Bone Cancer in Children: Diagnosis & Treatment
The most common type of bone cancer is Osteosarcoma which is also the 6th most common type of cancer found in children. Most types of cancer eventually spread to other parts of the body, but osteosarcoma is one of the few types which actually begin in the bones and spreads elsewhere, generally to the lungs or other bones.
Since osteosarcoma develops from osteoblasts (the cells responsible for making bones grow), it almost always affects teenagers who are experiencing a growth spurt, especially during puberty. Boys are at greater risk of having osteosarcoma than girls, and a majority of the cases of osteosarcoma involve the knees.
Risk of Childhood Osteosarcoma
Osteosarcoma is generally seen in teenage boys and evidence suggests that teenagers who are taller than children of average heights are at an added risk of developing the disease. Since radiation is a trigger for DNA mutations, children who have previously received these treatments for some other type of cancer are also at risk for osteosarcoma.
The most common symptoms of osteosarcoma include swelling and pain in your child’s arms or legs. Generally speaking, it occurs in the longer bones of the body like the ones below or above the knee or the ones in the upper arms (near the shoulders).
The pain can be worse during nights or when exerting your body, and a swelling or lump may develop in the affected area. This can happen many weeks after the pain starts. Pain that consistently wakes your child at night is of particular concern. In cases of osteosarcoma in the leg, children may also develop a limp. In other cases, the first sign of this disease can be a broken arm or leg, due to the fact that the cancer weakened the bones, making them vulnerable injuries.
To diagnose bone cancer, the doctors perform a physical exam and will obtain a detailed medical history of the patient. They will also order X-rays to help detect changes in the bone structure, and sometimes an MRI scan of the bones helps understand the best area for biopsy while also showing whether the disease has spread from the bones to surrounding muscles and fat.
A bone biopsy might also be required to get a sample of the tumour for further examination in the lab. If the correct diagnosis of osteosarcoma is made, CT chest scans and bone scans are ordered to show whether the cancer has spread to more parts of the body. These tests will be repeated after treatment starts to determine how well it is working and whether the bone cancer is continuing to spread or not.
The treatment of osteosarcoma in children includes therapies like chemotherapy (drugs used to kill cancer cells and shrink the size of the cancer) followed by surgery (which removes cancerous cells and tumours), and then maybe even more chemotherapy (kills remaining cancer cells to greatly minimize chances of the return of cancer). Surgery is mostly used to remove bone cancer while chemotherapy eliminates any remaining cancer cells in the body.
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