RGCIRC, Niti Bagh
Sarcoma Treatment in Delhi, India | RGCIRC
Overview
Receiving a sarcoma diagnosis can feel confusing and overwhelming, especially because many people hear about this type of cancer for the first time. Sarcoma is not a single disease but a group of cancers that can develop in bones, muscles, fat, nerves, blood vessels, and other connective tissues in different parts of the body. Although sarcomas are rare, timely diagnosis and treatment by an experienced specialist team are important for better treatment outcomes.
At RGCIRC (Rajiv Gandhi Cancer Institute and Research Centre), sarcoma treatment is provided through a multidisciplinary team that includes orthopaedic oncologists, surgical oncologists, medical oncologists, radiation oncologists, reconstructive surgeons, radiologists, pathologists, and physiotherapists. Every case is reviewed by the Multidisciplinary Tumour Board to develop a personalised and evidence-based treatment plan based on the tumour subtype, stage, location, and the individual needs of the patient.
Understanding Sarcoma
Sarcoma is a rare group of cancers that develops in the body’s connective tissues, such as bones, muscles, fat, cartilage, nerves, blood vessels, and tendons. Unlike more common cancers that begin in organs or surface linings, sarcomas can develop in many different parts of the body and often require specialised treatment approaches.
Sarcomas are broadly divided into two main categories:
- Bone sarcomas: Develop in the bones
- Soft tissue sarcomas: Develop in muscles, fat, blood vessels, nerves, tendons, and other soft tissues
Bone sarcomas are more commonly seen in children and young adults, while soft tissue sarcomas are more frequent in older adults. Although sarcomas are rare in adults, they account for a higher proportion of cancers in children and adolescents.
Types of Sarcoma
There are many different types of sarcoma, and each behaves differently depending on where it develops and how aggressive it is.
Bone Sarcomas
Bone sarcomas usually affect the long bones of the arms and legs, although they can develop in any bone.
- Osteosarcoma: The most common bone cancer, usually affecting teenagers and young adults. It often develops around the knee and is commonly treated with surgery and chemotherapy.
- Ewing Sarcoma: Commonly seen in children and young adults. It can develop in bone or soft tissue and is usually treated with chemotherapy, surgery, and sometimes radiation therapy.
- Chondrosarcoma: A cancer that develops from cartilage cells, mainly in adults over 40. Surgery is usually the main treatment.
- Giant Cell Tumour of Bone: A locally aggressive bone tumour that is usually non-cancerous but may occasionally become malignant and require specialised treatment.
Soft Tissue Sarcomas
Soft tissue sarcomas can develop in different parts of the body, most commonly in the arms, legs, abdomen, or deep tissues.
- Liposarcoma: Develops from fat tissue and commonly occurs in the thigh or abdomen.
- Leiomyosarcoma: Develops from smooth muscle tissue and may occur in the uterus, blood vessels, or abdomen.
- Rhabdomyosarcoma: The most common soft tissue sarcoma in children, developing from skeletal muscle cells.
- Synovial Sarcoma: Usually develops near joints or tendons, mainly in young adults.
- Gastrointestinal Stromal Tumour (GIST): Develops in the digestive tract and is often treated with targeted therapy.
- Undifferentiated Pleomorphic Sarcoma (UPS): A high-grade soft tissue sarcoma more commonly seen in older adults.
- Angiosarcoma: A rare and aggressive sarcoma that develops from blood or lymphatic vessels.
Signs and Symptoms of Sarcoma
The symptoms of sarcoma can vary depending on where the tumour develops in the body. Some people may notice a painless lump, while others may experience persistent bone pain, swelling, or reduced movement in a nearby joint.
Symptoms of Bone Sarcoma
Bone sarcoma often causes symptoms related to the affected bone or nearby joint. Common signs include:
- Persistent bone pain that gradually worsens, especially at night or during rest
- Swelling or a firm lump over a bone, commonly around the knee, upper arm, or pelvis
- Bones breaking more easily than expected after minor injury or trauma (pathological fracture)
- Difficulty moving a nearby joint or reduced range of motion
- Fever and fatigue in some cases of Ewing sarcoma
Symptoms of Soft Tissue Sarcoma
Soft tissue sarcomas are often painless in the early stages, which can delay diagnosis. Symptoms may include:
- A lump or swelling anywhere in the body, especially if it is growing, larger than 5 centimetres, or located deep under the skin
- A lump that changes in size, shape, or firmness over time
- Pain or discomfort as the tumour grows and presses on nearby tissues
- Abdominal fullness, discomfort, nausea, or bowel changes in abdominal or retroperitoneal sarcomas
When Should You See a Doctor?
