Stage 4 Bone Cancer

Understanding the difference between osteosarcoma and distant spread
By Kathryn E. Vinson, MS, CCRC

Stage 4 Bone Cancer

When we talk about stage 4 cancers, a lot of the time we hear about the disease spreading to the bones. It is important for us to understand that this is very different from cancer that originates in the bone.  Cancer that originates in the bone is known as osteosarcoma, and it is vastly different from cancers that began at another site and have since spread to the bone (that is a possible symptom of metastatic disease).  With that, let’s take some time today to talk about stage 4 osteosarcoma, its symptoms, outlook, and treatment options.

What is the prognosis for stage 4 bone cancer?

Advanced osteosarcomas don’t have the best 5-year survival rate, but its also not the worst.  At 27%, it is definitely a frightening diagnosis.  As with other aggressive cancers, early diagnosis is key, with local disease having a 77% five-year survival rate. Again, as is the story with many other cancers, early symptoms can be difficult to detect.

Sadly, 20% of osteosarcomas have spread by the time of diagnosis.

What are the symptoms of stage 4 bone cancer?

Osteosarcoma, or bone cancer, is a type of cancer that originates in the bones.  It is most typically seen in the long bones (think arms and legs) and is most common in people 10-30 years of age.  This largest segment are kiddos going through their teenage growth spurts. It is more common in males and shows a slightly higher prevalence in those with African and Hispanic/Latino heritage.

So, why am I mentioning these risk factors before symptoms? Well, as a mom, childhood cancers scare the hell out of me.  Osteosarcoma is also more prevalent in kids going through very fast growth, and in very tall kids.  For instance, my 13-year-old son is already 6’1”. Knowledge is key, my dear friends. With that being said, the main symptoms of osteosarcoma are bone pain and possible swelling (depending on how advanced the disease has become). As a mom with kids that experience pretty bad growing pains, I’ll tell you, differentiating those from something more serious can be difficult.  The American Cancer Society recognizes this difficulty and suggests seeing a physician should these pains not resolve within a few weeks.

In stage 4 osteosarcoma, the cancer has spread from the primary tumor to other bones, the lungs, the brain, or other organs. Symptoms of that spread vary depending upon the site affected.

How is stage 4 bone cancer treated?

Some stage 4 bone cancers can be cured, but treatments are aggressive.  Successful treatment largely depends on the ability of the treatment team to remove the tumor(s) surgically. Most often, chemotherapy is utilized prior to surgery in order to shrink the tumor(s).  For tumors that are unable to be resected, radiation therapy is utilized to help with pain control and quality of life.

New findings on osteosarcoma treatment

Osteosarcoma treatment hasn’t had a whole lot of advances in the last several decades.  Fortunately for those that are afflicted with this disease, researchers in Australia at the Garvan Institute for Medical Research have found that an existing drug may be able to be repurposed to treat this monster.  A drug that is used for the treatment of the skin disorder psoriasis, has been found to be effective in treating osteosarcomas in mice.  This drug, which blocks a chemical known as IL23, is well tolerated in humans.  When treated with this drug, mice with existing osteosarcomas saw their tumors shrink, while those without tumors, were protected against tumor growth.

The utilization of existing/approved medications is a giant leap forward in the treatment of diseases, as its tolerability in humans has already been established.  Many prayers that this treatment path continues to show success!

As always, much love, many prayers, and abundant blessings to all of the warriors out there!!

Sources:
https://www.cancer.org/cancer/osteosarcoma/detection-diagnosis-staging.html
https://www.sciencedaily.com/releases/2019/09/190918093054.htm

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