Osteosarcoma is a type of bone cancer. It can develop at any age, but most cases occur during childhood, early adolescence, and young adulthood. In young people, osteosarcoma tends to develop in the arm or leg bones. In older people, the disease typically affects the pelvis, shoulder, or hip.

Osteosarcoma can cause various symptoms, such as chronic bone pain, growths, and swelling. People who experience these symptoms should seek a diagnosis. Treating the disease in its early stages can significantly increase the chance of a full recovery.

This article describes what osteosarcoma is and outlines the symptoms, causes, and treatment options. It also provides information on the outlook for people living with osteosarcoma and answers some frequently asked questions about the disease.

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Osteosarcoma is a type of cancer that develops in bone tissue. In osteosarcoma, cancerous cells produce immature bone tissue called “osteoid.” This tissue is not as strong as regular bone tissue.

Osteosarcoma is rare, with doctors in the United States diagnosing about 1,000 new cases every year.

The disease can affect any bone and occur at any age. However, it is more common among children, teenagers, and young adults. It accounts for about 1% of cancers in the U.S., with doctors making an estimated 750–1,000 new diagnoses each year — 450 of them in children and adolescents.

In young people, osteosarcoma tends to affect rapidly growing bones, such as those surrounding the knees and shoulders. Examples include:

  • The proximal tibia: This is the upper part of the shin bone.
  • The distal femur: This is the lower part of the thigh bone.
  • The proximal humerus: This is the upper section of the arm bone.

In older people, osteosarcoma more commonly affects the following bones:

  • the pelvis
  • the shoulder
  • the jaw

People who have osteosarcoma often experience pain around a growing tumor. The pain may worsen when a person is trying to sleep or exercise.

Over time, individuals may also develop swelling around the tumor, which may present as a lump or mass. A tumor in the legs or pelvis may cause a person to limp.

According to tumor type

The symptoms associated with osteosarcoma also depend on how far the disease has progressed.

Healthcare professionals refer to newly developing tumors as low grade tumors, and these are associated with milder symptoms.

More advanced, or high grade, tumors may cause more severe symptoms. People with high grade tumors may develop fractures in the bones around the tumor. These advanced tumors may also spread to other parts of the body, which is known as metastasis.

Anyone who experiences unusual bone pains, growths, or other concerning symptoms should visit a doctor for a medical examination.

Researchers do not fully understand what causes osteosarcoma. However, certain genetic mutations are associated with syndromes that appear to increase the risk of the disease. Examples of these syndromes include:

  • Werner syndrome
  • Bloom syndrome
  • Li-Fraumeni syndrome
  • Rothmund-Thompson syndrome

Certain genes are also associated with the development and spread of osteosarcoma. Researchers have shown that these genes may help doctors diagnose osteosarcoma and identify people who are at increased risk of metastases.

Radiation therapy may also increase the risk of osteosarcoma. Individuals who have received this treatment for another condition during childhood have a higher likelihood of developing osteosarcoma at a later stage.

Future studies are necessary to understand the causes of osteosarcoma. People who have any of the risk factors above may wish to speak with a doctor to learn more.

The best treatment for osteosarcoma depends on the individual and the stage of their disease. Some of the most common treatments are those below.


Surgical treatment can be an effective option when an osteosarcoma tumor is localized in one area of the body.

In most cases, a surgeon will attempt to remove a tumor without permanently disfiguring or impairing the affected body part. They may use reconstruction or bone grafting to improve the appearance or function of the body part.

In rare cases, amputation may be necessary to ensure the removal of the tumor in its entirety. However, in most cases, surgeons will attempt to remove the tumor while sparing the affected limb.


Chemotherapy involves the use of specialized drugs that help prevent the growth and spread of cancer. These drugs work by killing cancer cells or preventing them from replicating.

Doctors typically inject chemotherapy drugs into a vein, allowing the drugs to target cancer cells throughout the body.

For less advanced cases of osteosarcoma, doctors may recommend surgery and then chemotherapy. The chemotherapy helps prevent the cancer from reoccurring in other parts of the body.

For more advanced osteosarcoma cases, chemotherapy is almost always part of the standard of care.

Radiation therapy

Radiation therapy directs high energy rays or particles at the tumor. This helps kill the cancer cells or damage their DNA in a way that prevents their growth and division.

According to the American Cancer Society (ACS), osteosarcoma cells are somewhat resilient to the effects of radiation. As such, radiation therapy does not play a significant role in the treatment of osteosarcoma. However, doctors may recommend it if the complete surgical removal of a tumor is not possible.

The survival rate for osteosarcoma depends on the stage of the disease.

The ACS provides 5-year relative survival rates for people who received an osteosarcoma diagnosis between 2010 and 2016. For cancer that has not yet spread, the 5-year survival rate is about 77%. For advanced cancer that has spread throughout the body, the rate drops to 26%.

According to a 2018 study, certain factors can increase the chances of survival. These include:

  • tumors that are differentiated from surrounding tissues
  • tumors that have not spread at the time of diagnosis
  • successful surgical treatment
  • younger age at diagnosis

A 2020 study notes that the outlook for people with osteosarcoma has improved dramatically in recent decades. Early detection and public education are important for continuing to improve osteosarcoma treatment and survival rates.

Below are some answers to common questions about osteosarcoma.

Is osteosarcoma cancer curable?

With early treatment, the survival rates for osteosarcoma are relatively high. If a doctor diagnoses the condition in its early stages, surgery alone may be enough to achieve disease remission.

The likelihood of recovery depends on several factors, including the person’s age and overall health, as well as the osteosarcoma type and severity.

People with osteosarcoma should consult a doctor to learn more about their chance of a full recovery.

What are the most significant symptoms of osteosarcoma?

The symptoms of osteosarcoma vary among individuals and can differ according to the size and location of the tumor and the stage of the disease.

One of the most common symptoms is pain around the tumor, which may accompany swelling. The pain will be chronic and may worsen with activity or when a person is trying to sleep.

A tumor on the leg or hip may also cause a person to limp when walking.

Who has the highest risk of osteosarcoma?

Individuals aged 10–30 years have the highest risk of osteosarcoma. The disease also seems to have an association with tallness in children, reinforcing the idea that osteosarcoma may have a link with rapid bone growth.

The risk of osteosarcoma decreases in middle age but rises again after about 60 years of age. Osteosarcoma in older age is typically associated with other chronic bone diseases.

Additional risk factors include:

  • being female
  • having a genetic syndrome associated with an increased osteosarcoma risk
  • undergoing radiation treatment

Osteosarcoma is a rare bone disease that can affect people of any age but primarily affects children and young adults. People with osteosarcoma may experience chronic bone pain, growths, and swellings.

With early diagnosis and treatment, individuals with osteosarcoma have a relatively high chance of recovery. Anyone experiencing symptoms of osteosarcoma should consult a doctor.

The treatment for osteosarcoma typically includes a combination of surgery and chemotherapy. Treatments have improved substantially in recent years, and further studies are underway to improve osteosarcoma care further.