How Will osteosarcoma affect me in the Longer Term?

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This information has been written for patients, their families and friends and the general public to help you learn more about and understand the things that can affect the outcome of osteosarcoma.

Prognosis

The word 'prognosis' (PROG-noh-siss) refers to what doctors think the chances are of the patient's cancer being cured with treatment or the likelihood of it returning. This depends on many different things, which vary between different patients.

In general, the prognosis for osteosarcoma depends on:

  • The patient's age and general health,

  • The location and size of the osteosarcoma,

  • Results of tests; the grade and stage of the osteosarcoma (how abnormal the cells look) and whether it is localised or metastatic (spread), or recurrent (come back),

  • How much of the cancer could be removed by surgery,

  • Response to treatment, for example, how effective was chemotherapy prior to surgery

  • Whether lung (pulmonary) metastases can be removed with surgery (resectable).

Doctors cannot be absolutely certain about a patient's prognosis because each patient and each cancer can behave differently.

The overall 5-year survival rate for osteosarcoma is around 55%. The term 5-year survival rate can sound quite misleading and worrying to some people. However, the term does not mean people only lived for 5 years after diagnosis; it refers to the fact that 55 out of every hundred people with osteosarcoma are alive 5 years after their diagnosis. These people may not all be cured; some may be still be undergoing treatment.

Follow up care

After finishing treatment, osteosarcoma patients will require follow up care. Outpatient hospital visits will be needed on a regular basis for the first few years after treatment and then probably yearly after that.

These visits will help to keep an eye on a patient's general health as well as an opportunity to carry out some tests. These tests are very important because they can show up any 'late effects' from the cancer treatment. Most centres encourage patients to get in touch if they have problems between appointments.

Follow up care with an orthopaedic surgeon also helps to look out for surgery-related complications and to make sure the limb is working well.

What are late effects?

Late effects are problems from cancer treatments such as chemotherapy that may show up weeks or months after treatment has finished. Chemotherapy drugs target cancer cells but they can also damage organs and kill healthy cells. Monitoring of patients during treatment and follow up should identify problems at an early stage and therefore recognising them should limit the possibility of serious effects occurring.

Types of late effect and drug or treatment causing it:

Problems/ Late Effects

Drug/ Treatment

Renal/ Kidney problems (nephrotoxicity)

High dose Methotrexate, Cisplatin, Ifosfamide

Heart problems (cardiotoxicity)

Doxorubicin

Hearing Loss (ototoxicity)

Cisplatin

Osteopenia (mineral loss from bone)

High dose Methotrexate, radiotherapy

Fertility problems (more likely in males than females)

Cisplatin, Ifosfamide, radiotherapy

Numbness, tingling or weakness (Neurotoxicity), more likely in older adults

Cisplatin

Liver problems (hepatotoxicity), very rare

High dose Methotrexate, Cisplatin, Ifosfamide

Second malignancy (cancer)

Ifosfamide, etoposide, cisplatin, doxorubicin, radiotherapy when used.

Last reviewed: October 2010; Version: 1.1
Review due: October 2011

The authors and reviewers of this information are committed to producing reliable, accurate and up to date content reflecting the best available research evidence, and best clinical practice. We aim to provide unbiased information free from any commercial conflicts of interest. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. BCRT can answer questions about primary bone cancers, including treatments and research but we are unable to offer specific advice about individual patients. If you are worried about any symptoms please consult your doctor.

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