Any lump that is increasing in size, larger than 5 centimetres, deep beneath the skin, or associated with unexplained pain should be evaluated by a specialist. Even painless lumps should not be ignored, as many soft tissue sarcomas remain painless in the early stages.
At RGCIRC, patients with suspected sarcoma undergo detailed evaluation by the Orthopaedic Oncology and Surgical Oncology teams.
Causes and Risk Factors of Sarcoma
In many sarcoma cases, the exact cause is not known. Sarcomas develop when genetic changes cause bone or soft tissue cells to grow abnormally. However, certain medical conditions, environmental exposures, and inherited disorders are known to increase the risk.
Inherited Genetic Conditions
Some inherited genetic conditions can increase the risk of developing sarcoma. These include:
- Li-Fraumeni syndrome
- Retinoblastoma (RB1 mutation)
- Neurofibromatosis type 1
- Familial Adenomatous Polyposis (FAP)
- Werner syndrome
- Gorlin syndrome
Previous Radiation Therapy
In rare cases, radiation therapy given for a previous cancer may increase the risk of developing sarcoma years later. This is known as radiation-induced sarcoma and is one reason long-term follow-up remains important after cancer treatment.
Chemical Exposure
Long-term exposure to certain industrial chemicals, such as vinyl chloride, arsenic, and dioxins, has been linked to an increased risk of some sarcoma types.
Chronic Lymphoedema
Long-standing lymphoedema, which causes persistent swelling due to problems in the lymphatic system, may increase the risk of a rare sarcoma called lymphangiosarcoma.
Previous Bone Conditions
Certain bone conditions, such as Paget’s disease of bone, can slightly increase the risk of osteosarcoma, especially in older adults.
Age
Different sarcoma types are more common at different ages. Osteosarcoma and Ewing sarcoma are usually seen in children, teenagers, and young adults, while many soft tissue sarcomas are more common after the age of 40.
How Is Sarcoma Diagnosed?
Diagnosing sarcoma requires careful evaluation using imaging tests, biopsy, and laboratory analysis. Because sarcomas are rare and include many different subtypes, diagnosis and treatment planning are best carried out at a specialist centre with experience in sarcoma care. At RGCIRC, the diagnostic workup is planned by the same multidisciplinary team that manages treatment, helping ensure accurate diagnosis and appropriate surgical planning. Diagnostic approach include:
Imaging Tests
Imaging tests help doctors understand the size, location, and spread of the tumour.
Common imaging investigations include:
- X-rays: Often the first test for suspected bone sarcoma
- MRI scan: The most important scan for evaluating bone and soft tissue sarcomas, especially to assess nearby muscles, nerves, and blood vessels
- CT scan of the chest: Used to check whether the sarcoma has spread to the lungs, which is a common site of spread
- Digital PET-CT: Used in selected cases to evaluate the disease throughout the body, especially in aggressive sarcomas
Biopsy
A biopsy is necessary to confirm whether the tumour is sarcoma and to identify its subtype and grade.
At RGCIRC, biopsies are carefully planned by the treating orthopaedic oncology or surgical oncology team before the procedure is performed. This is important because an improperly placed biopsy can affect future surgery.
In most cases, an image-guided core needle biopsy is used to obtain tissue samples safely and accurately.
Histopathology and Molecular Testing
The biopsy sample is examined by specialist pathologists experienced in bone and soft tissue tumours.
Additional tests such as immunohistochemistry and molecular testing may also be performed to identify specific genetic or molecular changes in the tumour. These tests help confirm the sarcoma subtype and guide treatment decisions, especially for targeted therapy.
At RGCIRC, advanced molecular testing facilities include next-generation sequencing and specialised testing for gene mutations and tumour markers in selected sarcoma types.
How Is Sarcoma Treated?
Surgery
Surgery is the main treatment for many sarcomas and offers the best chance of cure when the tumour can be completely removed.
