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More young people with osteosarcoma are now surviving this cancer. But their health as adults has come more into focus in recent years. Just as the treatment of cancer in young people calls for a very special approach, so does their care and follow-up after treatment. The earlier any problems can be spotted, the more likely it is they can be treated effectively.

Young people who survive cancer are at some risk for late effects of their cancer treatment. This risk depends on a number of things, such as the cancer treatments they had and their age when they had treatment. For example, the effects of surgery for osteosarcoma can range from small scars to the loss of a limb.

Some other late effects of treatment could include:

  • Heart or lung problems (due to certain treatments)
  • Loss of hearing (due to certain drugs)
  • Slowed or decreased growth and development (in the bones or overall)
  • Changes in sexual development and ability to have children (see below)
  • Learning problems in younger children
  • Development of second cancers (see below)

There may be other effects from treatment as well. Your child’s doctor should carefully review any possible problems with you before your child starts treatment.

Fertility issues

Fertility problems are not common after osteosarcoma treatment, but they can happen. Older girls and women may have changes in their periods, but normal monthly cycles usually return after chemotherapy ends. Boys and men may not be able to make sperm. This usually returns, but the sperm count may remain low.

Talk to your (child’s) cancer care team about the risks of infertility before treatment, and ask if there are options for saving fertility, such as sperm banking. To find out more, see our documents Fertility and Women With Cancer or Fertility and Men With Cancer.

Getting a second cancer

Rarely, some types of chemotherapy can cause a second type of cancer (such as leukemia), years after the osteosarcoma is cured. Radiation treatment can also raise the risk of a new cancer at the site of the treatment. But the need to treat the osteosarcoma far outweighs this risk. For more on second cancers, see our document Second Cancers Caused by Cancer Treatment.

Long-term follow-up care for children and teens

To help increase awareness of late effects and improve the long-term care of children who have had cancer, the Children’s Oncology Group (COG) has long-term follow-up guidelines for survivors of childhood cancers. These guidelines can help you learn what to watch for, what type of screening tests should be done to look for problems, and how late effects are treated.

It’s very important to discuss possible long-term problems with your child’s health care team, and to make sure there is a plan in place to watch for these problems and treat them, if needed. To learn more, ask your child’s doctors about the COG survivor guidelines. You can also view them for free at the COG website: www.survivorshipguidelines.org. The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well, but we urge you to discuss them with a doctor.

For more about some of the possible long-term effects of treatment, see our document Children Diagnosed With Cancer: Late Effects of Cancer Treatment.

Last Medical Review: 06/13/2014
Last Revised: 01/27/2016