Osteosarcoma and Children’s Palliative Care

Categories: Care, Featured, and Opinion.

Osteosarcoma is the most common malignant bone tumour in children and young people. It originates in the cells that form bones when a bone cells become abnormal and grows out of control to for a cancerous tumour. Osteo is a Greek work for bone, and ‘sarcoma’ is the name given to cancers that start in connective or supporting tissues such as bone, fat, cartilage, blood vessels and muscle. and most often occurs in the long bones although it can occur in any bone. Osteosarcoma tends to occur in teenagers and young adultsalthough it can occur in young children as well. Half of the cases of osteosarcoma occur in the long bones of the lower body  e.g. the femur or tibia, with another common site being the upper arm (humerus), although it can occur in other bones as well.  Treatment usually involves a mixture of chemotherapy, surgery and radiotherapy as it is usually aggressive and can spread to the bloodstream and into other parts of the body.

Sarcoma awareness month has been recognised since 2008 in order to increase awareness in sarcomas, including osteosarcomas. This month emphasises the importance of providing knowledge to the public about recent discoveries, early diagnosis, and their impact on the families of those affected.  This year 2023, the theme for sarcoma cancer awareness month is “Let’s talk about the Forgotten Cancer”, intending to raise awareness of sarcomas, including bone cancers that are frequently referred to as the “forgotten cancers” due to their rarity. In July 2008, the first Sarcoma Awareness Month was commemorated.

Osteosarcoma usually develops during the adolescent growth spurt (usually ages 13 to 16 in boys but a little younger in girls). It causes pain in the bone, which may be worse during exercise or at night. A lump or swelling may form. The symptoms in children are difficulty with normal activities, such as moving, lifting, or walking. Limping, pain, tenderness, swelling, or a lump close to or in a joint. The area may be warm and redand they may experience tiredness. These symptoms are not always caused by osteosarcoma. In fact, they usually are caused by a less serious condition as leg and arm pain is common in growing boys and girls, and usually, it is nothing to worry about. However, if the pain persists, worsens or if other symptoms are present, it is important to get it checked out.

Palliative care provision is important for children and adolescents with osteosarcoma. Generally, age at the time of diagnosis, tumour site, and tumour histological subtypes will impact survival in children and adolescents with osteosarcoma. It is important to be aware not only of the physical impact of the disease but also the psychological. Social and spiritual issues, alongside prognosis. The palliative care multi-disciplinaryteam will include doctors,  nurses, social workers, teachers, religious leaders along with others as appropriate. Despite the advances in the treatment of osteosarcoma, palliative care still continues to be an integral part of helping children and adolescents with osteosarcoma and their families.

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