Different surgical approaches may include:
- Limb Salvage Surgery: Commonly used for bone sarcomas of the arms or legs. The goal is to remove the tumour while preserving the limb and maintaining as much function as possible. Reconstruction may involve metal implants, bone grafts, or specialised replacement procedures.
- Wide Local Excision: Removal of soft tissue sarcomas along with a margin of healthy surrounding tissue to reduce the risk of recurrence.
- En Bloc Resection: Used when the tumour involves nearby structures such as the pelvis, spine, or chest wall, requiring removal of the tumour and surrounding affected tissues together.
RGCIRC also offers reconstructive procedures after major sarcoma surgery to help restore function and appearance.
Chemotherapy
Chemotherapy is commonly used in bone sarcomas such as osteosarcoma and Ewing sarcoma.
It may be given:
- Before surgery (neoadjuvant chemotherapy): To shrink the tumour and treat microscopic cancer cells.
- After surgery (adjuvant chemotherapy): To reduce the risk of recurrence.
Some high-grade soft tissue sarcomas may also respond to chemotherapy depending on the subtype.
Radiation Therapy
Radiation therapy is often used in soft tissue sarcomas before or after surgery to lower the risk of local recurrence.
In Ewing sarcoma, radiation therapy may be used when surgery cannot completely remove the tumour or when surgery is not possible.
At RGCIRC, advanced radiation techniques such as IMRT and IGRT are used to target tumours precisely while protecting nearby healthy tissues.
Targeted Therapy
Some sarcoma subtypes can be treated with targeted drugs based on specific genetic or molecular changes in the tumour.
For example, Gastrointestinal Stromal Tumours (GIST) are commonly treated with imatinib, a targeted therapy that blocks KIT or PDGFRA mutations. Molecular testing is important to identify patients who may benefit from these treatments.
Other rare sarcoma subtypes with specific genetic changes may also respond to targeted therapy identified through advanced molecular testing.
Immunotherapy
Immunotherapy is used in selected sarcoma subtypes, especially in recurrent or metastatic disease. These treatments help the immune system recognise and attack cancer cells.
At RGCIRC, molecular testing helps identify patients who may benefit from immunotherapy.
Palliative Care
For advanced sarcoma, palliative care focuses on symptom relief, emotional support, and improving quality of life. It may help manage pain, fatigue, mobility issues, and other treatment-related symptoms.
At RGCIRC, palliative care is integrated with cancer treatment and supportive care services from an early stage of management.
Why Choose RGCIRC for Sarcoma Treatment?
Sarcoma treatment often requires highly specialised care, advanced surgical expertise, and close coordination between multiple specialists. At RGCIRC, patients benefit from multidisciplinary sarcoma care, advanced limb salvage procedures, precision-based treatment planning, and long-term rehabilitation support under one roof.
The following strengths make RGCIRC a trusted centre for bone and soft tissue sarcoma treatment in Delhi and India.
Dedicated Sarcoma and Orthopaedic Oncology Expertise
RGCIRC has a dedicated team for bone and soft tissue tumour management that includes orthopaedic oncologists, surgical oncologists, medical oncologists, radiation oncologists, reconstructive surgeons, radiologists, pathologists, physiotherapists, nurses, and counsellors.
This multidisciplinary approach helps ensure that sarcoma patients receive specialised treatment planning and coordinated care throughout diagnosis, surgery, rehabilitation, and follow-up.
Advanced Limb Salvage and Reconstructive Surgery
RGCIRC offers advanced limb salvage procedures aimed at removing the tumour while preserving the affected limb and maintaining function whenever possible.
Specialised procedures available include:
- Endoprosthetic replacement
- Vascularised bone grafts
- Extracorporeal radiotherapy with bone re-implantation
- Total femur and total humerus replacement
- Internal hemipelvectomy and complex spinal tumour resections
The institute also provides reconstructive procedures after major sarcoma surgery to help restore movement, function, and quality of life.
Specialist Paediatric Sarcoma Care
Paediatric Haematology and Oncology programme at RGCIRC provides dedicated treatment for children and adolescents with sarcomas such as osteosarcoma, Ewing sarcoma, and rhabdomyosarcoma.
The paediatric oncology and surgical oncology teams work together to deliver age-appropriate multidisciplinary care supported by specialised rehabilitation and supportive services.
