Osteosarcoma
Osteosarcoma
Osteosarcoma
- Type of bone cancer that develops in the cells (forms the outer covering of the bone).
- Most common and fatal in children and males between 10-25 years old.
- 5% of all childhood cancers.
- Common sites: long bones, knee, upper leg, thigh bone, lower leg and upper arm.
Etiology
Causes:
- Unknown
- DNA mutation – either inherited or acquired after birth.
- Familial susceptibility
- Injury
- Infection
- Metabolic or hormonal disturbance
Risk Factors:
Children
- Teenage growth spurt
- Tall for the age
- Previous treatment with radiation
- Benign and non-cancerous bone tumors
- Retinoblastoma
Adult
- High fat diet
- Lack of exercise
- Smoking
- Drinking alcohol
Pathophysiology
- Osteoblast
- DNA mutation
- Malignant osteoblast (abnormal)
- Proliferation of abnormal osteoblast
- Formation of osteoid or immature bone
- Signs and symptoms are then observed such as pain, swelling, and tenderness.
Assessment
- Encourage patient to discuss problem and course of symptoms.
- Note patient and family’s understanding of the disease, coping with the problem and management of pain.
- Palpate mass gently on physical examination.
- Note size and associated soft-tissue swelling, pain and tenderness of the mass.
- Assess neuromascular status and range of motion extremity.
- Evaluate motility and ability to perform activities of daily living.
Diagnostic Procedures
- X-ray
- MRI
- CT scan
- Biopsy
- CBC
- Blood chemistry
- Urine analysis
- Sternal marrow puncture
Nursing Diagnosis
- Acute or chronic pain
- Risk for injury: pathologic fracture related to tumor
- Ineffective coping
- Activity intolerance
Nursing Intervention
- Provide quiet environment and calm activities to prevent or lessen pain.
- Provide comfort measure such as back rub, change position and use of heat or cold application.
- Encourage diversional activities
- Administer analgesics as indicated to maximal dose as needed.
- Encourage the patient to increase fluid intake.
- Encourage rest periods to prevent fatigue.
- Provide accurate information about the situation, medication and treatment.
- Assess muscle strength, gross and fine motor coordination.
- Provide pillows for cushion and support.
- Keep side rails up all the time.
Complications
- Alopecia
- Reduction in number of leucocytes and platelets
- Septicemia
- Bleeding
- Anemia
- Kidney damage
- Hearing loss
image from www.nlm.nih.gov
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
