Sarcoma is a rare type of cancer that begins in the bones or soft tissues, such as muscles, fat, and blood vessels. While less common than other cancers, understanding sarcoma is crucial for early detection and effective treatment.
Unlike carcinomas, which originate in the epithelial cells of organs, sarcomas develop from the mesodermal layer, forming tumours in diverse areas of the body, including the limbs and internal organs.
This guide will provide an in-depth look at sarcoma, covering its types, symptoms, causes, diagnostic methods, treatment options, and survival outlook to help you better understand this condition and its management.
What are the types of sarcoma?
Sarcomas are primarily classified into two categories: soft tissue sarcomas and bone sarcomas. Each type includes various subtypes, affecting different parts of the body.
Soft Tissue Sarcomas
Soft tissue sarcomas develop in soft tissues such as muscles, fat, blood vessels, and connective tissues. They can occur anywhere in the body but are most frequently found in the arms, legs, and abdomen. Due to their non-specific symptoms, these sarcomas can be challenging to diagnose.
Here are the main types of soft tissue sarcomas:
- Angiosarcoma: A rare cancer originating in blood or lymphatic vessels.
- Desmoplastic Small Round Cell Tumours (DSRCT): An aggressive sarcoma typically affecting the abdomen, often in young individuals.
- Gastrointestinal Stromal Tumour (GIST): Tumours found in the gastrointestinal tract, commonly in the stomach or small intestine.
- Leiomyosarcoma: Cancer of smooth muscle tissue, often found in the uterus, stomach, or blood vessels.
- Liposarcoma: A tumour in fatty tissues, usually located in the abdomen or thighs.
- Malignant Peripheral Nerve Sheath Tumour (MPNST): A cancer originating in the protective coverings of nerves, often seen in the limbs or trunk.
- Malignant Schwannoma: A subtype of MPNST derived from Schwann cells, responsible for forming the myelin sheath around nerves.
- Myxofibrosarcoma: A rare tumour affecting limbs, involving fibrous and mucous tissues.
- Rhabdomyosarcoma: The most common soft tissue sarcoma in children, beginning in skeletal muscles.
- Synovial Sarcoma: A soft tissue sarcoma commonly affecting joints, particularly around the knee.
- Undifferentiated Pleomorphic Sarcoma (UPS): Previously known as malignant fibrous histiocytoma, this tumour usually affects the limbs in older adults.
Bone Sarcomas
Bone sarcomas arise from bone cells and are commonly found in the arms, legs, pelvis, or spine. They can also be found in the jaw bones or facial areas. They are more prevalent in adolescents and young adults but can also affect older individuals. Symptoms often include localised pain or swelling, sometimes mistaken for fractures or arthritis.
Key subtypes of bone sarcomas include:
- Osteosarcoma: The most common bone sarcoma, usually affecting bones during growth spurts in adolescents and young adults but it can also affect older adults. If untreated, it can spread to the lungs or other areas. In the mouth this type of cancer is most frequently found in the lower jaw and often identified during routine visits and when your dentist takes a panoramic x-ray.
- Ewing’s Sarcoma: A rare, aggressive bone sarcoma primarily affecting children and adolescents. It often begins in the pelvis, legs, or ribs, causing pain, swelling, or fever. Although rare in the face region, it can occur in the soft tissue and bones. Early detection is critical due to its high risk of spreading.
- Chondrosarcoma: This type arises from cartilage cells, typically in older adults. It most commonly affects the pelvis, hip, or shoulder. In your mouth, this type of cancer occurs in the upper area of the mouth. Though it grows slowly, early detection is crucial for successful treatment.
Common Symptoms of Sarcoma
The symptoms of sarcoma vary depending on the tumour’s location. In its early stages, some sarcomas may not produce noticeable symptoms. In other cases, a sarcoma might present as a painless lump under the skin, becoming painful only as it grows and presses on nearby organs or tissues.
Bone sarcomas, in particular, may cause persistent pain or swelling in the arms or legs, often worsening at night, which can impair mobility. When it presents in the jaw bones it may cause swelling or changes in facial structure.
Common symptoms of sarcoma include:
- A new lump, which may or may not be painful.
- Pain in an arm, leg, abdomen, or pelvis.
- Difficulty moving a limb, such as limping or restricted motion.
- Unexplained weight loss.
