Childhood bone
cancer

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Treatments for childhood osteosarcoma

The healthcare team will create a treatment plan just for your child. It will be based on your child’s needs and may include a combination of different treatments for osteosarcoma.

Treatment is usually based on the stage of childhood bone cancer. When deciding which treatments to offer for osteosarcoma, your child’s healthcare team will also consider the:

  • location and size of the tumour
  • child’s age
  • child’s lifestyle and activity levels

Treatments for localized childhood osteosarcoma

Localized osteosarcoma is usually treated with chemotherapy followed by surgery to remove the tumour, and then more chemotherapy.

Chemotherapy

Chemotherapy is often the first treatment for localized osteosarcoma of the bone. It is given before surgery. Neoadjuvant chemotherapy is usually given for 10 weeks.

After at least 10 weeks of neoadjuvant chemotherapy, doctors will use imaging tests to plan surgery. Chemotherapy is then given again 2–3 weeks after surgery for another 18 weeks.

The most common chemotherapy combination used for osteosarcoma is:

  • high-dose methotrexate, doxorubicin (Adriamycin) and cisplatin (Platinol AQ)

Surgery

After neoadjuvant chemotherapy, surgery is used to remove the tumour and rebuild the bone.

Treatments for metastatic osteosarcoma

Metastatic osteosarcoma is usually treated with the same chemotherapy followed by surgery to remove the main tumour. If the child has lung metastases, surgery is also performed on the lungs to remove these tumours.

Chemotherapy

The most common chemotherapy combination used for metastatic osteosarcoma is:

  • high-dose methotrexate, doxorubicin (Adriamycin) and cisplatin (Platinol AQ)

Surgery

Surgery is often done after chemotherapy. It is used to remove the primary tumour and metastasis.

In some cases, surgery may be needed to remove the primary tumour to control pain or repair a broken bone. In these cases, surgery is done before chemotherapy is given.

Radiation therapy

Radiation therapy is not commonly used to treat childhood osteosarcoma. Radiation therapy may be used to relieve pain or to control the symptoms of advanced osteosarcoma.

Treatments for recurrent childhood osteosarcoma

The treatments offered for recurrent childhood osteosarcoma are based on:

  • whether the recurrence is local (close to the primary tumour) or metastatic (in another part of the body)
  • what treatments the child has already received
  • how long since the child’s last treatment

Recurrent childhood osteosarcoma may be treated with chemotherapy, surgery, radiation therapy or a combination of these treatments.

 

Chemotherapy with one or more of the following drugs may be given, depending on what chemotherapy the child has already received:

  • ifosfamide
  • gemcitabine (Gemzar) alone or in combination with docetaxel (Taxotere)

 

Surgery may be used to remove tumours that recur in the lungs. Surgery may also be used to remove cancer that recurs in other bones.

 

Radiation therapy may be used to relieve pain and improve quality of life.

Follow-up care

Follow-up after treatment is an important part of cancer care. Your child will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow your child’s healthcare team to monitor your child’s progress and recovery from treatment.

Clinical trials

Most children with osteosarcoma are treated in a clinical trial that is tailored to the stage and type of cancer. The clinical trial protocol, or plan, outlines the treatment, such as the chemotherapy drugs and dosages used. Find out more about clinical trials.

Questions to ask about treatment

To make the decisions that are right for your child, ask your child’s healthcare team questions about treatment.

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