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Learning About Bone Sarcomas in Children

Common places for bone sarcomas, including above and below the knee and on the upper arm

What is a bone sarcoma?

A bone sarcoma is a kind of tumour—a growth of abnormal cells in the bones. When the tumour grows out of control and destroys nearby tissue or spreads to other parts of the body, it's called malignant. That means it's a type of cancer.

Sarcoma is another name for a malignant bone tumour.

Bone cancer can spread to other parts of the body, like the lungs or lymph nodes.

What are some common types of bone sarcomas?

The most common types of bone sarcomas in children include:

Osteosarcoma.

This tumour is also common in young adults. It often appears in the wider ends of bones, in the knee, shoulder, and sometimes the pelvis.

Ewing sarcoma.

This can be in the bone shaft (the middle of bones), mainly near the knee, pelvis, and upper arm.

What are the symptoms?

Your child may feel pain near the tumour.

You may feel swelling or a lump over the bone. If the tumour is near a shoulder, hip, or knee joint, your child may not be able to move the arm or leg freely.

Bone tumours can weaken bones. Sometimes bones with tumours can break.

How are these tumours diagnosed?

The doctor will ask about your child's symptoms and past health. He or she will also examine your child. If the doctor can feel a bone tumour or if your child has other symptoms, your child will get some tests. The tests can find out if it's cancer. They can also help the doctor figure out the best treatment for the tumour.

The doctor may also find a tumour when taking X-rays or images for another problem.

  • Your child may have one or more imaging tests to get a better look at the tumour. These may include:
    • X-rays.
    • CT scan.
    • MRI scan.
    • PET scan.
    • Bone or other nuclear scan.
  • Your child may need blood tests and other lab work. This might include genetic testing.
  • Your child may need a biopsy so that a sample of the tumour can be looked at under a microscope. This sample may also be used to test for substances in your child's body that might indicate cancer (biomarkers), which will help with planning treatment.
  • Doctors may also examine other parts of your child's body to see if the tumour has spread.

The doctor may talk to you about what "stage" your child's cancer is. The stage refers to how large the tumour is and how far it has spread. It also includes the tumour grade, which describes what the cancer cells look like and how likely they are to grow and spread.

These can help the doctor find out what type of treatment your child may need. And it may help to find a clinical trial that has treatments for your child's type of cancer.

How is bone cancer treated?

Your child may need surgery to remove cancer from the bone or to remove part of the bone. Depending on how much bone is removed, your child may need a bone graft or metal part to replace the bone.

When cancer is found in the arm or leg, surgery can remove the cancer in most cases and save the arm or leg. But in a few cases, removing all the cancer requires amputation (removing part of the arm or leg).

Your child may have chemotherapy (chemo). Chemo is medicine that destroys cancer cells.

Radiation therapy is used to treat some bone cancers. It uses high-energy rays, such as X-rays, to destroy cancer cells and shrink tumours in the body. It may also be used along with surgery or after surgery.

Other treatments, including immunotherapy and targeted therapy, may be used to treat certain types of bone tumours.

What are some things to think about?

  • Some tumours are aggressive and need treatment right away. But most cancer grows slowly enough that you can take a little time to find out more about your child's cancer as you decide about treatment.
  • Talk to your child. Answer all of your child's questions honestly. If you don't know the answers, help your child find out.
  • Ask any questions you might have. You can talk to the doctor, nurses, counsellors, and other advisors.
  • Talk to family, friends, and supporters. Get the kinds of help you need.
  • Think about getting a second opinion from another doctor. Before your child starts major treatment, it's a good idea to check with another doctor about the type of cancer your child has and what stage it is. Your child's doctor can recommend someone for a second opinion.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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