Osteosarcoma

There are different types of osteosarcoma. They are named after the part of the bone where the cancer starts, for example the middle or surface of the bone. Knowing the type of osteosarcoma gives your doctors an idea of how quickly the cancer cells might grow. This is called the grade of the cancer.

The most common osteosarcoma is conventional osteosarcoma. It is found inside the middle of the bone. Types of conventional osteosarcoma include:

• osteoblastic
• fibroblastic
• chondroblastic.

There are also rarer types of osteosarcoma. These include:

• parosteal
• periosteal
• telangiectatic
• small cell osteosarcoma.

Your cancer doctor or specialist nurse can tell you more about the type of osteosarcoma you have.

The exact causes of primary bone cancer are not known. Sometimes osteosarcoma develops at times when the bones are growing quickly, such as during puberty. This could explain why osteosarcoma is more common in teenagers.

Adults may have a slightly higher risk of developing osteosarcoma later in life if they have:

• a bone condition called Paget’s disease
• had radiotherapy in the past.

Rarely, osteosarcoma may occur in people from families where there is an inherited faulty gene such as Li-Fraumeni syndrome. This gene change increases the risk of developing other types of cancer as well.

The results of your tests give your cancer doctor information about the stage and grade of the cancer.

The stage refers to the size of the cancer and whether it has spread outside the bone.

The grade is how the cancer cells look under the microscope. This gives an idea of how quickly a cancer may grow and develop.

The most common grading system for primary bone cancer uses the following 3 grades:

• Grade 1 - cancer cells are low-grade and look like normal bone cells. They are usually slow-growing and less likely to spread.
• Grade 2 - cancer cells are high-grade and look abnormal. The cells are likely to grow more quickly and are more likely to spread.
• Grade 3 - cancer cells are high-grade and look more abnormal than grade 2. This means the cancer is more likely to come back (recur) or spread to other parts of the body.

Most osteosarcomas are high-grade. But there are some rarer types which are usually low-grade.

We have more information about staging and grading bone cancer.

After you finish treatment, you will have regular check-ups for a few years. This will include chest x-rays. You may also have scans and blood tests.

If you have any problems, or notice any new symptoms in between your regular follow-up appointments, tell your cancer doctor as soon as possible.

A small number of people have side effects that continue after treatment. This will vary depending on the size and position of the tumour and the treatment. You may have rehabilitation to help you recover and manage any side effects.

Sometimes side effects develop after treatment and some may happen many years later. Your cancer doctor or specialist nurse will explain more about any possible late effects and what can help to manage them. Always tell them if side effects are not improving.

Cancer and its treatment can sometimes affect your sex life. There are ways to help your sexual well-being and to manage any problems.

Cancer and its treatment may cause changes to your body that affect your body image. There are things that can help you to cope with these changes.

Treatment for sarcoma may affect your fertility. If you are worried about your fertility it is important to talk with your doctor before you start treatment. We have more information about:

• getting pregnant after treatment
• making someone else pregnant after treatment
• LGBTQ+ people and cancer treatment.

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and well-being and help your body recover.

After finishing treatment, you may still be coping with difficult feelings. Talking to your family and friends or health professionals about how you feel can help to support your well-being.

Organisations such as Sarcoma UK and the Bone Cancer Research Trust can provide information and support. Cancer52 works to improve the quality of life for people with rare cancers.

Macmillan is also here to support you. If you would like to talk, you can:

• call the Macmillan Support Line for free on 0808 808 00 00
• chat to our specialists online
• visit our bone cancer forum to talk with people who have been affected by bone cancer, share your experience, and ask an expert your questions.