Oncologist-approved cancer information from the American Society of Clinical Oncology
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Osteosarcoma - Childhood

This section has been reviewed and approved by the Cancer.Net Editorial Board, 7/2013
After Treatment

ON THIS PAGE: You will read about your child’s medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for osteosarcoma ends, talk with your child’s doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. All children and teens treated for osteosarcoma should have life-long, follow-up care.

There are two major considerations for the long-term health of children and teens who have had osteosarcoma. The first is whether the surgery resulted in a well-functioning limb or whether there were complications. The following are the most common orthopedic complications: fracture (break) if a bone allograft (bone from another person) has been used; metallic failure or loosening if an internal prosthesis, such as an artificial knee, has been inserted; or infection. These complications can usually be treated with another surgery and, if there is an infection, long-term antibiotic therapy. Occasionally, these approaches fail and an amputation is needed.

The second consideration is whether there is a recurrence or late effects. Recurrence of the tumor more than five years later is rare. The drugs used to treat osteosarcoma have a small chance, approximately 1.5%, of causing a blood cancer called leukemia (called a secondary or induced leukemia). Other possible late effects are related to the type of chemotherapy used. The most common drugs and long-term effects from them are:

Chemotherapy drug used

Potential long-term effect

How long-term effects are monitored

Doxorubicin (Adriamycin)

Heart failure

Monitored most frequently with periodic echocardiograms (echo)

Cisplatin (Platinol)

Hearing loss

Monitored by hearing tests; hearing aids are sometimes needed.

Ifosfamide

Infertility and

kidney damage

Freezing of sperm is recommended for boys who have gone through puberty before beginning chemotherapy. When it becomes a standard technique, ovarian cryopreservation (freezing a portion of the ovary) could be recommended for girls. Learn more about preserving fertility in children with cancer.

Kidney damage, especially loss of salts in the urine, may occur and requires supplements, but this is unlikely to develop if it has not already been a problem during treatment.

Etoposide

Induced leukemia

Treated similarly to a newly diagnosed person with leukemia depending on the type.

Generally, most children and teens recovering from osteosarcoma do well. Based on the type of treatment your child received, the doctor will determine what examinations and tests are needed to check for long-term side effects, such as heart failure, hearing loss, kidney damage and the possibility of secondary cancers. Follow-up care should also address your child’s quality of life, including any developmental or emotional concerns, especially if amputation was necessary. Learn more about childhood cancer survivorship.

You and your family are encouraged to organize and keep a record of your child’s medical information. That way as your child enters adulthood, he or she has a clear, written history of the treatment given and the doctor’s recommendations about the schedule for follow-up care. The doctor’s office can help you create this. This information will be valuable to doctors who care for your child during his or her lifetime. ASCO offers treatment summary forms to help keep track of the treatment your child received and develop a survivorship care plan once treatment is completed.

Children and teens who have had cancer can also enhance the quality of their future by following established guidelines for good health into and through adulthood, including not smoking, maintaining a healthy weight, eating a balanced diet, and participating in regular physical activity. Talk with the doctor about developing a plan that is best for your child’s needs. Learn more about the next steps to take in survivorship.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.

© 2005-2014 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.

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