Learning About Bone Sarcomas in Children

What is a bone sarcoma?

A bone sarcoma is a kind of tumor—a growth of abnormal cells in the bones. When the tumor 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 tumor.

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 tumor 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 tumor.

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

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

How are these tumors 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 tumor 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 tumor.

The doctor may also find a tumor 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 tumor. 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 tumor 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 tumor has spread.

The doctor may talk to you about what "stage" your child's cancer is. The stage refers to how large the tumor is and how far it has spread. It also includes the tumor 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 it treated?

Treatment for bone cancer is based on the stage of the bone cancer and other things, such as your child's overall health. The main treatments include:

Surgery.

Your child may need surgery to remove cancer from the bone or to remove part of the bone. A bone graft or metal part may be used to replace the bone that was removed. If cancer is found in an arm or a leg, the limb can usually be saved.

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells.

Radiation therapy.

This uses high-dose X-rays to destroy cancer cells and shrink tumors. It may be used along with surgery or after surgery.

For certain types of bone tumors, other treatments may be used, such as a stem cell transplant, targeted therapy, or immunotherapy.

The doctor will talk with you about the options and then make a treatment plan for your child.

What are some things to think about?

• Some tumors 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, counselors, 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 or insurance company can recommend someone for a second opinion.