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What is a sarcoma?

A Sarcoma is a type of cancer that originates in the cells of mesenchymal (connective tissue) origin. The main types of sarcomas are: bone and soft tissue sarcomas.

Sarcomas that start in bones are known as osteosarcomas, and sarcomas which are most often seen in children, are the Ewing Sarcomas or the Ewing Family of Tumours.

As the name suggests, these are tumours, which can develop in soft tissues like muscle, fibrous tissue or fat surrounding joints, blood vessel, or deep skin tissues. They can develop in any part of the body. Most soft tissue sarcomas start in the arms or legs but can also be seen in the head and neck area, trunk, in the internal organs and in the area behind the abdominal cavity. Based on the type of tissue they start in, there are many types of soft tissue sarcomas, some of which are also benign.

As in some other cancers, soft tissue sarcomas might not exhibit obvious symptoms in the early stages but as a tumour grows, these are some signs to watch out for:

• A noticeable lump or swelling
• If the tumour is pressing down on nerves or muscles, it will cause pain
• Abdominal pain, a feeling of fullness or constipation that persists over time
• A cough or breathlessness if the cancer is near the lungs

See your doctor if you have a lump that is increasing in size or becomes painful, recurrence of a lump that’s been removed or a lump of any size located deep within a muscle. Although these could be cysts or lipomas (fatty lumps), which are non-cancerous, it’s recommended to have them checked out.

In a majority of soft tissue sarcomas, the exact cause is unclear. Generally speaking, cancer is caused by cells dividing uncontrollably and forming tumours in parts of the body, but there are a number of factors, which are known to increase the risk of soft tissue sarcomas:

• Age: while sarcomas can occur at any age (even children can be affected), they are more commonly seen in older age groups and the risk increases as you get older;
• Genetic conditions: conditions, such as neurofibromatosis type 1 and retinoblastoma, are linked to an increased risk of soft tissue sarcomas
• Previous treatment with radiotherapy: some people who have been treated with radiotherapy for other cancers might be at a greater risk
• Exposure to certain chemicals: chemicals, such as dioxins and phenoxyacetic herbicides, may also raise the risk of getting sarcomas.

The following are some methods to help diagnose sarcoma:

• X-rays, which can show the location, shape and size of a tumor;
• A bone scan, which is a test in which a small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it then collects in the bones and is detected by a scanner;
• A computed tomography (CT or CAT) scan and/or magnetic resonance imaging (MRI) procedure;
• A positron emission tomography (PET) scan, in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used;
• Biopsy (removal of a tissue sample from the bone tumor) to determine whether cancer is present. The surgeon may perform a needle biopsy or an incisional biopsy; and An angiogram, which is an x-ray of blood vessels.

What are the treatment options for soft tissue sarcoma?
Before deciding on a treatment plan, doctors take into account various factors, such as where the cancer has developed, how far it has spread, the type of sarcoma it is, the patients age and overall health. The main treatments include surgery, radiation therapy, and chemotherapy.