- Persistent back pain.
These symptoms can overlap with those of other conditions, making it crucial to consult a healthcare provider for an accurate diagnosis. Early medical evaluation is essential to distinguish sarcoma from other potential causes and to initiate timely treatment if necessary.
How symptoms of sarcoma vary by type and location?
The symptoms of sarcoma can differ significantly based on its type and location. While some symptoms are common across many types of sarcomas, others are more specific to the tumour’s location or subtype. Below are examples of symptoms associated with different sarcoma types:
- Soft Tissue Sarcomas: Pain, swelling, or digestive issues may occur if the tumour is located in the abdomen or involves internal organs.
- Bone Sarcomas: Commonly cause bone pain, swelling, and, in severe cases, fractures. Osteosarcoma and Ewing’s sarcoma often result in pain that worsens with activity or at night.
- Liposarcoma: Usually appears as a painless lump but may cause discomfort or pressure if the tumour grows large.
- Ewing’s Sarcoma: Symptoms include pain, swelling, fever, and sometimes skin discoloration near the tumour site.
- Leiomyosarcoma: Depending on its location, it may cause abdominal pain, blood in the stool or urine, or abnormal bleeding.
Important Note: If you experience any of these symptoms, particularly unexplained lumps or persistent pain, consult a healthcare provider promptly. Early evaluation is critical for accurate diagnosis and effective treatment.
What are the causes and risk factors of sarcoma cancer?
Sarcoma develops when immature bone or soft tissue cells undergo DNA mutations, transforming into cancer cells that grow uncontrollably. These abnormal cells form tumorus that can invade nearby healthy tissues.
If left untreated, sarcomas can spread to other organs through the bloodstream or lymphatic system, a process known as metastasis, which is challenging to treat. While the exact cause of these mutations remains unclear, certain factors may increase the likelihood of developing sarcoma.
Risk Factors for Sarcoma:
- Exposure to Chemicals: Prolonged contact with harmful substances such as arsenic, vinyl chloride (used in plastic production), phenoxyacetic acid (found in herbicides), and chlorophenols (used in wood preservatives) may heighten the risk. Smoking contains a lot of harmful carcinogenic substances and enters through your mouth and soft tissue.
- Radiation: High doses of radiation from previous cancer treatments can contribute to the development of sarcoma.
- Lymphedema: Chronic swelling in the arms or legs due to fluid buildup increases vulnerability to certain types of sarcoma.
- Genetic Conditions: Specific inherited disorders and chromosomal mutations are linked to a higher risk of sarcoma. These include:
- Gardner syndrome
- Werner syndrome
- Von Hippel-Lindau disease
- Gorlin syndrome
- Tuberous sclerosis
- Li-Fraumeni syndrome
- Retinoblastoma
- Neurofibromatosis type 1
Understanding these risk factors can aid in early detection and preventative measures. However, it’s important to note that many individuals with these risk factors may never develop sarcoma, while others without them might still be diagnosed. Regular medical check-ups and discussing concerns with healthcare professionals are crucial for managing risks.
How is sarcoma diagnosed?
Diagnosing sarcoma begins with a thorough medical history review and physical examination conducted by your healthcare provider. Based on the findings, they may recommend specific diagnostic tests to confirm the presence of sarcoma and identify its type.
A biopsy, where tissue from the tumour is analyzed, is typically the definitive method for diagnosis. Below are some commonly used diagnostic tools and their purposes:
X-ray
X-rays use a small amount of radiation to capture images of bones and soft tissues. They are often the first test used to detect abnormalities in the affected area. In dentistry jaw bone issues can be identified through a routine PAN x-ray (Panoramic)
CT Scan
A CT scan combines multiple X-ray images to create cross-sectional views of your body. It provides detailed images of bones, organs, and tissues, helping to locate and assess the size of the tumour.
MRI (Magnetic Resonance Imaging)
MRIs use magnets and radio waves to produce highly detailed images of soft tissues. Your provider may recommend this test for better visualization of the tumour, especially if an X-ray or CT scan suggests an abnormality.
Bone Scan
In a bone scan, a small amount of radioactive material is injected into your bloodstream. This material accumulates in areas of abnormal bone activity, which may indicate the presence of bone sarcoma.
