Care pathway for osteosarcoma

Osteosarcoma, or bone sarcoma, is a malignant tumor that originates in the bone. The most common symptoms of osteosarcoma and Ewing’s sarcoma are

• increasing pain
• joint swelling and limited range of motion, as well as
• a lump or swelling that can be felt by touch.  

Sometimes a person seeking treatment may have a minor sports injury that does not heal in the expected time. The injury itself is not related to the onset of cancer, but the affected bone becomes painful more easily. A bone fracture may also be a symptom.

Ewing’s sarcoma is a malignant tumor mainly found in children and young adults, primarily in the skeleton. Ewing’s sarcoma may also include general symptoms such as fever and weight loss.

Some patients are diagnosed with metastases already at the stage of diagnosis. These are most commonly located in the lungs, causing symptoms such as coughing and shortness of breath.

The first additional examination performed in primary care is usually a native X-ray. If the imaging scans reveal signs of a bone tumor, the physician will refer the patient to HUS for further examinations.  

If osteosarcoma is suspected, the physician will make a referral to the HUS Bone Tumor Unit.  

The physician will review your situation, plan the required additional examinations, and give a treatment recommendation. You will receive an invitation by mail and in the Maisa Portal

We usually begin the examination of bone tumors with an X-ray. Other additional examinations include

• computer tomography
• magnetic resonance imaging, and
• radioisotope scanning (PET-CT or bone scan) of the entire body.

With the help of computed tomography, we look for visible cancer metastases, which are usually found in the lungs. If there is a suspicion of a bone tumor, we take a biopsy to confirm the diagnosis. 

At the appointments with the physician and nurse, we will review your examination results, overall situation, and treatment plan. At the nurse’s appointment, you will receive more information about the practical implementation of treatment and its adverse effects, and possible supportive therapies.

We plan the treatment of osteosarcoma in a multiprofessional treatment meeting according to the extent and characteristics of the tumor.

In osteosarcomas of low malignancy, surgical treatment is sufficient. In highly malignant osteosarcomas, we supplement surgery with chemotherapy or radiation therapy, or a combination of both.

A multiprofessional treatment team is in charge of the treatment of osteosarcoma. You can reach your treatment team in the Maisa Portal and by phone. You will find the contact information for the unit treating you on the invitation letter.

• The Comprehensive Cancer Center helpline at 09 471 74900 is open Monday through Friday from 7:30 a.m. to 4:00 p.m.
• If your condition deteriorates suddenly or your fever rises above 38 degrees Celsius, contact the 24-hour emergency Medical Helpline at 116 117 (toll-free) or the nearest hospital with on-call services.
• In an emergency, always call 112.

We will create a personalized follow-up plan for you. At the end of your treatments, we will monitor your condition every 2–3 months for the next two years and then every six months until five years have passed since your treatment. After this, follow-up usually ends, since most recurrences of osteosarcomas occur within the first two years.

The follow-up regarding the functionality of prostheses can take longer, sometimes for the rest of your life. In the follow-up, we use X-ray, magnetic resonance or computed tomography imaging.

In general, your follow-up at HUS does not continue after the five-year follow-up period. The follow-up regarding the functionality of prostheses can take longer, sometimes for the rest of your life.