Osteosarcoma Nursing

Osteosarcoma occurs most often in the wide ends of long bones (the femur and tibia in the leg and arm, and the humerus in the upper arm). It sometimes spreads to the lungs and other bones.

Most kids and teens with osteosarcoma have pain that comes and goes, and they might say it’s “growing pains.” They might also have swelling or a lump in the bone.

Assessment

Patients with osteosarcoma experience musculoskeletal changes that affect mobility. They have pain, which usually is a dull localized pain that is relieved by flexing the involved extremity. The pain is often attributed to trauma or growth pains.

Osteosarcoma is a cancer that starts in bone cells or spreads from another part of the body to the bone. It is less common than other types of sarcoma (cancers that start in muscle, fat, nerves, tendons, or blood vessels).

To help find osteosarcoma, your doctor may use an X-ray or MRI. An X-ray creates pictures of the bones in your body using a small amount of radiation. The X-ray pictures show that osteosarcoma looks different than normal bone and shows a large mass in the affected bone.

Care Planning

Osteosarcoma happens when bone cells start to grow out of control. They can form lumps (tumors) and cause pain, swelling or limping in the bone or joint where the tumor is. The cancer can also break bones.

Doctors diagnose osteosarcoma with a physical exam and other tests. They may use imaging to find the size and shape of the tumor, such as an X-ray or magnetic resonance imaging (MRI). Other tests can check how much blood is going to the bone or if the cancer has spread to other bones or tissues. They might take a sample of tissue from the cancer for testing in a laboratory.

People with osteosarcoma can live well with treatment, including surgery to remove the tumor and chemotherapy. St. Jude has experts in limb-saving surgery and other cutting-edge therapies. The team includes orthopedic surgeons, oncologists (cancer doctors), radiation treatment specialists, rehabilitation experts and nurses. They work closely with laboratory researchers to bring new treatments quickly to the clinic.

Nursing Diagnosis

Osteosarcoma is a type of bone cancer that most often affects the bones around the knee or shoulder in young adults and teens. It can also occur in other bones in the body.

Pain and swelling are usually the main symptoms of osteosarcoma. The pain may be severe or dull. It may get worse when the patient bends or lifts a heavy object. It is usually relieved when the patient flexes the affected area.

A doctor may order a blood test to see how much calcium is in the blood. They may also do other tests to find out if the cancer has spread.

The most common treatment for osteosarcoma is surgery and chemotherapy. Sometimes radiation therapy is used. Patients with osteosarcoma that has spread may also need amputation. Patients with amputation should be educated about using an artificial limb (prosthesis) and managing phantom limb pain. They should also be taught how to manage wound care and PICC line maintenance.

Nursing Interventions

Providing supportive care during treatment is important to prevent short- and long-term side effects. This includes preventing infections, helping patients manage pain and managing complications.

Osteosarcoma starts in the marrow cavity of long bones, like those in the arms and legs. It most often occurs in teens during a growth spurt, but it can occur at any age. It can also spread to other bones or organs in the body, most commonly to the lungs.

If osteosarcoma is diagnosed, your child will have surgery to remove the cancer and a margin of healthy tissue around it. They will also receive chemotherapy to kill any remaining cancer cells. The type of surgery and chemotherapy used depends on where the tumor is, your child’s age and whether they are still growing. If the cancer is in and around the knee joint, a surgery called rotationplasty might be an option. This surgery removes the lower part of the leg and foot, but uses your child’s remaining knee to work as a knee.

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