What is osteosarcoma?

Osteosarcoma is a type of bone cancer that originates in cells of the bone. The word “osteosarcoma” comes from the Greek words sarc , meaning fleshy substance, and oma , meaning growth. Osteo adds bone-like to the word sarcoma . It can occur anywhere along the skeleton, but the most common sites are in longer bones, for instance around the knee (distal femur and proximal tibia) and shoulder (proximal humerus).

How common is osteosarcoma?

Osteosarcoma is rare — only around 1,000 people are diagnosed in the United States each year. Osteosarcoma most commonly occurs in children, teenagers and young adults between the ages of 10 and 30. It is slightly more common in boys and young men. There is a peak incidence of osteosarcoma during the adolescent growth spurt. It is very rare in children under 5 years old.

What causes osteosarcoma?

The exact cause is still unknown. Osteosarcoma develops when healthy cells responsible for making new bone experience changes in their DNA. These DNA changes tell the cells to make abnormal bone. This results in a tumor that invades and destroys surrounding healthy bone and surrounding tissue.

Can osteosarcoma be prevented?

It cannot be prevented. However, there are certain risk factors to be aware of. Osteosarcoma risk factors include: ● Bone disorders (Paget’s disease and fibrous dysplasia) ● Exposure to radiation (for example, previous cancer treatment) ● Rare, inherited disorders (hereditary retinoblastoma, Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome and Werner syndrome)

What are the symptoms?

People with osteosarcoma may have a variety of symptoms, including: ● Pain in and around a bone that becomes persistent and severe over time ● Swelling near a bone ● Limping and/or inability to lift or use a limb ● Bone injury/fracture from minor trauma If you or your child is experiencing any of the above symptoms, contact your doctor.

How is osteosarcoma diagnosed?

The diagnosis of osteosarcoma can only be definitively made with a biopsy of the affected area. Thanks to advanced imaging technology, doctors can see — with precision — where the abnormality is located in the body and help guide the biopsy. Once a biopsy confirms the diagnosis of osteosarcoma, a variety of other tests may be ordered to further determine the extent of the tumor. These may include: ● X-Ray ● Computed tomography (CT) scan ● Magnetic resonance imaging (MRI) ● Positron emission tomography (PET) scan ● Additional blood tests

Can osteosarcoma spread?

Yes, osteosarcoma can metastasize, or spread, to other areas of the body, most commonly to the lungs. Osteosarcoma that spreads to the lungs happens when tumor cells travel to the lungs through the bloodstream. But since our blood always travels to the lungs to provide oxygen to our blood (and not all cancers spread to the lungs first), there must be additional reasons that osteosarcoma is so prone to lung metastases. This is an area of active research.

What are the treatment options for osteosarcoma?

Current therapy for osteosarcoma almost always includes the combination of a standard chemotherapy treatment and surgery. Most commonly, chemotherapy is given for several months before surgery and is continued after the patient has recovered from their surgery. The type of surgery performed can vary, but usually includes limb-preservation surgery. Following recovery from surgery, patients begin physical rehabilitation as part of their recovery process.

What should I know about clinical trials?

Clinical trials are available, if and when a patient recurs, following standard treatment. These trials provide patients access to novel treatment methods and drug therapies that are being developed to treat osteosarcoma. Depending on your individual case, you may be eligible to participate in one. The Osteosarcoma Institute is pleased to connect you with a free and confidential clinical trial matching service . Most clinical trials for osteosarcoma include newer “targeted therapy drug” or combinations with immunotherapy.

What are treatment side effects?

With any cancer treatment, there are side effects. This is also true for osteosarcoma treatment. Surgery often involves use of an internal prosthesis and rarely an external prosthesis. Physical therapy will be provided as you heal to help guide rehabilitation and ensure strength and movement are regained in the safest way possible. Chemotherapy side effects can include hair loss, nausea, fatigue, weakness, loss of appetite and weight loss. These side effects will resolve when chemotherapy is completed.

What is the outlook for people with osteosarcoma?

The outlook depends on many factors, including the location and size of the tumor, whether the cancer has spread and the person’s age and overall health. For more information on osteosarcoma survival rates, click here.

Why is more research needed?

