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【Major Points】

  1. Standard treatments for osteosarcoma include surgery and chemotherapy.
  2. Osteosarcoma usually occurs in skeletal system of adolescent, especially in long bones, thighs, legs, or arms.
  3. Pain is a common symptom of osteosarcoma, will not improve by resting, and often increases in the night time.
  4. Pain relief requires the correct use of painkillers and other non-drug pain relief methods.
  5. Bones with osteosarcoma have been damaged by cancer cells, they fail to support weight or withstand external force. Even a gentle pull can cause fracture.
 
What is osteosarcoma?
Osteosarcoma is the most common malignant tumor in children, which usually occurs in skeletal system of adolescent, especially in long bones, thighs, legs, or arms, and maybe metastasis to other organs, such as lung, brain or kidney.
 
What are the common symptoms of osteosarcoma?
  1. Persistent local pain: It is the most common symptom in the early stage. And the pain persists during rest, get worse at night.
  2. Localized masses: Bone tumor grow rapidly, causing localized skin swelling, or even localized masses.
  3. Pathological fractures: Because bones are severely damaged by tumor cells, they fail to support weight or withstand external force. Even a gentle pull can cause fracture.
  4. Motor dysfunction: It may affect motor function due to pain or muscular and nervous system compressed by bone tumor. Patients may limp, or even fail to walk or climb stairs.
  5. Other symptoms: Body weight loss, poor appetite or fever.
     
    If you have above symptoms, does not mean that your child have osteosarcoma, please take your child to see a doctor of pediatric hematology as soon as possible.
     
What are the common treatment strategies?
Standard treatment combines with surgery and chemotherapy. When diagnosis is confirmed, chemotherapy will be given several times to shrink the tumor. Add then the tumor removal surgery will be scheduled. After the operation, chemotherapy will be given.
 
Principles of Care:
  1. Pain relief: Use painkillers and cooperate with other non-drug pain relief methods, such as listening to music, reading, etc.The way of shifting attention.
  2. Emotional support: Encourage children to express their thoughts and feelings and provide comfort and support.
  3. Infection prevention: The immunity decreases after chemotherapy. Before returning home, you must learn to prevent infection and take care of your daily life.If you have symptoms such as high fever, dizziness, pale face, and persistent bleeding, you should return to the doctor immediately.
  4. Nutrition:Calcium and protein should be properly supplemented after surgery to help wound healing.
  5. Rehabilitation: The rehabilitation program will start before the operation. After the operation, early getting out of bed, walking and rehabilitation training will be encouraged to help the children restore the function of independent self-care.
  6. Multidisciplinary team: As children's bones are not fully developed, in the treatment stage, a treatment plan will be jointly formulated by various types of personnel in a cross-medical team field mode to provide better holistic care.
 
References
  1. Chen, C. M. (2019). Care of Children with Cancer. In Mu P. F. (Ed.), Pediatric Nursing (first edition, pp. 713-719). New Wun Ching.
  2. Cheng, M.-L.(2018). Children's musculoskeletal system diseases and nursing. Huang, M. C. & Chiang, L. C. (ed.), Pediatric Nursing (6th ed., pp. 628-630), Yeong Dah。
  3. Eaton, B. R., Schwarz, R., Vatner, R., Yeh, B., Claude, L., Indelicato, D. J., & Laack, N. (2021). Osteosarcoma. Pediatric Blood & Cancer, 68, e28352. https://doi.org/10.1002/pbc.28352
  4. Yuan, S. C. (2020). Musculoskeletal disorder and nursing. In Liu H. E. (Ed.), Adult health nursing (8th ed., pp. 628-630). Farseeing.
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