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  • Writer's pictureRobin R Varghese, PT.

"We provide Specialized Physical Therapy for Osteosarcoma, thereby enhancing quality of life".

  • Osteosarcoma is also known as osteogenic sarcoma. Osteosarcoma is a malignant primary cancer of long bones.(1)

  • It is the most common primary bone cancer of childhood.

  • Osteosarcoma frequently occurs near the metaphysis of the long bones

  • The most common locations include the femur, Tibia and Humerus.(2)

  • In very rare instances, it occurs in soft tissue outside the bone.

  • Osteosarcoma tends to occur in teenagers and young adults, but it can also occur in younger children and older adults.(3)

  • Other potential sites include the skull or jaw (8%) and the pelvis (8%). As mentioned previously, osteosarcoma can subdivide into primary and secondary forms:

Types:

  • Primary tumors usually occur in the metaphysis of long bones and have a marked predilection for the knee, with nearly 60% occurring at this location. Children and adolescents account for the vast majority of those affected by this condition.

  • Secondary tumors have a much wider distribution, reflecting the varied nature of their underlying predisposing condition. They almost always occur in the adult population. Notably, they feature a higher incidence in flat bones, the pelvis in particular (a common location of Paget disease)

Symptoms


  • Most commonly, the presenting symptom is bone pain, particularly with activity.

  • Respiratory symptoms are rare and, when present, indicate extensive lung involvement.(2)

  • The majority of patients with osteosarcoma present with localized pain at the primary tumor site.

  • Range of motion may also be limited as the tumor encroaches upon the joint space.

  • The patient most often presents with pain prior to soft tissue swelling and an enlarging bone mass. This is due to the stretching of the periosteum which usually causes pain before the tumor is detected. Pain could also result from the weakening of the bone and the development of minute stress fractures. The pain may be present for several weeks to several months.(1)


Physical examination findings are typically focused around the location of the primary tumor and may include:

  • A palpable mass may be tender and warm with or without an overlying pulsation or bruit, though these signs are nonspecific

  • Joint involvement with decreased range of motion

  • Local or regional lymphadenopathy (unusual)

  • Respiratory findings with metastatic forms.(2)


Treatment includes:

  • Chemotherapy

  • Radiotherapy

  • Surgery


  • Osteosarcoma should be treated at large medical centers where a multi-disciplinary team including physical therapists, occupational therapists, pediatricians, surgeons, psychologists and nursing staff who will help manage the patient care.

  • In an oncology setting, physical therapists manage the patient’s musculoskeletal, neuromuscular, integumentary and cardiopulmonary rehabilitation needs.

  • Physical therapy interventions will consist of early postsurgical mobility training, strength and endurance restoration, pain control, and education and training of family members in helping patients with limited mobility.

  • Physical therapists will help to correct balance and coordination impairments, make recommendations for home modifications that will enhance the patient’s independence, and educate and train the family members to assist and enable the patient to function independently.

  • In addition, physical therapists will train the patient in stump management and training with the prostheses for those patients who undergo amputation.

  • Rehabilitation following limb-sparing procedures, rotation plasty, or amputations focuses on retraining muscles, increasing strength and endurance, balance and range of motion as well as helping the patient return to school or work activities.


Researches:

  • Research suggests that knowledge on the changes occurring in muscle architecture and its impact on long-term impairments in bone sarcoma survivors after limb salvage surgeries can impact treatment outcomes.(1)

  • Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy.(4)

  • Tumors of the lower extremity can initially mimic common musculoskeletal pathology. Physical therapists must remain alert for red flags, atypical signs and symptoms, and poor responses to treatment, even when patients are referred through medical channels. Particular attention is necessary in the case of unusual symptoms in the lower extremity, where over half of primary malignant tumors occur.(5)

  • Physical therapists regularly perform comprehensive examinations of their patients and use tailored screening strategies when the presentation or response to intervention is atypical.(6)

  • Physical-therapy and occupational-therapy interventions are now tailored to address the multiple physical and psychosocial difficulties these patients will face for the remainder of their lives. Integral parts of the interdisciplinary team, practitioners of these disciplines, provide services that enable patients to achieve their highest functional status to permit them to return to their role in society and hence enjoy dignity and improved quality of life(7).


At Valley Healing Hands, we provide the best Physical Therapy treatment for patients with Osteosarcoma. Depending on the severity and underlying cause of the condition, our physical therapist who are highly qualified will plan an individualized treatment routine, customized to the specific needs of our patient. Our patients are highly satisfied with our services. You can learn about what they have to say about us here and get connected to us here. Our patients love us and you too will!!!


Sources

(1) https://www.physio-pedia.com/Osteosarcoma

(2)https://www.ncbi.nlm.nih.gov/books/NBK549868/

(3)https://www.mayoclinic.org/diseases-conditions/osteosarcoma/symptoms-causes/syc-20351052#

(4)https://pubmed.ncbi.nlm.nih.gov/32483741/

(5)https://www.jospt.org/doi/10.2519/jospt.2017.7037

(6)https://www.jospt.org/doi/pdf/10.2519/jospt.2017.7037

(7)pubmed.ncbi.nlm.nih.gov/20213402/



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