Soft Tissue Sarcoma- What is Soft Tissue Sarcoma Soft Tissue Sarcomas are a group of rare cancers affecting the tissues that connect, support and surround other body structure and organs. Tissues that can be affected by soft tissue sarcoma include fat, muscle, blood vessels, deep skin tissues, tendon and ligaments. Sarcomas also occur in the as well. Soft tissue sarcomas can develop in almost any part of the body, including the legs, arms and tummy (abdomen).
Where can Sarcomas grow? • • • • •
In early stages soft tissue sarcomas, have no symptoms. As they spread and grow in size, symptoms are seen. The symptoms mainly depend on where the cancer develops. For example: If there is a swelling under the skin—a painless lump, grows bigger and does not move. Swelling in the tummy (abdomen)—there is pain, one feels the abdomen is full and constipation. Swelling near the lungs and causes a cough and breathlessness. Better to see a doctor immediately, when one sees a lump.
Who gets it? 1. No particular cause, why soft tissue sarcomas develops. But the risk factor is more. 2. Soft Tissue Sarcoma—can occur at any age children, middle aged (common) or senior citizens. Risk increases as one gets older. 3. Due to certain genetic conditions of the brain and sight. 4. People who have had radiotherapy. 5. If People are exposed to chemicals like vinyl chloride, dioxins and phenoxy acetic herbicides. 6. DNA mutations is common-exposure to radiation. This can cause cancer in the breast, Colon, kidney and eyes. 7. It can be because of defect in genes that was inherited from a parent.
Soft tissue sarcoma diagnosis
1. Physical examination by a hospital specialist. 2. Scans: An ultrasound scan—MRI Scan. 3. A Biopsy: A suspected cancerous tissue is removed and analysed in a laboratory. If the diagnosis is confirmed, further tests will be conducted.
Risk Factors • • •
There are three main risk factors in soft tissue sarcomas: Inherited Syndroms: Inherited from parents, they are Retinoblastoma, Tuberous, Sclerosis, Werner Syndrome and so on. Chemical Exposure: Being exposed to chemicals like—herbicides, arsenic and dioxin. Radiation Exposure: Radiation treatment taken previously for other cancers can increase the risk of soft tissue sarcomas.
Types of Soft tissue sarcomas: •
ANGIOSARCOMA: It is a cancer that can occur in the inner lining of blood vessels, in any part of the body. Commonly occurs in the skin, breast, liver, spleen and deep tissue. Causes: a) Swelling of an area of the body, due to the collection of fluid. b) Exposure to radiation or treatment. Treatment: Surgery, Chemotherapy, Radiation therapy. Follow up: Appointment every 3 months for the first two years and every six months for five years.
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DERMOTOFIBROSARCOMA: PROTUBERANS (DFSP) This is a rare type of cancer. It develops in the skin and has tentacles, that grow into the surrounding fat, muscle and bone. Causes: a) Cause is unknown. b) An injury on the affected skin, of an earlier removed tumour. Treatment: 1) Dermatologist, will see how deeply into the skin the tumour has grown.
2)Mohs Micrographic Surgery: Removing one layer of skin at a time, until cancer cells are no longer found. 3) Excision: Surgery to remove a large sized tumour. 4) Systematic Therapy: If chemotherapy does not succeed, then through food and drugs it is treated. In advanced cases, both medication and surgery is advised. 5) Radiation Therapy: Treatment after surgery, if surgery cannot be done. Follow up : Every three to six months within three years. •
EPITHELOID SARCOMA: A small growth of lump that’s painless begins under the skin of a finger, hand, forearms, lower leg or foot. Treatment: Surgery, Chemotherapy, Radiation Therapy.
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GASTROINTESTINAL STROMAL TUMORS: (GISTs)—These are soft tissue sarcomas located in the digestive system, in the stomach and small intestine. They start in the specialized nerve cells, in the walls of the digestive system. Causes: The exact cause is not known. Cancer develops when cells begin to grow out of control and build up a mass called tumour. Blood in tools is seen, pain in abdomen nausea and vomiting, bowel obstruction, tiredness, feeling full, pain or difficulty while swallowing. Risk: Develops in people between the age groups- 50 and 80. Can rarely happen in people younger than 40 years of age. Treatment: Surgery, Targeted therapy, Watchful waiting, Supportive Care. Follow up: Some of the tests may be repeated. Based on the result, the treatment may continue, change, or stopped. Sometimes to check if the cancer has come back.
