Sarcomas are large group of malignant tumors that can be found almost anywhere in the body and can strike young and old alike. Soft tissue sarcomas can develop in every type of soft tissue in the body, including nerves, fat, muscle and blood vessels. Sarcomas can also occur in almost any organ, including the lungs, heart, gastrointestinal tract, liver, kidney and the extremities.
More than half of soft tissue sarcomas—about 60% —occur in the arms and legs. Other common sarcoma sites include the trunk (20% of cases), the abdomen (15%) and the head and neck region. For more information on sarcomas that occur in cartilage and bone, view bone cancer.
There are more than 30 different types of malignant soft tissue sarcoma. They can be simply categorized according to the types of cells affected: fat, smooth muscle, skeletal muscle, nerve tissue, joints, blood and/or lymph vessels and fibrous tissue. There is also a category for sarcomas of undetermined or mixed type. Some of the most common types of sarcoma are listed below:
Liposarcoma appears as a malignant form of fatty tissue and is most often found in the legs (back of the knee and thigh), or the posterior abdominal area. Liposarcomas can be slow-growing or aggressive. Most patients are between the ages of 50 and 65 years.
Leiomyosarcoma appears as a malignant form of smooth muscle, which is found in the lining of the gastrointestinal tract, womb, blood vessels, skin and other organs. The abdomen, extremities and posterior abdominal area are the most common site for leiomyosarcomas, but internal organs and blood vessels may also be affected.
Pleomorphic Sarcoma and Malignant Fibrous Histiocytoma (MFH) occurs in fibrous tissue in the arms and legs. It is a common form of malignant sarcoma in older adults, and has a tendency to spread to distant areas of the body, particularly the lungs.
Rhabdomyosarcoma has the appearance of rhabdomyoblasts, immature cells that form the body’s skeletal muscles. It occurs in two age groups: children under five years of age, and adolescents and older individuals. Although it is the most common soft tissue cancer in children, only about 350 cases are diagnosed each year in the United States. Since rhabdomyosarcoma can be a very fast-growing tumor, immediate treatment is crucial.
Fibrosarcoma originates in the fibrous tissue found at the end of long bones in the arms and legs, and in the trunk. Fibrosarcomas generally occur in adults under 60, but infants and the elderly can also be affected.
Synovial sarcomas are composed of cells that are similar to cells that line joints, although it's not believed to arise from the synovium, which produces fluid to lubricate the joints. These tumors are usually found in the knees, ankles, hips and shoulders. Adolescents and young adults are most likely to have synovial sarcomas, although they can occur later in life.
Gastrointestinal stromal tumors (GIST) occur in the interstitial cells of Cajal (ICC), which are special cells that line the walls of the gastrointestinal tract. These cells signal muscles to contract to move food and liquid along the digestive tract. More than half of GIST tumors are found in the stomach, but can also occur in the small intestine, esophagus, colon and rectum. Most GIST patients are 50 to 70 years of age.
Sarcomas close to the surface of the skin may be easily detected, but those deeper in the body may not become apparent until they get large. Only about half of sarcomas are detected in the early stages before they spread. Sarcoma Symptoms may include:
Having one or more of the symptoms listed above does not necessarily mean you have a soft tissue sarcoma. However, it is important to discuss any symptoms with your doctor, since they may indicate other health problems.
Risk factors for soft tissue sarcomas include several inherited genetic conditions. People with genetic mutations responsible for neurofibromatosis type 1, Li-Fraumeni syndrome, Gardner’s syndrome and inherited retinoblastoma are at increased risk of sarcoma. Other risk factors include people whose lymph nodes were damaged or removed during previous cancer treatments, and prolonged exposure to vinyl chloride (used in making plastics). While previous radiation treatment may be a risk factor, it is only responsible for about 5% of sarcoma cases.
At this time, it is not possible to prevent the development of a soft tissue sarcoma and no test is available to find sarcoma cells before they begin to grow.
Soft tissue sarcomas can be difficult to classify, and the only way to get an accurate diagnosis is with a biopsy. A sample of the suspected tumor is taken with a needle (or a scalpel if the tumor is close to the surface) and inspected under a microscope. Images with a CT scan or X-ray are generally taken after diagnosis to determine the size and location of the tumor.
Because sarcomas are rare, oncologists may have treated few patients, if any. Statistics show that sarcoma patients treated at large comprehensive cancer centers where specialized oncologists have more experience with the disease have better outcomes. MD Anderson treats more sarcoma patients than any other cancer hospital, enabling physicians to build on their expertise in an ongoing effort to discover new therapies and diagnostic methods.
Surgery is the most common treatment for soft tissue sarcomas. Advances in surgical limb-sparing techniques have greatly reduced the need for amputations. Only about 5% of sarcoma patients will lose a limb to disease.
Radiation therapy as a stand-alone treatment for sarcoma is not common, and may only be used in patients who aren’t healthy enough for surgery or to ease pain and other symptoms of disease. In some cases, radiation may be used before surgery to shrink the tumor. External beam radiation is not an option for patients with recurrent sarcoma who were previously treated with radiation.
Chemotherapy may be used as a primary treatment for sarcoma or in combination with surgery or radiation. Treating soft tissue sarcomas usually requires a combination of two or more chemotherapy drugs.
Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, help is available in many forms. Listed below are just some of the ways to find help...and hope.
Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.
Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression; and traditional Eastern medicine such as acupuncture.
Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.
Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.
Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.
Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.