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Osteosarcoma: Signs, Symptoms, and Disease Characteristics

Signs and Symptoms

Pain: Persistent bone pain that worsens at night or with activity, often in the long bones of the arms or legs. Swelling: Noticeable swelling or lump near the affected bone, which might not appear until the tumor grows significantly. Fractures: Bones weakened by the tumor may fracture easily, even with minimal trauma. Limited Range of Motion: Tumors near joints can restrict movement and cause stiffness. Fatigue: General fatigue and weakness, possibly exacerbated by cancer treatments. Weight Loss: Unexplained weight loss and reduced appetite, common in many cancer types.

Disease Characteristics

Primary Bone Cancer: Osteosarcoma is the most common type of bone cancer, primarily affecting children and young adults. High-Grade Malignancy: Typically aggressive and fast-growing, often originating in the metaphysis of long bones like the femur, tibia, or humerus. Metastasis: Often spreads to the lungs and, less commonly, to other bones. Treatment: Includes a combination of surgery (e.g., limb-sparing or amputation), chemotherapy, and occasionally radiation.

How Physical Activity/Exercise Can Prevent, Treat, or Reverse Osteosarcoma-Related Challenges

Prevention While osteosarcoma itself cannot be entirely prevented due to its links to genetic mutations, physical activity can indirectly contribute to overall bone health and reduce risks associated with bone weakness and fractures: Promotes Bone Density: Weight-bearing exercises like walking or resistance training can enhance bone density, reducing fracture risks in individuals predisposed to bone fragility. Boosts Immune System: Regular physical activity strengthens the immune system, improving the body's ability to repair damage and potentially delay the onset of related bone conditions.

During Treatment

Physical activity is highly beneficial during osteosarcoma treatment to counteract the side effects of chemotherapy, surgery, and immobilization: Prevents Muscle Atrophy: Targeted resistance exercises (e.g., resistance bands, light weights) maintain muscle strength in areas not affected by surgery or the tumor. Reduces Fatigue: Light aerobic activity, such as walking or cycling, has been shown to decrease cancer-related fatigue by improving circulation and oxygen delivery. Improves Joint Mobility: Stretching and low-impact yoga maintain joint flexibility and prevent stiffness after surgery or periods of inactivity. Supports Psychological Health: Regular exercise releases endorphins, which help combat anxiety and depression associated with cancer diagnoses and treatment.

Post-Treatment and Recovery

Exercise can play a transformative role in rehabilitation and long-term health: Rebuilds Strength: Progressive resistance training strengthens muscles and stabilizes joints, particularly around prosthetics or reconstructed areas. Improves Balance and Coordination: Balance-focused exercises like tai chi or simple stability drills help reduce fall risks in patients adapting to limb loss or prosthetics. Enhances Cardiovascular Health: Post-treatment fatigue and deconditioning are countered by moderate aerobic activities like swimming or elliptical training, which also improve lung function (important for those with pulmonary metastases). Bone Health: Weight-bearing activities help rebuild bone density lost during prolonged immobilization or chemotherapy-induced bone weakening. Prevents Recurrence of Secondary Issues: Maintaining a healthy weight and reducing systemic inflammation through physical activity can lower the risk of secondary health conditions, such as metabolic syndrome.

Recommendations for Specific Exercises

Early-Stage: Focus on low-impact and adaptive exercises. Duration: 10–15 minutes daily, gradually increasing intensity as tolerated. Mid-Treatment (During Chemo or Recovery): Gentle walking, seated resistance exercises, or aquatic therapy. Emphasize rest when needed but remain as active as possible. Post-Treatment: Develop a progressive exercise routine including: 150 minutes of moderate aerobic activity per week. Strength training 2–3 times per week with a focus on major muscle groups. Flexibility and balance exercises (e.g., yoga, Pilates).

