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OSTEOSARCOMA
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FUNCTIONS OF BONE TISSUES 1. SUPPORT 2. PROTECTION 4. BONE HOMEOSTASIS 5. PRODUCTION OF BLOOD CELLS

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FOUR MAJOR TYPES OF CELL IN THE BONE TISSUES Osteogenic cells Osteoblast cells Osteocyte cells Osteoclast
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TYPES OF BONES
a. b. c. d.

Long Bone Short Bone Irregular Bone Flat Bone

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B O N E

C A N C E R

also known as OSTEOGENIC SARCOMA.

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comes from a Greek work osteon which means bone and sarcoma which is a type of cancer that develops from a certain
q

OSTEOSARCOMA

is a cancerous (malignant) bone tumorthat usually develops during the period of rapid growth. most common type malignant bone tumor. of primary

it is 6/25/12

the 6th most common type of

O S T E O S A R C O
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begins in bones and sometimes

spread (or metastasize) usually to the lungs or other bones. Most common and fatal in children

and males between 10-25 years old.

Common sites: a. long bones,

o knee, o upper leg, o thigh bone, o lower leg and o upper arm.
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O S T E O S A R C O M A

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Etiology
q

Unknown.

It is thought to be

related to rapid bone growth, such as in adolescents.

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Pathophysiology

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Risk Factors
Predisposing Factors Age (10 to 30 years old qGender ( males ) qGenetics
q

Precipitating Factors Exposure to radiation therapy qPagets Disease q Li Fraumeni Syndrome q RothmundThomson Syndrome
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Changes in cell behavior Damaged in the DNA Error in the cellular growth Genetic mutation occurs of NORMAL cell into ABNORMAL cell (bone cells)

Failure of the DNA to repair itself

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overactive bone cells Produces immature bone cells Develop into tumor cells instead of bone CODMAN S TRIANGL E
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Formation of new bone tissue

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TYPES of OSTEOSARCOMA
HIGH GRADE
q

LOW GRADE

Most tumors arisingq most tumors arising from the central (orfrom the surface of the medullary) portion ofbone. the bone.

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SUB TYPES OF HIGH GRADE

A. OSTEOBLASTIC OSTEOSARCOMA

OSTEOSARCOMA

the cancer cells look like bone forming cells

B. CHONDROBLASTIC If the cancer is trying to make OSTEOSARCOMA cartilage as well as bone then the tumor C. FIBROBLASTIC Produces a small amount of bone SARCOMA D. TELANGIECTATIC If there are lots of abnormal blood OSTEOSARCOMA vessels in the tumor as well as bone forming cells then the tumor D. SMALL CELL contain small round cells OSTEOSARCOMA
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Stages of Osteosarcoma
STAGE IA STAGE IB STAGE IIA STAGE IIB STAGE III
The cancer is found only in the bone, is smaller than 8 cm, and is low grade The cancer is found only in the bone, is larger than 8 cm, and is low grade The cancer is found only in the bone, is smaller than 8 cm, and is high grade The cancer is found only in the bone, is larger than 8 cm, and is high grade The cancer is found only in the bone but has spread to other places on the bone

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Clinical

Bone Pain Swelling and tenderness near the affected area Limping (if the legs are the affected part)

MOST COMMON Chief Complaint

brokenmanifestations bone (fracture)

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Diagnostic Tests

a. Chest Xray

spread (metastasized) to the lung

Determine the indicate

b. Bone Xray

bone lesions that could osteosarcoma.

Allows a views cross that show

c. CT Scan

sectional will

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Diagnostic Tests

d. Positron emission tomography (PET) e. Radionuclide bone scan f. BIOPSY

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This test is useful to see if the cancer has spread. to show how responsive the tumor was to the chemotherapy drugs DEFINITIVE TESTS FOR BONE CANCER

Laboratory Tests

C-reactive Protein Lactic Dehydrogenase (LDH) Alkaline Phosphatase (ALP)

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Therapeutic Management
Radiation

therapy- uses high energy beams of radiation to shrink tumors and eliminate cancer cells.
High-dose methotrexate with

Chemotherapy

leucovorin

citrovorum factor rescue Doxorubicin (Adriamycin)c

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Combinations of bleomycin,

Surgical Management
Limp-sparing

surgery- removes the cancerous tumor and bone, replacing it with either a graft or prosthesis to make the limb as functional as possible. Seventy percent to 90 percent of osteosarcomas in the limbs can be treated by this method

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Surgical Management

Rotation-plasty is a limb-sparing technique. The doctor removes a portion of the leg, including the knee. The lower part of the leg is rotated and reattached so that the ankle becomes the new knee, and a prosthetic device is attached to replace the ankle and foot. is the removal of the limb. In most cases, prosthesis can be used to replace the limb.

Amputation

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Assessment

Encourage patient to discuss problem and course of symptoms. patient and familys understanding of the disease, coping with the problem and management of pain. mass gently on physical

Note

Palpate
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Assessment
Note

size and associated soft-tissue swelling, pain and tenderness of the mass. neuromuscular status and range of motion extremity.

Assess

motility and ability 6/25/12 perform activities of daily to

Evaluate

Priority Nursing Diagnosis

Acute

pain related to physical injuring agents breathing pattern related to musculoskeletal impairment as evidenced by usage of accessory muscles in breathing intolerance related

Ineffective

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Activity

Priority Nursing Diagnosis

Impaired

social interaction related to limited physical mobility roleperformancerelated tobody imagealteration; physical illness

Ineffective

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Planning and Implementation

Assist patient in doing his ADLs. analgesics as prescribed.

Administer Encourage Use

visitors to entertain the patient. pain alleviating techniques like relaxation, imaging, deep breathing exercises and the likes.

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Planning and Implementation

Encourage the patient to verbalize his feelings. wound care for postoperative patients. the patient to high-fowlers or semi-fowlers position. patient in doing ROM exercises. Keep side rails up all the time.

Provide Place

Assist 6/25/12

THANK YOU!!

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