All You Need to Know Soft Tissue Sarcoma Cancer

What is Sarcoma?

A sarcoma is a rare malignant or cancerous tumor that forms or develops in the connective tissue and the bone, including muscle, fat, and the tissue and nerves surrounding joints and bones. Sarcoma can occur anywhere in the body, as these tissues and nerves are everywhere. However, it is relatively uncommon and can also be considered a “forgotten cancer”. It can develop in the neck, arms, shoulders, head, chest, abdomen, hips, tendons, and hands.

Nearly 15% of sarcomas occur in the head or neck; 40% occur in the arm or leg; 30% occur in the abdomen; and 15% occur in the shoulders or hands. Sarcomas are of different types, which are dependent on the location and size of the tumor. Also, some of the sarcomas grow and spread more rapidly than others.

What are the Types of Sarcomas?

It can be divided into bone and/or soft tissue tumors. Sarcoma has more than 70 known subtypes.

1. Bone carcinomas: This type of primary sarcoma develops in the bone. However, metastatic bone cancer has a different origin in a different organ and spreads to the bone. This cancer develops in many forms, often traveling from the breast, lung, prostate, lung, or kidney. When this spreads to the skeleton, it can cause structural problems in the bones that may lead to pain and reduction in function. It includes osteosarcoma, chordoma, fibrosarcoma, chonrosarcoma, and Ewing’s sarcoma.

2. Soft Tissue Sarcoma: This type of sarcoma develops in the connective tissue or other muscles in the body. Unlike bone sarcomas, soft tissue sarcomas mostly occur in adults. It commonly develops in the abdomen, arms, and legs. It includes-

• Angiosarcoma– It is a rare kind of soft tissue cancer that forms in blood and lymph vessels. It commonly occurs in the neck and head, although it can occur anywhere in the body.
• Gastrointestinal Stromal Tumor (GIST)– It begins in the digestive system. The tumor grows in the nerve cells in the walls of digestive organs like the small intestine and stomach.
• Dermatofibrosarcoma Protuberans (DfSP)– It is rare and develops in the connective tissue cells in the dermis, or middle layer, of the skin. It develops in the trunk, arms, and legs.
• Liposarcoma– It is a rare form of cancer that develops in the fat cells. It most commonly occurs in the abdomen or in the muscles of the legs and arms. But can also occur in the fat cells anywhere on the body.
• Epithelioid Sarcoma– It develops as a firm growth or lump under the skin (nodule) of the knee, forearm, hand, finger, or lower leg.
• Leiomyosarcoma– It develops in smooth muscle tissue like the urinary system, uterus, digestive system, and blood vessels.
• Malignant Schwannoma– This is a rare form of sarcoma that occurs in the lining of the nerves. It might be present as a lump or mass.
• Rhabdomyosarcoma (common in children)– It is a rare type of cancer and develops specifically in skeletal muscle tissue or sometimes in organs like the uterus or bladder (hollow organs).
• Synovial Sarcoma– It is rare and usually develops near large joints. A lump is common swelling that may be painless.

What are the Sarcoma Symptoms?

• A painless lump that can be felt under the skin that gets bigger over time
• Swelling in the abdomen leads to constipation and a feeling of fullness
• Pain in the bone
• Swelling near the lungs leads to breathlessness and coughing
• Pain in the abdomen
• Unexpected weight loss

What are the Causes of Soft Tissue Sarcoma?

In most cases of sarcoma cancer, there is no apparent reason for its development.

• Age: Soft tissue cancer can develop at any age, in both adults and children, but it is more common in elderly and middle-aged people
• Genetic conditions: People who have been diagnosed with certain kinds of inherited and genetic diseases have an increased risk of sarcoma.
• Chemical exposure: According to research, exposure to certain chemicals like thorium dioxide, vinyl chloride (found in plastic), phenoxyacetic acid (herbicides), arsenic, and chlorophenols (preservatives for wood).
• Radius radiotherapy: Patients with previous radiation therapy for unrelated cancer have a higher risk of developing cancer in the location of the radiation.
• Exposure to viruses: Infections by Human Immunodeficiency Virus (HIV) and Herpesvirus 8 can weaken the immune system and increase the chances of sarcoma. The autoimmune disease also increases the risk.

