Osteosarcoma: Therapy Options

General measures

  • Nicotine restriction (refraining from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
  • Aim for normal weight! Determination of BMI (Body Mass Index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for the underweight.
    • Falling below the BMI lower limit (from the 19th year of life: 19; from the 25th year of life: 20; from the 35th year of life: 21; from the 45th year of life: 22; from the 55th year of life: 23; from the 65th year of life: 24) → Participation in a medically supervised program for the underweight.

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular follow-up examinations for early detection of a relapse (recurrence of the disease)
    • Because recurrence can occur locally, imaging checks of the primary tumor region should be performed for up to five years (at least until the fourth year) after diagnosis. Thereafter, local recurrences are rare.95% of recurrences occur within the first five years after diagnosis, 80% of which involve the lung. After initial exclusion of lung metastases and successful therapy of the osteosarcoma, pulmonary metastases (daughter tumors in the lung) can still occur 10 years later. Regular X-ray examinations of the thorax (chest) are therefore essential.Skeletal scintigraphy is not necessarily part of routine follow-up examinations, as secondary skeletal metastases without concurrent pulmonary metastases are rare.Local recurrences and pulmonary metastases must be surgically removed. If necessary, chemotherapy is again administered (e.g., carboplatin and etoposide or high-dose ifosfamide). Radiatio (radiotherapy) may be used for inoperable recurrences.
  • Due to the aggressive tumor therapy, follow-up examinations of heart and kidney function and hearing should be performed to detect and treat possible late effects at an early stage. If you wish to have children, the possibility of sperm donation with cryopreservation (deep freezing) should be addressed before chemotherapy.

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
    • Consume only limited energy-rich foods.
    • Moderate total fat intake
    • Little red meat (pork, beef, lamb, veal) and sausages.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
    • Refrain from polluted foods such as offal and wild mushrooms.
    • Do not eat moldy food
  • Observe the following special dietary recommendations:
    • Calcium-rich (1,000 mg calcium/day) diet: fish, fresh vegetables, dairy products, whole grains and nuts are beneficial for bone formation.
    • Vitamin D-rich diet (supplementation with 800-1,000 IU of vitamin D3 required, since no sufficient absorption of vitamin D from food is possible!)
    • Avoidance of phosphate-containing drinks and foods (eg cola drinks, various sausages and meat products).
    • Note that for optimal bone metabolism must be fed less acid-forming foods and instead more base-donating foods.
    • Diet rich in:
      • Vitamins (A, C, D, E, folic acid)
      • Minerals
      • Trace elements (selenium, zinc)
      • Omega-3 fatty acids
      • Secondary plant compounds (e.g.B. Carotenoids, polyphenols)
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Psychotherapy