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15 Cards in this Set
- Front
- Back
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Osteosarcoma (osteogenic sarcoma)
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MOST COMMON BONE CANCER IN CHILDREN
PEAK INCIDENCE BETWEEN 10-25 YEARS OF AGE |
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Osteosarcoma presumably arises from
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bone-forming mesenchyme, which gives rise to MALIGNANT OSTEOID TISSUE.
most PRIMARY tumor sites are in the METAPHYSIS (wider part of the shaft, adjacent to the epiphyseal growth plate) of long bones.....ESPECIALLY LOWER EXTREMITIES |
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More than half of osteosarcoma cases occur in the
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FEMUR (particularly the DISTAL portion) with the rest involving the:
1) humerus 2) tibia 3) pelvis 4) jaw 5) phalanges |
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CLINICAL MANIFESTATIONS |
Pain or tenderness in affected area, limited range of motion, swelling with a palpable mass, fatigue, anemia, nausea & vomiting, weight loss, pathological fractures, cough & chest pain |
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DIAGNOSTIC EVALUATION |
1. History & physical examine. 2. Radiograph x ray Sunburst. 3. CT, MRI 4. Radioisotope Bone Scan. 5. Arteriography |
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Optimum treatment for osteosarcoma is
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1) surgery
2) chemotherapy |
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Surgical approach to osteosarcoma involves
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1) surgical biopsy followed by
2) limb salvage 3. Thoracotomy, Pulmonary metastases, 4. Amputation |
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Limb salvage procedure which involves
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1) en bloc resection of the primary tumor
2) prosthetic replacement of the involved bone Ex: osteosarcoma of the distal femur (a total femur and joint replacement is performed) Pre-operatively: CHEMO (to decrease tumor size) |
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Chemotherapy - Osteosarcoma Medications:
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1) Antineoplastic (high-dose methotrexate with citrovorum factor rescue. 7) Cisplatin. |
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Pulmonary metastasis (Osteosarcoma)
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Thoracotomy
Chemotherapy prolonged survival and POTENTIAL CURE |
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Nursing Education - Diagnosis of Cancer
1. Should not disguise with falsehoods such as infection. |
2) Child should be aware of lack of alternatives for treatment
3) Responsibility of telling the child lies with the physician but the nurse should be present or aware of the exact conversation 4) Child should be told a few days before the surgery to think about the diagnosis, treatment and prepare questions |
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Chemotherapy, as well, shoud be discussed without offering too much information,
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1) Hair loss, focus on the positive aspects, such as wearing a wig.
2) Adolescent may become angry over all the radical body alterations |
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If amputation is performed, the child
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1) is fitted with a temporary prosthesis immediately after surgery
2) permits early functioning 3) psychological adjustment 4) PERMANENT PROSTHESIS IS USUALLY FITTED WITHIN 6-8 WEEKS |
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Phantom limb pain, signs and symptoms
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1) tingling
2) itching 3) pain REAL NOT IMAGINED Administer: Amitriptyline (Elavil) |
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Stump care requires |
elevation for the first 24 hours then no elevation after that to prevent contractures |