There have been no improvements in survival of osteosarcoma patients for more than 30 years. Osteosarcoma is complex, and more research is needed. For a brief history of osteosarcoma treatment, click here . Areas of research include gene therapy, targeted drug therapy and immunotherapy.

Support Osteosarcoma Research in Honor of Ella Beck's Cousin, Fox

Support Osteosarcoma Research in Honor of Ella Beck’s Cousin, Fox.

About Fox

At the start of fourth grade in September 2024, my cousin Fox Thornhill was an athletic, fun-loving nine year old, who was looking forward to playing quarterback on his flag football team and trick-or-treating with his friends. All of that changed in the span of a few weeks when he was diagnosed with high-grade osteosarcoma, a life-threatening form of bone cancer.

On October 21, 2024, after a biopsy and several scans, Fox’s parents and a team of oncologists sat down with Fox to tell him that he has osteosarcoma. On the ride home, Fox was quiet and then asked, “So I have cancer?”

Two days later, Fox had a port placed on his chest and he was admitted to the hospital for his first of 18 rounds of MAP chemotherapy.

While Fox arrived home from the hospital in time for Halloween, he had to skip the group trick-or-treating because he was too sick from treatment. Instead, between bouts of nausea, he went in a wheelchair to just a few houses in his neighborhood. It was not the Halloween he had imagined.

The subsequent chemotherapy infusions only got harder. It was so difficult at times that Fox would ask his parents if the doctors could just amputate his leg. They explained to him several times that, regardless of his leg status, he would still have to complete all 18 rounds of chemotherapy, as osteosarcoma is known for micrometastases that can spread throughout the body. There is no way to test for these micrometastases so osteosarcoma patients must endure the full chemotherapy regimen.

Fox had his limb-salvage surgery in January 2025, which required his surgeon, Dr. Robert Henshaw, to remove the lower portion of Fox’s femur and replace it with an adjustable Stanmore prosthetic implant. A week later, pathology showed clear margins and 92 percent tumor necrosis – meaning 92 percent of the tumor cells were dead. Dr. Henshaw delivered the good news to Fox: “Right now, we can say you don’t have cancer.” This was welcome news, but it was also hard for Fox to understand why he must then endure four more months of 12 rounds of chemotherapy, many of which require 5-day inpatient stays.

By the time Fox finishes his treatment in June 2025, he will have spent approximately 80 days in the hospital .

Fox’s parents believe that the support of friends, relatives, and the wider community has made an immense difference in helping their family stay afloat during this time. My mother (a CNRA) came for the week of Fox’s surgery to assist with his early recovery. Fox’s friends rallied with creative gestures like a head-shaving-mohawk party, care packages, arcade trips, and videos to keep him smiling and connected. Families from his school community provided meals, transportation, and emotional support to help sustain the entire household. Meanwhile, his grandparents, aunts, and uncles stepped in whenever an extra set of hands was needed at home.

Fox is eager to finish treatment so that he can keep building back his strength, go fishing, and resume football with his team. He’s also looking forward to his Make-A-Wish trip to meet the Washington Commanders.

Fox still has a journey ahead of him. He will have scans at regular intervals, as osteosarcoma can return in the lungs and the science does not currently exist to predict to whom and why this happens. Fox will spend the summer building his endurance and working to improve his gait.

While he originally hoped to return to flag football in the spring after his surgery – neither his parents nor his doctors had the heart to tell him that was an unrealistic goal – he now hopes to play with his team in the Fall.

This is why I am running the Marine Corps Marathon … to raise money for the Osteosarcoma Institute in order to support its mission to fund research and the development of new treatments so that kids like Fox have an easier time getting back to doing what they love most … and just being kids.

Osteosarcoma Statistics

Osteosarcoma is the most common childhood bone cancer.

No new treatments have been approved for osteosarcoma patients in 40 years.

1 in 3 children with osteosarcoma will not survive.

Frequently Asked Questions

What is osteosarcoma?

Osteosarcoma is a type of bone cancer that originates in cells of the bone. The word “osteosarcoma” comes from the Greek words sarc, meaning fleshy substance, and oma, meaning growth. Osteo adds bone-like to the word sarcoma. It can occur anywhere along the skeleton, but the most common sites are in longer bones, for instance around the knee (distal femur and proximal tibia) and shoulder (proximal humerus).
How common is osteosarcoma?

