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Sarcoma is a rare type of cancer that originates in the body's connective tissues, which include bones, muscles, fat, blood vessels, nerves, tendons, and soft tissues. Sarcomas account for only a small percentage of all cancer cases, approximately 1% of adult cancers and 15% of childhood cancers. Despite their rarity, sarcomas are a significant concern due to their aggressive nature and potential to spread to other parts of the body.
Types of Sarcoma
- Soft Tissue Sarcomas: These arise in the soft tissues of the body and can develop in any part, including the muscles, tendons, nerves, blood vessels, and fatty tissues.
- Bone Sarcomas: They form in the bones, most commonly around the knee.
Sarcoma Symptoms
The symptoms of sarcoma depend on the location and size of the tumour. Common signs and symptoms may include:
- A palpable lump or mass that may or may not be painful
- Localised pain or tenderness
- Limited range of motion, especially if the tumour affects joints or muscles
- Fatigue and unexplained weight loss in advanced cases
- Pressure or compression of nearby structures, leading to symptoms such as nerve pain or difficulty breathing (depending on the location of the tumour)
Sarcoma Causes
The exact cause of sarcomas is not always known. However, certain risk factors have been identified, including:
- Genetic Factors: Some rare genetic conditions, such as Li-Fraumeni syndrome and hereditary retinoblastoma, increase the risk of developing sarcomas.
- Radiation Exposure: Prior exposure to high doses of radiation, such as during cancer treatments, may increase the risk of developing sarcomas.
- Environmental Factors: Some chemicals, such as vinyl chloride and arsenic, have been associated with an increased risk of developing sarcomas.
- Age: Sarcomas can occur at any age, but some subtypes are more common in specific age groups (e.g. Ewing sarcoma in adolescents).
Sarcoma Diagnosis
Diagnosing sarcoma requires a comprehensive approach involving various tests and procedures, including:
- Biopsy: A tissue sample is taken from the suspected tumour site and examined under a microscope to confirm the presence of cancerous cells and determine the type of sarcoma.
- Imaging Studies: X-rays, MRI (Magnetic Resonance Imaging), CT (Computed Tomography) scans, and PET (Positron Emission Tomography) scans help evaluate the size, location, and extent of the tumour, as well as check for potential metastasis.
- Genetic Testing: It may be performed to identify specific genetic abnormalities associated with certain sarcoma subtypes.
Sarcoma Treatment
The treatment approach for sarcoma depends on several factors, including the type and stage of the cancer, its location, and the patient's overall health. Common treatment modalities include:
- Surgery: It is the primary treatment for localised sarcomas. Whenever possible, surgeons aim to achieve wide margins to reduce the risk of recurrence.
- Radiation Therapy: This treatment uses high-energy X-rays or other forms of radiation to target and kill cancer cells. It may be used before surgery to shrink the tumour or after surgery to eliminate any remaining cancer cells.
- Chemotherapy: Systemic administration of anticancer drugs to destroy cancer cells or stop their growth. Chemotherapy is commonly used for sarcomas that have a higher risk of spreading or those that cannot be adequately treated with surgery alone.
- Targeted Therapy: Some sarcomas have specific genetic abnormalities, and targeted drugs can be used to block the signalling pathways that promote tumour growth.
- Immunotherapy: Although still in the early stages of sarcoma treatment, immunotherapy aims to stimulate the patient's immune system to recognise and attack cancer cells more effectively.
Prevention of Sarcoma
Since the exact cause of most sarcomas remains unknown, specific prevention measures are challenging to define. However, some general strategies that may reduce the risk include:
- Avoiding Exposure to Harmful Chemicals: Minimise exposure to known carcinogens and hazardous chemicals.
- Monitoring Genetic Risk: If there is a family history of sarcoma or related genetic conditions, genetic counselling and testing may be considered.
- Radiation Safety: If you require radiation therapy for another medical condition, discuss the potential risks and benefits with your healthcare team.
- Regular Health Checkups: Timely detection and early intervention can significantly improve the prognosis, so it's crucial to undergo regular health checkups and report any unusual symptoms promptly.
- Any lump or swelling that is more than 5cm in size should be promptly investigated.
- Bone pain in an adolescent or a child that does not get better with the usual treatment should be further investigated.
Reviewed & Updated On
Reviewed by Dr. Akshay Tiwari, Director & Head, Musculoskeletal Surgical Oncology, Cancer Care / Oncology, Paediatric (Ped) Oncology, Surgical Oncology on 28-July-2023.
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