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KAPOSI SARCOMA: It causes lesions in the skin, lymph nodes, internal organs, and mucous membranes lining the mouth, nose, and throat. It also affects people with HIV OR AIDS., red or brown patches are a common. Causes: Can be caused by a virus, the human herpesvirus 8 (HHV -8). It spreads during intercourse, through blood or saliva, or from a mother to her baby during birth. Treatment: there no treatment, can only be controlled.
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LEIOMYO SARCOMA: This is a rare type of cancer. It affects the muscle tissue. They are common in the abdomen, blood vessels, skin uterus, intestines, liver, pancreas, bladder. Causes: When gene changes, on their own, or might have got the changed genes from one of the parents. People above 50. If a person had radiation for another cancer. Exposed to certain chemicals. Treatment: Surgery is mostly advised. Women, who have this cancer uterus, fallopian tubes and ovaries are removed. Radiation therapy, Chemotherapy Follow up: Regular checks ups. If it comes back, surgery, radiation or chemotherapy, clinical trials for testing new drugs.
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MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR: A rare type of cancer. It occurs in the lining of the nerves that extend from the spinal cord into the body. They also occur in the tissue of the arms, legs and trunk. A lump can grow and is painful. Treatment: surgery, radiation therapy and chemotherapy. Rehabilitation sometimes.
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RHABDOMYPOSARCOMA: RMS-is an aggressive and highly malignant form of cancer. It’s a disease of childhood, as it occurs below the age of18. Causes: Cell develops a change in its DNA. The changes in the cell multiply quickly when healthy cells die. The result is a mass of abnormal cells that break away and spread throughout the body. Treatment: Children are treated by a team of specialist, who treat cancer in children. Surgery, Radiation therapy, Chemotherapy. New types of treatments are Immunotherapy, and Targeted therapy. Follow up: Sometimes tests need to be repeated, to see if the child has recovered or the cancer has come back.
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SOLITARY FIBROUS TUMOUR: Can occur anywhere in the body. Mostly occur in the lining outside of the lungs. It’s also known as fibrous tumour of the pleura. Causes: These are rare spindle cell neoplasms, commonly arise from the pleura. They are also found in the head, neck, breast, kidney, prostate and the spinal cord regions. Treatment: Surgery, Radiation, Chemotherapy. Targeted medications.
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SYNOVIAL SARCOMA: It is a rare cancer. It affects soft tissues, which connect, support, and surround bones and other organs in the body, like the muscle, fat, blood vessels, nerves, tendons, and the lining of the joints. Very few people are affected with this disease. Causes: If exposed to chemicals. Treated with radiation. For a long time swelling in the arms or legs. In cells with genes that have errors in them. The error happens when certain Chromosomes break the pieces in other Chromosomes. As these tumours grow the person may get a lump or swollen spot. Around hip, knee, ankle, or shoulder joints. As the tumour grows it becomes difficult to move and causes numbness or pain. In rare cases it happens in the head, neck or chest. Treatment: Surgery and the tumour is removed. Before surgery sometimes radiation or chemotherapy to reduce the size of the tumour. Follow up is a must. If it grows back, the doctor can see on a scan. Sometimes when they come back, they spread to the other parts of the body.
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UNDIFFERERENTIATED (PLEOMORPHIC SARCOMA): UPS—begins in the soft tissue of the body, in the arms and legs. Rarely it can happen even in the area behind the abdominal organs. Causes: This cancer begins when a cell develops changes in the DNA. The cell multiply rapidly, creating a mass of abnormal cells. It can destroy the healthy tissue and the cancer cells can break away and spread to the other parts of the body, to the lungs and bones. Treatment: Surgery to remove the cancer cells. Radiation, Chemotherapy, drug treatments, targeted therapy, and immunotherapy. Alternative treatments are: Acupuncture, Exercise, Massage, Meditation, Music therapy and Relaxation exercises. Follow is needed with the doctor, but also to be talking to friends and family to come out of the fear. July is Sarcoma awareness month. Malignant (cancerous) tumours of the connective tissues are called “Sarcomas”. There are more than 50 sub- types of Sarcomas. It’s more likely to affect children and young adults. So, it important to consult a cancer specialist in the treatment of this disease.