Chemotherapy for osteosarcoma
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.
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.
Chemo is part of the treatment for most osteosarcomas, although some patients with low-grade osteosarcoma may not need it. Often, chemo is given both before (for about 10 weeks) and after surgery for up to a year. Most of the time 2 or 3 drugs are given together.
Before starting chemo, the doctor might advise surgery to put a venous access device into a large vein in the chest. The device is a hollow tube that 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.
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
- 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)
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.
Rarely, chemo may cause a second type of cancer (such as leukemia) years after the osteosarcoma is cured. But the need for chemo in treating osteosarcoma far outweighs this risk. Some other side effects, such as damage to the heart and not being able to have children (infertility), can happen with certain drugs. Serious side effects are rare, but they do happen. Side effects can often be prevented or controlled. Anyone who has problems with side effects should talk with their doctor or nurse about them. Some of these long-term effects are described in the section, “Long-term effects of cancer treatment for osteosarcoma.”
Tests to check for side effects of chemo: Before each treatment, the doctor will check your (or your child’s) lab results to be sure the liver, kidneys, and bone marrow (which makes blood cells) are working well.
The complete blood count (CBC) includes counts of white blood cells, red blood cells, and blood platelets. White blood cells fight infections, so it is important to know the white blood cell count before chemo starts. Platelets are small cells that plug up holes in blood vessels and stop bleeding. Red blood cells carry oxygen from the lungs to the rest of the body.
Blood chemistry panels measure certain blood chemicals that tell doctors how well the liver and the kidneys are working.
A test may be done to check the patient’s hearing, which can be harmed by certain chemo drugs. Tests to check other body organs, such as the heart, may be done as well.
To find out more about chemo, please see our document, Understanding Chemotherapy: A Guide for Patients and Families.
Last Medical Review: 01/24/2013
Last Revised: 01/24/2013