OSTEOSARCOMA

PRESENTED BY: MELINDA A. CORPUZ

BSN – 3B
OSTEOSARCOMA
 Type of bone cancer that begins in the
cells that form bones.
 Most often found in the long bones, more
often the legs, but sometimes the arms, but
it can start in any bone. In very rare
instances, it occurs in soft tissue outside the
bone.
 Osteosarcoma tends to occur in teenagers
and young adults, but it can also occur in
younger children and older adults.
The bones and areas most often affected
include the:
 Femur ( thigh bone) near your knee.
 Tibia (shin bone) near your knee.
 Humerus (upper arm bone) near your shoulder.
 Rarely in the soft tissues or organs in your abdomen or chest

Other less common location for

osteosarcoma include your:
 Pelvis
 Skull
 jaw
CAUSES AND RISK FACTORS
Causes

Rapid bone growth: the risk of osteosarcoma increases

during a child and adolescent’s growth.
Exposure to radiation: this might have occurred from
treatment for another type of cancer. This can take a few
years to occur.
Bone infarction: this happens when there’s a lack of blood
supply to your bone tissue. This destroys the cell
When something goes wrong in one of the cells that are
responsible for making new bone.
It is not caused by inherited gene mutation, but instead are
result of gene changes acquired during the person’s
lifetime.
RISK FACTORS
These factors increase the risk of osteosarcoma:
 Previous treatment with radiation therapy.
 Other bone disorders, such as Paget's disease
of bone and fibrous dysplasia.
 Certain inherited or genetic conditions,
including hereditary retinoblastoma, Bloom
syndrome, Li-Fraumeni syndrome, Rothmund-
Thomson syndrome and Werner syndrome
SIGNS AND SYMPTOMS

Signs and symptoms of osteosarcoma may

include , among others:
 Swelling and redness at the site of tumor
 A mass or lump that is warm and might be felt through
your skin
 Limping
 Unexplained fever
 Bone or joint pain
 Bone injury or bone break for no clear reason
COMPLICATIONS
Complications of osteosarcoma
and its treatment include:
Cancer that spreads ( metastasizes)
Adapting to limb amputation
Long-term treatment side effects
CLASSIFICATIONS
PRIMARY OR SECONDARY
• PRIMARY OSTEOSARCOMAS ( 15-25
YRS)
Conventional/ classic osteosarcoma ( high grade,
intra medullar)
Low-grade intramedullary osteosarcoma
Paraosteal osteosarcoma
Periosteal osteosarcoma
High-grade surface osteosarcoma
Telangiectatic osteosarcoma

CLASSIFICATIONS

SECONDARY OSTEOSARCOMAS
• Osteosarcoma occurring at the site of another disease process
• More common in >50 years of age
• Most commonly with premalignant condition like;
 Paget disease
 Previous radiation treatment
 Endochondromatosis
 Fibrous dysplasia
 Osteochondromas
 Osteogenesis imperfecta
DIAGNOSTIC TEST
Imaging tests
Imaging tests may include:
• X-ray
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• Bone scan
Removing a sample of cells for testing (biopsy)
Types of biopsy procedures used to diagnose osteosarcoma include:
• Needle biopsy
• Surgical biopsy
MEDICATION
Chemo Drugs used to treat osteosarcoma. The
Usually, 2 or more drugs are given
drugs used most often to treat osteosarcoma include:
together. Some common combinations of
 Methotrexate (given in high doses, along with
drugs includes:
leucovorin to help limit side effects)
 Doxorubicin (Adriamycin)
 High-dose methotrexate, doxorubicin, and
 Cisplatin or Carboplatin
 Ifosfamide
cisplatin (known as the MAP regimen),
 Cyclophosphamide
sometimes with ifosfamide. This is used more
 Etoposide
often in children, teens, and young adults.
 Gemcitabine
 Doxorubicin and cisplatin. This is used
more often in older adults.
TREATMENT
Surgical Management
The goal of surgery is to remove all of the
cancer cells. The extent of surgery for
osteosarcoma depends on several factors, such as
the size of the tumor and it’s location.
Operations used to treat osteosarcoma includes:
Surgery to remove the cancer only (limb-
sparing surgery)
Surgery to remove the affected limb
( amputation)
Surgery to remove the lower portion of the leg (
rotationplasty)
Chemotherapy
Radiation therapy
NURSING MANAGEMENT
• Tumor management.
Addressing the primary concern of treating and managing the osteosarcoma tumor
through surgical intervention, chemotherapy, and/or radiation therapy.

• Pain management
Implementing effective strategies to manage and alleviate the pain.

• Limb function preservation

Preserving limb function and mobility through limb-sparing surgeries whenever feasible
to maintain quality of life.

• Metastasis prevention
Monitoring for and managing the potential spread of cancer cells to other parts of the
body, particularly the lungs and other bones.
• Rehabilitation and physical therapy
Providing comprehensive rehabilitation programs to restore optimal
function and mobility following surgery or other treatments.
• Psychological support
Offering psychological support and counseling to help patients cope with
the emotional and psychological challenges.
• Long-term follow-up and surveillance
Conducting regular monitoring, including follow-up visits, imaging
studies, and laboratory tests, to detect potential recurrence, assess treatment
response, and manage any late effects or complications.
NURSING INTERVENTIONS AND ACTIONS
Therapeutic interventions and nursing actions for patients with osteosarcoma may include:

1. Preventing infections
Patient with osteosarcoma may experience compromised protection related to
antineoplastic medication, which can suppress the immune system and increase the risk of
infection.

2. Preventing Injuries
Patient with osteosarcoma may be at risk for injury related to their disease and its
treatment.

3. Reducing Anxiety
Patient with osteosarcoma may experience anxiety related to the uncertainty of their
prognosis, the potential for long-term complications and disability.
THANK YOU!