Will my child need surgery?
Osteosarcoma requires surgery for the initial biopsy and for removal of all visible tumor tissue. This is often accomplished using bone grafts, limb-sparing procedures and reconstruction. Only rarely is amputation required. In the past, amputation of the involved limb was the first line of treatment for tumor removal. At Comer Children’s, our orthopaedic surgeons and sarcoma team avoid amputation whenever possible. In fact, in the 1980s, UChicago Medicine was among the first institutions in the U.S. to perform limb-sparing surgery. We continue to be innovators in using surgical techniques that remove cancerous bone and tissue while leaving as much of the child's healthy bone and tissue intact as possible.
Will my child need chemotherapy? If so, how is it given?
Chemotherapy, before and after surgery, is a critical part of the comprehensive and multidimensional treatment of osteosarcoma. It is given before surgery in order to shrink the tumor, and in an attempt to prevent or control the spread of the tumor. Chemotherapy after surgery targets potential tumor sites not removed completely by surgery. It is important to know that chemotherapy is nearly always needed even if the osteosarcoma is only visible at one site and can be removed. In the past, when osteosarcoma was only treated with surgery, it often came back and was even harder to eradicate. Chemotherapy is usually given intravenously (IV) through a temporary central line. Other medications that control the side effects of chemotherapy are given orally.
Will my child need radiation treatment?
Because osteosarcoma cells are not easily killed by radiation, it is not typically used in the initial treatment phase. But, if complete removal of the tumor is not possible or if there is still visible cancer in the tissue surrounding the tumor site after the surgery, radiation may be necessary.
How long will treatment take? How long will my child be in the hospital?
The length of stay will vary from patient to patient. In general, the first phase of treatment lasts 10 to 15 weeks, during which time chemotherapy is given to begin to shrink the tumor. During this phase, you should anticipate being in the hospital only for periods of three to five days every three weeks when the chemotherapy is actually administered. Surgery typically takes place immediately following this first chemotherapy phase and requires some inpatient stay. After surgery, treatment continues for about 18 more weeks, with inpatient stays lasting a few days every few weeks to administer the chemotherapy.
What are the side effects of treatment?
Chemotherapy drugs not only attack the cancer cells, they can injure normal tissue and blood-forming cells. For this reason, your child may experience some of the common side effects of chemotherapy including low blood counts (causing anemia), nausea, vomiting, hair loss, mouth sores, irregular periods (girls) and inability to produce sperm (boys). Your treatment team will do everything they can to reduce or prevent side effects of treatment.
Does treatment cause infertility?
You and your child should talk to your doctor about the reproductive risks associated with cancer treatment. In certain situations, there are options available to try to preserve fertility, such as with sperm banking. These programs are available at Comer Children’s.