Treatment

In general, cancer in children is uncommon, so it can be hard for doctors to plan treatments unless they know what has been most effective in other children. That’s why more than 60% of children with cancer are treated as part of a clinical trial. Clinical trials are research studies that compare the standard treatments (the best treatments available) with newer treatments that may be more effective. Investigating new treatments involves careful monitoring using scientific methods, and all participants are followed closely to track progress.

To take advantage of these newer treatments, all children with cancer should be treated at a specialized cancer center. Doctors at these centers have extensive experience in treating children with cancer and have access to the latest research. A doctor who specializes in treating children with cancer is called a pediatric oncologist. Many times, a team of doctors treats a child with cancer. Pediatric cancer centers often have extra support services for children and their families, such as nutritionists, social workers, and counselors. Special activities for kids with cancer may also be available.

The treatment of osteosarcoma depends on the size and location of the tumor, whether the tumor has spread, and the child’s overall health. Three types of treatment are typically used to treat osteosarcoma: surgery, chemotherapy, and radiation therapy. Descriptions of each treatment option for osteosarcoma are listed below.

Surgery

To treat osteosarcoma, the orthopedic surgeon (bone surgeon) removes the cancer and a portion of the surrounding healthy tissue. Chemotherapy and, rarely, radiation therapy may be used in combination with surgery, particularly with limb-sparing surgery. In limb-sparing surgery, doctors use surgical techniques, such as bone grafting and reconstructive surgery, to help the child retain use of the limb (arm or leg) and to give the limb a more normal appearance. Limb-sparing surgery is used whenever possible. Sometimes, the operation that results in the most useful and strongest limb is different from the one that gives the most normal appearance. Learn more about cancer surgery.

Occasionally, a limb will need to be amputated (removed) to be sure that all of the cancer has been removed. If amputation is necessary, rehabilitation, including physical therapy, can help the child maximize his or her physical functioning. Learn more about rehabilitation.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor’s office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time.

Drugs for osteosarcoma are usually injected into a vein (IV; intravenous). Occasionally, medications are taken by mouth or injected under the skin, usually to limit the side effects of treatment. Chemotherapy is often given before surgery to reduce tumor size and avoid amputation of the arm or leg. Also, it is almost always given after surgery to kill any remaining cancer cells.

The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These immediate side effects can be controlled during treatment and usually go away once treatment is finished. Other side effects, such as decreased strength of the heart muscle, hearing loss, or decreased kidney function, may continue after treatment. The severity of the side effects depends on the type of drug given and the length of treatment.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your child’s doctor is often the best way to learn about the medications prescribed for your child, their purpose, and their potential side effects or interactions with other medications. Learn more about your child’s prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment for osteosarcoma is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body.

Radiation therapy for osteosarcoma is generally used only with surgery to try to avoid amputating an arm or leg, as radiation treatment alone is not effective against osteosarcoma cells. In fact, because of this radiation resistance of osteosarcoma cells, radiation therapy is infrequently used in osteosarcoma. Surgery and chemotherapy are the most common forms of treatment.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Recurrent osteosarcoma

Treatment for recurrent osteosarcoma depends on three factors:

• Where the cancer recurred
  
  
• The type of treatment the child received for the original tumor
  
  
• The overall health of the child

If the disease recurs in the lungs, surgery is typically used to remove the nodules (tumors) in the lung. In these situations, there is usually a better outcome for children who have the lung nodules completely removed. This is especially true if the disease has recurred only after the initial treatment program has been completed. Chemotherapy or other approaches may be tried as well. If the cancer comes back elsewhere in the body, a combination of drugs may be used. If the cancer has spread to another bone or a limited number of other bones, surgery may be performed, particularly if chemotherapy has been effective.

Find out more about common terms used during cancer treatment.