The prospect of facing a cancer diagnosis after agonizing over the recognition of disconcerting symptoms is troubling enough for anyone. But when it’s your own child dealing with similar concerns and the weighty decisions associated with potential cancer treatments, this is harder still. And unfortunately, malignancies among children are not so uncommon.

Childhood osteosarcoma is a rare cancer, though the 6th most common type of cancer in children aged 14 and under. The disease is the most frequented form of malignant bone cancer and affects approximately 900 people every year, 400 of whom are children.

What Leads to Osteosarcoma

Unfortunately, the causes behind osteosarcoma are not known. Theories exist about environmental triggers such as fluoride in drinking water or exposure to radium.

Symptoms Associated with Osteosarcoma

The first complaint or symptom that most patients experience is pain at the tumor location – typically this discomfort is more severe at night. Large tumors can often look like swelling. Another feature is that the bone affected by the cancer is frequently weaker and more susceptible to fracture.

Over 50% of all cases of childhood osteosarcoma occur around the knee area.

Risk Factors Associated with Osteosarcoma


The risk of osteosarcoma is highest during the teenage “growth spurt” period. Since children with osteosarcoma are often tall for their age, some researchers believe there may be relationship between rapid bone growth and the risk for developing the disease.

Gender of the Patient

Osteosarcoma typically occurs in males and is seen twice as frequently as in young women.


If a patient has been subjected to radiation treatment for other cancers or conditions, they will have a higher risk of contracting the disease.

Other Bone Diseases

Patients who have suffered from other bone diseases, like Paget’s disease of the bone, have an increased risk of being diagnosed with osteosarcoma. Typically though, this occurs in adults and is rare with children.


Children with inherited and rare cancer syndromes, like retinoblastoma, are more prone to developing childhood osteosarcoma.

Types of Osteosarcoma

There are three sub-types of osteosarcoma that can be recognized by how they appear on X-rays and under a microscope. Some of these sub-types have a better prognosis than others.

The sub-types are high grade, which is a conventional, small cell and high grade surface development of the disease; intermediate, which is periosteal; and low grade, which is parosteal and characterized by low grade intrasseous.

How Osteosarcoma is Treated

Osteosarcoma is occasionally treated with surgery – at which point the afflicted limb or a portion of the afflicted limb is amputated. Usually, the patient or parents of the patient choose to use the same surgeon for both the biopsy and the therapeutic surgery.

Patients or the parents of patients should consult with their surgeon about the best method and how best to remove the cancer while saving as much use of the affected arm or leg as possible.

Despite the prevalence of surgery, most cases of childhood osteosarcoma are treated with chemotherapy in conjunction with surgery. There are a variety of drugs used in osteosarcoma chemotherapy programs, with each dose determined by the individual patient and disease.

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