# Care pathway for osteosarcoma On this page you will find information about the different stages of examinations and treatment of osteosarcoma at HUS. ## [ From symptoms to diagnosis ](#from-symptoms-to-diagnosis) ## [ Getting a diagnosis ](#getting-a-diagnosis) ## [ Treatments ](#treatments) ## [ After treatments ](#after-treatments) ## [ Support and information ](#support-and-information) ## From symptoms to diagnosis Primary health care ### A symptom appears or an abnormal finding is made --- 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, swelling and limitation of movement in the joint, and palpable lumps or nodules. Sometimes a patient 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. ### Required additional examinations in primary health care and a physician’s assessment --- The first additional examination performed in primary care is usually a native X-ray. If the imaging results reveal signs of a skeletal tumor, a referral will be made to specialized medical care for further examinations. ### A physician writes a referral --- If osteosarcoma is suspected, the physician will refer you to the HUS bone tumor unit. ## Getting a diagnosis Comprehensive Cancer Center and other specialized medical care ### The referral arrives at specialized medical care and an invitation is sent to the patient --- A physician will review your situation, plan the required additional examinations, and give a treatment recommendation. ### If necessary, additional examinations can be carried out --- We usually begin the examination of bone tumors with an X-ray. Other additional examinations include computed tomography, magnetic resonance imaging and nuclear imaging (PET-CT or bone scintigraphy) 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. ### Appointment with a physician and a nurse --- 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. ## Treatments Specialized medical care ### Treatment begins --- We plan the treatment of osteosarcoma in a multi-professional treatment meeting according to the extent and characteristics of the tumor. In osteosarcomas of low malignancy, surgical treatment is sufficient. In highly malignant osteosarcomas, surgery is supplemented with chemotherapy or radiation therapy, or a combination of both. [ Read more about the treatment of osteosarcoma ](/en/patient/treatments-and-examinations/cancer/care-pathway-osteosarcoma/treatment-local-osteosarcoma) ### Healing and follow-up --- We draw up a follow-up plan for each patient individually. 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. ### If the disease recurs or treatments do not help --- Some osteosarcomas have already metastasized when found. In such cases as well, your treatment will start with chemotherapy. The goal of treatment is still to cure the cancer, although the probability of recovery is lower than in a localized osteosarcoma. You will receive chemotherapy in the same way as with localized osteosarcoma. Some of our patients have an excellent response to chemotherapy and can recover from osteosarcoma. We can also treat metastases with radiation therapy and by removing them surgically. If osteosarcoma recurs after treatment, your treatment options are limited. With cancer medication and radiation therapy, we aim to slow down the progression of the cancer, prolong life, and alleviate the symptoms caused by cancer. When planning treatment, we take into account your general physical condition and functional capacity, other illnesses, and the likely benefits and harms of the treatment. [At the Clinical Trial Unit](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/clinical-pharmaceutical-research-unit "Clinical Trial Unit, Comprehensive Cancer Center") we offer an increasing number of patients the opportunity to be among the first to receive new research treatments. ### Palliative care and psychosocial support --- Good palliative care and psychosocial support are an integral part of cancer treatment. The Palliative Care Center provides help in the stressful life situation caused by the illness or cancer treatments. We help treat difficult symptoms and offer conversational support. A decision on palliative, i.e. symptomatic, treatment is made when the focus of your treatment shifts from slowing down the progression of cancer to managing the symptoms. In this case, treatment aims to alleviate symptoms and, as far as possible, to ensure a good and active life with the illness until death. Typically, at this stage, your care responsibility is transferred to the palliative care unit or to the palliative outpatient clinic or a hospital-at-home unit in your area. [ Read more about the Palliative Care Center ](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/palliative-center-comprehensive) ## After treatments ### Follow-up in specialized medical care ends --- 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. ## Support and information Getting cancer is a big life change. Here you will find information and support for living with the disease. ### [ Support during cancer treatment ](/en/patient/treatments-and-examinations/support-during-cancer-treatment) Here you can find discussion help and support for rehabilitation for cancer patients.  ### [ Instructions and additional information for cancer patients ](/en/patient/treatments-and-examinations/cancer/instructions-and-additional-information-cancer-patients) Here you will find our patient guide and more information about cancer treatments.  Updated: 10.10.2024