Osteosarcoma is rare — only around 1,000 people are diagnosed in the United States each year. Osteosarcoma most commonly occurs in children, teenagers and young adults between the ages of 10 and 30. It is slightly more common in boys and young men. There is a peak incidence of osteosarcoma during the adolescent growth spurt. It is very rare in children under 5 years old.
What causes osteosarcoma?

The exact cause is still unknown. Osteosarcoma develops when healthy cells responsible for making new bone experience changes in their DNA. These DNA changes tell the cells to make abnormal bone. This results in a tumor that invades and destroys surrounding healthy bone and surrounding tissue.
Can osteosarcoma be prevented?

It cannot be prevented. However, there are certain risk factors to be aware of. Osteosarcoma risk factors include:
● Bone disorders (Paget’s disease and fibrous dysplasia)
● Exposure to radiation (for example, previous cancer treatment)
● Rare, inherited disorders (hereditary retinoblastoma, Bloom syndrome, Li-Fraumeni syndrome, Rothmund-Thomson syndrome and Werner syndrome)
What are the symptoms?

People with osteosarcoma may have a variety of symptoms, including:
● Pain in and around a bone that becomes persistent and severe over time
● Swelling near a bone
● Limping and/or inability to lift or use a limb
● Bone injury/fracture from minor trauma
If you or your child is experiencing any of the above symptoms, contact your doctor.
How is osteosarcoma diagnosed?

The diagnosis of osteosarcoma can only be definitively made with a biopsy of the affected area. Thanks to advanced imaging technology, doctors can see — with precision — where the abnormality is located in the body and help guide the biopsy. Once a biopsy confirms the diagnosis of osteosarcoma, a variety of other tests may be ordered to further determine the extent of the tumor. These may include:
● X-Ray
● Computed tomography (CT) scan
● Magnetic resonance imaging (MRI)
● Positron emission tomography (PET) scan
● Additional blood tests

Can osteosarcoma spread?

Yes, osteosarcoma can metastasize, or spread, to other areas of the body, most commonly to the lungs. Osteosarcoma that spreads to the lungs happens when tumor cells travel to the lungs through the bloodstream. But since our blood always travels to the lungs to provide oxygen to our blood (and not all cancers spread to the lungs first), there must be additional reasons that osteosarcoma is so prone to lung metastases. This is an area of active research.
What are the treatment options for osteosarcoma?

Current therapy for osteosarcoma almost always includes the combination of a standard chemotherapy treatment and surgery. Most commonly, chemotherapy is given for several months before surgery and is continued after the patient has recovered from their surgery. The type of surgery performed can vary, but usually includes limb-preservation surgery. Following recovery from surgery, patients begin physical rehabilitation as part of their recovery process.
What should I know about clinical trials?

Clinical trials are available, if and when a patient recurs, following standard treatment. These trials provide patients access to novel treatment methods and drug therapies that are being developed to treat osteosarcoma. Depending on your individual case, you may be eligible to participate in one. The Osteosarcoma Institute is pleased to connect you with a free and confidential clinical trial matching service. Most clinical trials for osteosarcoma include newer “targeted therapy drug” or combinations with immunotherapy.
What are treatment side effects?

With any cancer treatment, there are side effects. This is also true for osteosarcoma treatment. Surgery often involves use of an internal prosthesis and rarely an external prosthesis. Physical therapy will be provided as you heal to help guide rehabilitation and ensure strength and movement are regained in the safest way possible. Chemotherapy side effects can include hair loss, nausea, fatigue, weakness, loss of appetite and weight loss. These side effects will resolve when chemotherapy is completed.
What is the outlook for people with osteosarcoma?

The outlook depends on many factors, including the location and size of the tumor, whether the cancer has spread and the person’s age and overall health. For more information on osteosarcoma survival rates, click here.
Why is more research needed?

There have been no improvements in survival of osteosarcoma patients for more than 30 years. Osteosarcoma is complex, and more research is needed. For a brief history of osteosarcoma treatment, click here. Areas of research include gene therapy, targeted drug therapy and immunotherapy.