor and whether or not the cancer has spread. Typically, children with osteosarcoma do not appear to be ill, and an x-ray for an injury may expose suspicious bone lesions that lead to further testing.

Although there is a great deal of individual variation, the most common symptoms of osteosarcoma include:
  • Pain (sharp or dull), often around the knee or in the upper arm; initially, the pain may be worse at night
  • Pain associated with lifting or physical activity
  • Reduced mobility of the affected limb
  • Swelling and/or redness at the site of the tumor; it may be possible to feel a lump
  • Limping
  • Bone fractures (broken bone)

How many types of osteosarcoma are there?

Osteosarcomas are classified into three types based on how they appear under a microscope:

  1. High-grade osteosarcomas: These are the fast-growing types. The bone does not look like normal bone and has an abnormally high number of cells dividing into new cells. Most childhood and teenage osteosarcomas are high-grade, with the most common types being osteoblastic, chondroblastic, and fibroblastic.
  2. Intermediate-grade osteosarcomas: These tumors (such as periosteal tumors) are uncommon and treated in the same way as low-grade osteosarcomas.
  3. Low-grade osteosarcomas: These are the slowest growing types. The tumors appear similar to normal bone and have few cells in the process of dividing into new cells. The most common types include parosteal and intramedullary.

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Sheba Medical Center provides innovative, personalized medical care to patients from around the world. We are the largest, most comprehensive hospital in the Middle East and dedicated to providing advanced and compassionate medicine for everyone. We welcome all cases, including the rarest and the most challenging. Our medical teams collaborate to provide the best possible health outcomes. From your initial inquiry through the long-term follow-up care, we are here for you.

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