Sarcoma – the ‘forgotten cancer’ |10 July 2020

Image source: National Cancer Institute

July is sarcoma cancer awareness month, a time dedicated to improving awareness and understanding of what is considered to be a ‘forgotten cancer’.

To learn more about sarcoma, Seychelles NATION spoke to the Cancer Concern Association (CCA). The CCA is a local, non-profit organisation which aims to educate the public, encourage healthy lifestyles, and support cancer patients as well as their families.

In the journey to achieve its mandate and objective, the CCA partners with organisations and individuals both locally and internationally and remains continuously active in its advocacy of the fight against cancer.

Below we share key information about sarcoma cancer obtained from the CCA:

A sarcoma is a type of cancer that starts in tissues like bone or muscle. Bone and soft tissue sarcomas are the main types of sarcoma. Soft tissue sarcomas can develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. They can be found in any part of the body.

The signs and symptoms of sarcoma cancer are usually a bump on the skin or joint pain associated with a formation of a bump pressing on the nerves below.

Types of soft tissue sarcomas

There are more than 50 different types of soft tissue sarcomas and some are quite rare. Below are a few examples of the different types of soft tissue sarcomas but not all are listed here:

-          Adult fibro sarcoma usually affects fibrous tissue in the legs, arms or trunk. It’s most common in people between the ages of 20 and 60, but can occur in people of any age, even in infants.

-          Angiosarcoma can start in blood vessels (hemangiosarcomas) or in lymph vessels (lymphangiosarcomas). These tumors sometimes start in a part of the body that has been treated with radiation. Angiosarcomas are sometimes seen in the breast after radiation therapy and in limbs with lymphedema.

-          Gastrointestinal stromal tumor (GIST) is a type of sarcoma that starts in the digestive tract.

-          Leiomyosarcoma is a type of cancer that starts in smooth muscle tissue. These tumors often start in the abdomen, but they can also start in other parts of the body, such as the arms or legs, or in the uterus.

-          Liposarcomas are malignant tumors of fat tissue. They can start anywhere in the body, but they most often start in the thigh, behind the knee, and inside the back of the abdomen (belly). They occur mostly in adults between 50 and 65 years old.

Intermediate soft tissue tumors

These may grow and invade nearby tissues and organs, but they tend to not spread to other parts of the body. Below are some examples:

-          Dermatofibrosarcoma protuberans is a slow-growing cancer of the fibrous tissue beneath the skin, usually in the trunk or limbs. It grows into nearby tissues but rarely spreads to distant sites.

-          Hemangioendothelioma is a blood vessel tumor that is considered a low-grade cancer (meaning it grows slowly and is slow to spread). It does grow into nearby tissues and sometimes can spread to distant parts of the body. It may start in soft tissues or in internal organs, such as the liver or lungs.

-          Infantile fibrosarcoma is the most common soft tissue sarcoma in children under one year of age. It tends to be slow-growing and is less likely to spread to other organs than adult fibrosarcomas.

Benign soft tissue tumors

Many benign tumors, or tumors that are not cancer, can start in soft tissues. Some examples are:

-          Elastofibromas: benign tumors of fibrous tissue

-          Glomus tumors: benign tumors that occur near blood vessels

-          Granular cell tumors: usually benign tumors in adults that often start in the tongue but can be found almost anywhere in the body

-          Hibernomas: benign tumors of fat tissue

-          Leiomyomas: benign tumors of smooth muscle that can be found anywhere in the body but are very common in the walls of the uterus where they are known as fibroids

Spindle cell tumors

Spindle cell tumors and spindle cell sarcoma are descriptive names used because the cells look long and narrow under the microscope. Spindle cell tumor is not a specific diagnosis or a specific type of cancer. The tumor may be a sarcoma or it can be sarcomatoid – meaning another type of tumor (like a carcinoma) that looks like a sarcoma under the microscope.

Tumor-like conditions of soft tissue

Some changes in soft tissues are caused by inflammation or injury and can form a mass that looks like a soft tissue tumor. Unlike a real tumor, they don't come from a single abnormal cell, they have limited ability to grow or spread to nearby tissues, and never spread through the bloodstream or lymph system to other parts of the body. Nodular fasciitis and Myositis ossificans are two examples which affect tissues under the skin and muscle tissues, respectively.

Sarcoma treatments

How your sarcoma is treated depends on what type you have, where in your body it is, how developed it is, and whether or not it has spread to other parts of your body, or metastasized.

Surgery takes the tumor out of your body. In most cases of osteosarcoma, the doctor can remove just the cancer cells, and you won't need your arm or leg removed.

Radiation can shrink the tumor before surgery or kill cancer cells that are left after surgery. It could be the main treatment, if surgery isn't an option.

Chemotherapy drugs can also be used with or instead of surgery. Chemo is often the first treatment when the cancer has spread.

Targeted therapies are newer treatments that use drugs or manmade versions of antibodies from the immune system to block the growth of cancer cells while leaving normal cells undamaged.

Surviving sarcoma

Most people diagnosed with a soft tissue sarcoma are cured by surgery alone, if the tumor is low-grade; that means it is not likely to spread to other parts of the body. More aggressive sarcomas are harder to treat successfully.

The survival rate for osteosarcoma is between 60% and 75% if the cancer has not spread outside the area it started. It is more likely to be cured if all of the cancer can be removed by surgery.

For more information, contact the CCA:

-          Telephone: 2 522 440

-          Email: cancerconcern@outlook.com

-          Follow ‘Cancer Concern Association Seychelles’ Facebook page