Special Considerations and Contraindications for Physical Activity in Osteosarcoma

Bone Health and Risk of Fracture Avoid high-impact or contact sports (e.g., running, basketball) to reduce the risk of fractures, particularly in weakened or post-surgical bones. Emphasize low-impact activities and adapt exercises to avoid stressing affected areas. Surgical Recovery and Prosthetics For patients recovering from surgery (e.g., limb-sparing procedures or amputations), consult a physical therapist to design a safe and gradual rehabilitation program. Prosthetic users may require balance training and modifications to certain activities. Fatigue and Chemotherapy Effects Adjust intensity and duration based on energy levels. Cancer-related fatigue may limit exercise tolerance, necessitating frequent rest breaks. Pain or Discomfort Stop activities that cause sharp pain or exacerbate swelling. Use non-weight-bearing exercises if weight-bearing is painful.

Exercise Prescription

Here is a list of possible activities or exercises Cardiovascular Activities

Walking Cycling (recumbent or stationary) Swimming/Aquatic Therapy Elliptical Training Strength Activities

Resistance Band Exercises Bodyweight Exercises (e.g., wall push-ups, seated leg lifts) Light Dumbbell Exercises (e.g., seated shoulder presses) Modified Pilates Flexibility/Balance Activities

Gentle Yoga or Chair Yoga Stretching (e.g., hamstring stretches, shoulder rolls) Tai Chi Balance Drills (e.g., heel-to-toe walking, single-leg stance)

Here are 3 sample Exercise Plans to cover Cardio Vascular, Strength, and Bench and Flexibility

Aerobic Exercise (10–15 minutes) Low-impact options to improve cardiovascular health and stamina: Walking (flat surface or treadmill, starting with 5 minutes and gradually increasing) Cycling on a recumbent bike Aquatic exercises, such as water walking or light swimming (great for joint and bone stress reduction)

Strength Training (10–15 minutes) Focus on maintaining muscle mass and bone strength: Upper body: Seated resistance band exercises (e.g., chest press, rows) Lower body: Chair-assisted squats or standing leg lifts Core: Seated leg raises or gentle pelvic tilts Use light weights (1–2 lbs) or resistance bands, gradually increasing as tolerated.

Flexibility and Balance (5–10 minutes) To improve mobility, reduce stiffness, and prevent falls: Gentle yoga poses, such as seated forward folds or cat-cow stretches Standing heel-to-toe walk for balance Stretching major muscle groups (hamstrings, calves, shoulders)

Here are four YouTube videos that explains the different sections of this page

https://www.youtube.com/watch?v=h7MNWBtiiy0

https://www.youtube.com/shorts/8Mi0jAbkaBU

https://www.youtube.com/shorts/8IfBM-IZUto

https://www.youtube.com/watch?v=hAV33PRpFLk

Here is a video to explain our wiki entire wiki information page

Here are 10 pages to learn more about Osteosarcoma

Mayo Clinic https://www.mayoclinic.org/diseases-conditions/osteosarcoma/care-at-mayo-clinic/mac-20351055?customer_id=173-378-9621&mc_id=google&campaign=21409886136&geo=9010391&kw=osteosarcoma&ad=703920883113&network=g&sitetarget=&adgroup=160800892501&extension=&target=kwd-305804590708&matchtype=p&device=c&account=1733789621&invsrc=cancer&placementsite=enterprise&gbraid=0AAAAAD8Qu2-wKE3NUMQ09kYD7fWF4_6s9&gclid=CjwKCAiA0rW6BhAcEiwAQH28InENI6EGlgLsmlL2zHlXG9RlnweZtj5aHDD3PPNRlumOLUMKPKKiUBoCP9QQAvD_BwE American Cancer Society https://www.cancer.org/cancer/types/osteosarcoma/about/what-is-osteosarcoma.html

National Library of Medicine-https://pubmed.ncbi.nlm.nih.gov/32483741/#:~:text=Exercise%20has%20the%20potential%20to,directly%20impact%20cancer%20treatment%20efficacy.Osteosarcoma Institute

Bone Cancer Research Trust- https://www.bcrt.org.uk

National Cancer Institute (NCI -https://www.cancer.gov

Osteosarcoma Collaborative -https://oscollaborative.org

Children’s Cancer Research Fund -https://childrenscancer.org

Osteosarcoma Now -https://osteosarcomanow.org

Osteosarcoma Decision Aid- https://osteosarcomadecisionaid.com

MIB Agents Osteosarcoma Alliance- https://www.mibagents.org