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Chemotherapy (chemo) is the use of drugs to kill cancer cells. Most often the drugs are given into a vein. Once the drugs enter the bloodstream, they go throughout the body. This makes it a useful treatment for osteosarcoma, which has often spread to the lungs or other organs, or is likely to do so, even if tumors can’t be seen on imaging tests.

Chemo is part of the treatment for most osteosarcomas, although some patients with low-grade osteosarcoma might not need it. Often, chemo is given both before surgery (for about 10 weeks) and then again after surgery for up to a year. Most of the time 2 or 3 drugs are given together in high doses. Doctors give chemo in cycles, with each round of treatment followed by a rest to allow the body time to recover. Each chemo cycle lasts for a few weeks.

Before starting chemo, the doctor might advise surgery to put a thin, soft tube called a catheter or venous access device (VAD) into a large vein in the chest. This lets the health care team give chemo and other drugs and to draw blood samples without having to stick needles into the veins each time. The catheter usually stays in place for several months while chemo is being given.

Side effects of chemo

Chemo kills cancer cells, but it also harms some normal cells. Side effects from chemo will depend on the type of drugs given, the amount taken, and how long treatment lasts. Side effects could include:

  • Nausea and vomiting
  • Loss of appetite
  • Hair loss (the hair grows back after treatment ends)
  • Mouth sores
  • Diarrhea
  • Increased chance of infection (caused by a shortage of white blood cells)
  • Bleeding or bruising after small cut or injuries (from a shortage of platelets)
  • Tiredness or shortness of breath (from a shortage of red blood cells)

Most of these side effects are short-term and tend to go away after treatment. Often there are ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting, or to help get blood counts back to normal levels. Be sure to discuss any questions you have about side effects with the cancer care team, and tell them about any side effects so that they can be controlled.

Children seem to do better than adults when it comes to chemo. They tend to have less severe side effects and to get over side effects faster. Because of this, doctors can give them higher doses of chemo to try to kill the cancer.

Some chemo drugs can cause other side effects, such as:

  • Bladder or kidney damage
  • Damage to nerves, which can cause numbness, tingling, or pain in the hands and feet
  • Loss of hearing
  • Damage to the heart
  • Increased risk of a second cancer (such as leukemia) later on
  • Loss of fertility (ability to have children)

Serious side effects are rare, but they do happen. Some of these long-term effects are described in the section “Long-term effects of cancer treatment for osteosarcoma.”

To find out more about chemo, please see the “Chemotherapy” section of our website.

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