How is Sarcoma Diagnosed?

Both cancerous and benign tumors can show up in imaging tests.

• X-ray: In this, images are created of the organs, and structures in the body are formed by using a small amount of radiation. They are specifically useful for sarcomas in the bones but can be less efficient in soft-tissue sarcomas.
• Biopsy: It is the most accurate way to diagnose sarcoma. A section of tissue is removed from the affected area and sent for diagnosis. After investigation, it is confirmed whether the tumor is sarcoma.
• Computed tomography (CT Scan): This scan forms images inside the body using X-rays taken from different angles. These images are combined in 3D and detailed images. It is useful for spotting abnormalities and tumors.
• MRI Scan: Magnetic fields are used to obtain detailed images of the body. It also provides information about the size of the tumor. A special dye or contrast medium is given prior to the scan. It is used to check if the sarcoma can be operated on.
• PET Scan: In this, a glucose tracer is injected into the body. This tracer is radioactive and detects abnormal or cancerous cells that accumulate high amounts of glucose. The scanner detects the tracer and produces images of the locations that show such abnormalities.

What are the Treatment Options for Sarcoma?

Doctors like Orthopedics, Surgical Oncologists, and Radiation Oncologist diagnose Sarcoma and dispense treatment accordingly. Treatment depends on the location, size, and stage of the tumor.

• Surgery: In this, the tumor and some surrounding healthy tissue are removed during the operation. It is important that a person have a biopsy to check if surgery is possible. It is effective for benign or localized tumors but may not be useful for metastatic tumors as they spread to other organs.
• Chemotherapy: Specialized medications are used to treat sarcoma. These medicines destroy or stop the growth and division of the tumor cells. It can be given before or after the surgery and in combination with radiation. The side effects of chemotherapy subside after the therapy is over.
• Radiation therapy: In this, high-energy X-rays or other particles are used to destroy the cancer cells. Advanced techniques minimize the damage to healthy tissues surrounding the tumor. It can be given before surgery to shrink the tumor, but it can also be given after the surgery to destroy any remaining cancer cells.
• Thermal therapy: The tumor is heated or frozen for destruction. It is usually done through guided imaging, like a CT Scan, through which the probes are placed at the location of the tumor for the procedure to be carried out.
• Targeted therapy: In this, the genes and proteins or the environment supporting the growth of cancer that are specific to the growth of the tumor are targeted. Proteins called kinases are blocked in the tumor, stopping its growth and spread and limiting damage to healthy cells.

Some doctors who treat sarcoma are-

>>Orthopedic doctors

1. Dr. Dhananjay Gupta

Fortis Flt. Lt. Rajan Dhall Hospital, Delhi

Qualification: MBBS, DNB

Experience: 20 years

2. Dr. Devendra Singh

Artemis Health Institute, Gurgaon

Qualification: MBBS, MS Ortho, MCh Ortho

Experience: 21 years

>>Surgical Oncologists

1. Dr. Pankaj Kumar Pande

Max Super Specialty Hospital, Shalimar Bagh, Delhi,

Qualification: MBBS, MS

Experience: 20 years

2. Dr. Naveen Sanchety

Asian Institute of Medical Sciences, Faridabad

Qualification: MBBS, DNB(Surgery), DNB (Oncosurgery)

Experience: 10 years

>>Radiation Oncologist

1. Dr. Gagan Saini

Max Super Speciality Hospital, Vaishali

Qualification: MBBS, MD

Experience: 19 years

2. Dr. Anil Thakwani

Sharda Hospital, Noida

Qualification: MBBS, MD

Experience: 22 years

References:

• MediGence
• Cleveland Clinic
• Cancer.Net