BENGALURU : Human body is made up of various organs such as brain, lung, liver, breast, uterus, ovary, kidneys and so on. When cancers develop in these organs they are called carcinomas. However, these organs are held together and supported by various tissues such as bones, muscle, fat, blood and lymph vessels, and nerves, which are termed as connective tissues. When cancer develops in these connective tissues, they are called sarcomas. When cancers occurs in the bones it is called bone sarcoma and in the other connective tissue, it is called soft tissue sarcoma.
By and large, sarcomas are much rarer that carcinomas and constitute less than 1% of all cancers seen in the adults. However, it is much more common in the children and youth where it constitutes 20% of all cancers. Since the connective tissues are present everywhere in the body, it can occur at any place, but is more commonly seen in arms, legs and trunk. Depending upon the tissue of origin, these sarcomas can be of various types such as bones – osteosarcoma, muscles- leiomyosarcoma, fat – liposarcoma, blood vessels – angiosarcoma, lymph vessels – lymphangiosarcoma etc. They all look different under the microscope and different type of sarcoma may need different treatment.
Most of the time, there is no specific cause identified of sarcoma. However, various factors may increase one’s risk of developing sarcoma such as exposure to certain chemicals (arsenic, vinyl chloride etc), radiation or having certain genetic defects (Retinoblastoma, Li- Fraumeni, Neurofibromatosis, Gardner syndrome, Tuberous Sclerosis etc).
They frequently present with pain and swelling. Depending upon the location of the sarcoma they can present with a variety of symptoms and can sometime be difficult to diagnose and hence are frequently diagnosed late. Sarcomas have the ability to invade the surrounding tissues and spread (metastasize) to other organs. Once a suspicion of sarcoma is there, the best way to diagnose it, is to undergo a biopsy test, where a needle is inserted into the swelling and a small piece of the disuse is sent for testing. This test will enable the doctor to confirm if this is indeed a sarcoma and also the type of sarcoma that is present.
Often, various other tests such as Immunohistochemistry and Molecular profilling are required to obtain the correct diagnosis. A CT Scan, MRI scan or PET CT scan may also be required to ascertain the characteristics of the tumour and the extent of spread. The main treatment modalities are surgery, radiotherapy, chemotherapy and targeted therapy. Sometimes a combination of these treatment are required depending upon the nature and stage of sarcoma. Sarcoma diagnosed in early stages are generally curable, but not so in advanced stages. Limb preservation surgeries are generally attempted and have become standard practise wherever possible. In advanced stages chemotherapy and targeted therapies are the mainstay on treatment.
Early diagnosis of sarcoma is vital to its outcome. Sarcomas are commonly present as a lump on the arms or legs. If identified and treated at size less than 5 cm (golf ball), the outcomes are significantly better than larger sizes. People with a strong family history of cancers should talk to their doctor regarding family genetic counselling and testing to identify their risk of sarcoma. Routine screening is not required for individuals who do not have a genetic predisposition, but should certainly seek medical help if they have any symptoms.– Lead & Senior Consultant, Medical Oncology & Haematology,Aster CMI Bangalore