Molecular Testing and Precision Treatment
The molecular laboratory at RGCIRC offers advanced testing, including next-generation sequencing and specialised biomarker analysis, to help confirm sarcoma subtypes and guide treatment decisions.
This is especially important in sarcomas such as GIST, where KIT and PDGFRA mutation testing helps determine eligibility for targeted therapy.
Multidisciplinary Tumour Board
Every sarcoma case at RGCIRC is reviewed by the Multidisciplinary Tumour Board before treatment begins. Specialists from surgical oncology, orthopaedic oncology, medical oncology, radiation oncology, radiology, pathology, and rehabilitation services work together to plan surgery, chemotherapy, radiation therapy, and supportive care in the most effective sequence for each patient.
Accredited and Recognised Cancer Care
RGCIRC holds NABH (5th Edition) and NABL accreditation along with Green OT and Nursing Excellence certifications. The institute has also received recognition among leading specialised cancer hospitals nationally and internationally for its comprehensive oncology care and multidisciplinary cancer treatment approach.
Commitment to Accessible Care
As a not-for-profit institution, RGCIRC provides financial assistance and subsidised treatment support through its Philanthropy Department for eligible patients and families requiring additional support during treatment.
Book a Consultation at RGCIRC
A growing lump, persistent bone pain, or an unexplained swelling should not be ignored, especially if symptoms continue to worsen over time. Early evaluation by a specialist team can help ensure accurate diagnosis and timely treatment planning. At RGCIRC, the Orthopaedic Oncology and Surgical Oncology teams provide specialised sarcoma care for both bone and soft tissue tumours, including second opinions and multidisciplinary treatment planning.
For consultations, second opinions, or treatment guidance: Call +91-11-4702 2222 (Rohini) / +91-11-4582 2222 (Niti Bagh, South Delhi) Book online at care.rgcirc.org | Download the RGCI Care app on iOS and Android
OPD Hours: Monday to Saturday, 9:00 AM to 5:00 PM | Emergency Services: 24×7 at both campuses
Frequently Asked Questions (FAQs)
Q: What is sarcoma and how is it different from other cancers?
Sarcoma is a rare group of cancers that develops in connective tissues such as bone, muscle, fat, nerves, and blood vessels. Unlike more common cancers that arise in organs or surface linings, sarcomas require specialised diagnosis and treatment approaches.
Q: Is sarcoma curable?
Yes, many sarcomas can be treated successfully when diagnosed early and managed by a specialist team. Treatment outcomes depend on the subtype, stage, tumour grade, and overall health of the patient.
Q: What does a sarcoma lump feel like?
Sarcoma lumps are often painless in the early stages. They may feel firm, deep beneath the skin, and gradually increase in size. Any lump that is growing, larger than 5 centimetres, or associated with unexplained pain should be evaluated by a specialist.
Q: Which is considered among the best hospitals for sarcoma treatment in Delhi?
RGCIRC (Rajiv Gandhi Cancer Institute and Research Centre) is considered among the leading centres for sarcoma treatment in Delhi, offering multidisciplinary care, advanced limb salvage surgery, molecular testing, paediatric sarcoma care, and specialised treatment for both bone and soft tissue sarcomas.
Q: Can sarcoma spread to other parts of the body?
Yes. Sarcomas can spread to other organs, most commonly the lungs. Some subtypes may also spread to bones or lymph nodes depending on the type of sarcoma.
Q: What is the difference between bone sarcoma and soft tissue sarcoma?
Bone sarcomas develop in bones or cartilage, while soft tissue sarcomas develop in muscles, fat, nerves, blood vessels, or other soft tissues. Both groups include several subtypes and may require different treatment approaches.
Q: Is amputation always required for bone sarcoma?
No. In many cases, limb salvage surgery can remove the tumour while preserving the affected limb. Amputation is usually considered only when limb preservation is not safely possible.
Q: How is GIST different from other sarcomas?
Gastrointestinal Stromal Tumour (GIST) is a type of soft tissue sarcoma that develops in the digestive tract. Unlike many other sarcomas, GIST is commonly treated with targeted therapy based on specific genetic mutations.
Q: Where can I find sarcoma treatment near me in Delhi?
RGCIRC offers specialised treatment for bone and soft tissue sarcomas through its Orthopaedic Oncology, Surgical Oncology, Medical Oncology, and Radiation Oncology teams at its Rohini and Niti Bagh campuses in Delhi.