PET Scan (Positron Emission Tomography)
A PET scan uses a special glucose tracer that attaches to cells with high glucose levels, such as cancer cells. It highlights areas of increased metabolic activity, which can indicate tumorus or metastasis.
Biopsy
A biopsy involves removing a small sample of tissue from the tumour for laboratory analysis. A pathologist examines the sample under a microscope to determine if it is sarcoma and to identify its specific type. This step is critical for guiding treatment decisions.
What are the treatment options for sarcomas?
Sarcoma treatment involves a team of specialists, including surgeons, radiologists, geneticists, oncologists, and supportive care professionals. Treatment plans vary depending on the type, size, location, and stage of the sarcoma, as well as the patient’s overall health.
Surgery
Surgery is often the primary treatment, aiming to remove all cancer cells while preserving as much healthy tissue as possible. This may involve:
- Wide Local Excision: Removing the tumour along with a margin of healthy tissue to ensure no cancer remains.
- Limb Salvage: Removing the tumour and reconstructing the area with metal replacements or bone grafts from another part of the body.
- Amputation: In rare cases, amputation may be necessary, especially when preserving the limb isn’t feasible.
Radiation Therapy
Radiation therapy uses high-energy X-rays to kill cancer cells while sparing healthy tissues.
- Internal Radiation (Brachytherapy): Delivered during or after surgery via implanted catheters.
- External Radiation: Directed at the tumour from a machine.
Advanced radiation techniques focus the beams on cancerous areas, reducing harm to surrounding tissues.
Chemotherapy
Chemotherapy uses drugs to kill or slow fast-dividing cancer cells. It can be administered intravenously or orally and is often used before surgery to shrink tumours or after surgery to eliminate residual cancer cells. In some cases, chemotherapy is combined with radiation therapy to enhance its effectiveness.
Targeted Therapy
Targeted therapy focuses on genetic or molecular vulnerabilities in cancer cells, leaving healthy tissues unharmed. This precision approach is suitable for specific sarcoma types and is often combined with other treatments.
Immunotherapy
Immunotherapy enhances the immune system’s ability to detect and destroy cancer cells. It helps the body overcome cancer’s strategies to evade immune detection, offering a valuable option for some sarcoma patients.
Thermal Ablation
Thermal ablation destroys cancer cells using extreme temperatures. Guided by imaging tools like CT scans, a probe delivers heat or cold directly to the tumour, effectively eliminating the cancerous tissue.
Palliative Care
Palliative care prioritizes symptom relief and quality of life for individuals with sarcoma. This approach includes pain management, emotional support, and nutritional guidance provided by a team of specialists.
Clinical Trials
Clinical trials offer access to experimental treatments and cutting-edge therapies. These studies may be recommended for patients seeking innovative options based on their specific diagnosis and treatment goals.
Prognosis and Survival Rates
The prognosis for sarcoma depends on factors such as early diagnosis, tumour type, location, and the treatments applied.
Early Detection: Timely diagnosis is critical for better outcomes. Just as regular dental checkups can identify issues like dental implant infections, detecting sarcoma early significantly improves survival rates and treatment success.
Treatment Type: The choice of treatment, influenced by the tumour’s size, location, and stage, plays a major role in determining outcomes.
Sarcoma Location: Tumours in accessible areas, like the limbs, are generally easier to treat compared to those in less accessible regions, such as the abdomen or chest.
What are the survival rates of sarcomas?
The 5-year survival rate for sarcoma depends on its type and stage at diagnosis. Localised sarcomas, which have not spread, have a survival rate of 80-90%. However, for advanced cases where the cancer has metastasized, the survival rate drops significantly.
Early detection and prompt treatment greatly improve survival chances. Regular medical check-ups and monitoring unusual symptoms are essential for better outcomes.
Conclusion
Sarcoma is a rare cancer that can develop in soft tissues or bones. Understanding its types, symptoms, causes, and treatments is essential for early detection and improving outcomes.
Timely treatment significantly boosts survival rates. If you or someone you know has sarcoma, consult healthcare professionals for personalized advice and treatment options.
At Enhance Dental Centre, we prioritize your overall health and offer oral cancer screening services to support early detection. Whether you need expert guidance on managing health concerns or tips for maintaining a healthy lifestyle, our team is here to help.
Contact us today to schedule a consultation and learn how we can support your healthcare needs. Your health is our top priority!
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