What are Soft Tissue Sarcomas?
Soft tissue sarcomas are malignant (cancerous) tumors that can develop from fat, muscle, nerve,
joint, blood vessel, or deep skin tissues. They can develop in any part of the body though many of
them develop in the arms or legs. The rest arise in the trunk, head and neck area, internal organs,
uterus, or the back of the abdominal cavity.
According to the American Cancer Society:
- In 2005, about 9,420 new soft tissue sarcomas will be diagnosed in the United States. Of these, 5,330 cases will be diagnosed in males, and 3,890 cases will be diagnosed in females.
- During 2005, 3,490 Americans (1,910 males and 1,580 females) are expected to die of soft tissue sarcomas. These statistics include both adults and children.
>
Back to top
Risk Factors
A risk factor is anything that may increase your chance of developing a disease. Different diseases, including cancer, have different risk factors. Although these factors may put you at greater risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop soft tissue sarcoma, while others develop the disease without having any of the following risk factors:
- Ionizing radiation: This risk factor accounts for only a small percentage of sarcomas (less than 5%).
The most common cause of radiation exposure in patients who develop sarcomas is from radiation given to treat other tumors, such as breast
cancer or lymphoma.
- Family history: Certain inherited conditions increase a person's risk of developing soft tissue
sarcomas including Neurofibromatosis, Gardner's syndrome, Li-Fraumeni syndrome, Retinoblastoma.
- Damaged lymph nodes: Lymph (a clear fluid containing immune system cells) is transported throughout
the body by lymph vessels and filtered by lymph nodes (small bean-shaped collections of immune system cells). Lymphangiosarcomas, a cancer
of lymph vessels, can develop in parts of the body where lymph nodes have been removed by surgery or damaged by radiation therapy. Although
this is a rare complication, it affects some women who have been treated with radiation to treat their breast
cancer.
>
Back to top
Common Symptoms
There aren't many symptoms for Soft Tissue Sarcomas. The most common is a lump or swelling in a part of the body. The lump may not be
painful.
The vast majority of soft tissue sarcomas occur spontaneously with no known predesposing factors.
>
Back to top
Diagnosis
To find the cause of symptoms, a physical examination and medical testing are required. During the exam, your doctor will review your personal medical history, family history, and potential symptoms. You may also receive one or more of the following medical tests:
- Ultrasound: Ultrasound uses sound waves and their echoes to produce a picture of internal organs or masses.
- Computed Tomography (CT) scan: CT scans use a computer to combine a series of x-rays and produce a three-dimensional image of internal organs and structures within the body. This test may also be done to determine whether the sarcoma has spread to other parts of the body.
- Magnetic Resonance Imaging (MRI): MRI uses radio waves and magnetic fields to obtain superbly detailed anatomical images of the body.
- Positron emission tomography (PET scan): PET is a powerful imaging technique that provides unique information about the body's chemistry, cell function and exact location of disease.
- Biopsy: To diagnose soft tissue sarcoma, a doctor must take a biopsy by removing a portion of tissue from the lump or swollen area of the body. The tissue is then viewed under a microscope to see if cancer cells are present.
>
Back to top
Stages of Soft Tissue Sarcoma
Once adult soft tissue sarcoma is found, more tests (see above) will be done to find out if cancer cells have spread to other parts of the body.
This testing is called staging. A doctor needs to know the stage of the disease to plan a curative treatment strategy. Unlike most other cancers, the size
of a soft tissue sarcoma is not as important as how the cancer cells look under a microscope. The more different the cancer cells look
from normal cells, the higher the grade of malignancy. The following stages are used for adult soft tissue sarcoma:
Stage I
Primary tumor only.
Stage II
Primary tumor with local extension to nearby tissue or regional lymphnodes.
Stage III
Primary and operable metasteses.
Stage IV
The cancer may have spread to other parts of the body, such as the bones or other organs.
Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the tissues where it first started, or it may come back in another part of the body.
>
Back to top
Common Treatment Options
Treatment for soft tissue sarcoma cancers is based on the type, stage, and size of the tumor, prognosis, and ability to tolerate certain medical procedures or medications. The goal of treatment is to preserve healthy tissue while destroying tumors at their point of origin, as well as any cancer cells that have spread throughout the body.
- Surgery
Surgery is the most common treatment of adult soft tissue sarcoma. A doctor may remove the cancer and some of the healthy tissue
around the cancer. Sometimes all or part of an arm or foot may have to be removed (amputated) to make sure that all of the cancer is
taken out. If cancer has spread to lymph nodes, the lymph nodes will be removed as well (lymph node dissection).
Chemotherapy and/or radiation therapy may be used before surgery to shrink the tumor to make surgery more curative.
- Radiation Therapy
Radiation therapy can be used as an adjunct to surgery in the treatment of Soft Tissue Sarcoma. Radiation Therapy uses penetrating beams of high-energy waves called x-rays or gamma rays. Radiation injures or destroys tumor cells by damaging their genetic material, making it impossible for these cells to continue to grow. When radiation therapy is given pre-operatively, it may make surgery more permanently curative. There are two types of radiation therapy:
-
External-beam radiation therapy - Specialized medical equipment is used to deliver radiation to the tumor site from outside the body.
-
Internal radiation therapy - Radioactive material is placed in the body near the cancer cells (also called implant radiation or brachytherapy). Internal radiation therapy is usually used when patients recur after external-beam radiation therapy and the skin and surrounding structures can't tolerate more external-beam radiation therapy.
The way radiation therapy is given depends on the type and stage of the cancer being treated.
- Chemotherapy
Chemotherapy is a type of treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the
cells from dividing. Chemotherapy drugs can be taken orally or by injection depending on the type and stage of the cancer and the type of
drug protocol your doctor has prescribed. Most drugs for sarcomas are given by intravenous injection. It is important to discuss your treatment protocol with your treatment team so you are aware of
any possible side effects. Chemotherapy for Soft Tissue Sarcoma is complicated by the fact that many cancers are resistant to standard
chemo that is used for more common cancers, and there are many types of Soft Tissue Sarcomas that respond to specifically different chemo
requirements.
Some low grade malignant Soft Tissue Sarcomas may not require chemotherapy at all. Chemotherapy given pre-operatively can make surgical resection (not amputation) more permanently curable and yield information about prognosis and/or the need to adjust or change chemotherapy post-operatively to yield the highest cure rate.
