Soft Tissue Sarcoma

Soft tissue sarcoma’s comprises 2% of all cancers. Sarcomas can start anywhere in the body, typically muscles, blood vessels, nerves, fat, joints and tissues.

More than 30 different types of sarcomas have been identified and are usually named on the type of tissue they start like liposarcomas for fat tumours, rhabdomyosarcomas for muscle tumours, angiosarcomas for blood vessel tumours etc.

Warning Signs

• A new lump or Increase in size of a preexisting lump
• Difficulty in normal movements
• Pain in the lump
• Fatigue
• Unintended weight loss

Risk Factors

Most of the patients who develop soft tissue sarcomas do not have any risk factor. However, certain factors are associated with an increased risk, including:

• Inherited genetic syndromes like Neurofibromatosis, Li-Fraumeni syndrome and Gardner syndrome.
• Exposure to large doses of radiation, such as those given during radiation therapy for other cancer types.
• Exposure to certain chemicals like Vinyl chloride.

Progression

Soft tissue sarcomas can spread to lungs, draining lymph nodes, and other solid organs. Your doctor would advice screening of these sites before commencing treatment for soft tissue sarcomas.

Diagnosis

Doctor may recommend one or more imaging tests to evaluate the area of concern which include radiographs, MRI and/or CT scan.

Accurate diagnosis is the key in the management of soft tissue sarcomas. Doctor may recommend a procedure to remove a sample of tissue (biopsy) from the tumour for laboratory testing. It is recommended that your biopsy should be at the cancer centre where you will receive treatment. Evaluation at a cancer centre that treats large number of sarcoma patients and has a specialized sarcoma management team improves chances of correct diagnosis and treatment and reduces the risks for relapse. A wrong biopsy may cause cancer to spread.

Once diagnosis of a cancer is confirmed, your doctor will ask for some further investigations to rule out the spread of disease which can include a PET scan, CT scan of chest and ultrasonography of draining glands etc.

 Treatment in a Nutshell:

Surgery is the main treatment for soft tissue sarcomas.

Limb sparing surgeries, which removes the cancer cells with some normal tissues but allows you to keep optimal use of your leg or arm are the most common surgeries performed for the management of these tumours.  

Almost all patients undergoing limb sparing surgeries for high grade soft tissue sarcomas will require radiation therapy. Radiation therapy can be given as External beam or by placing radiation catheters during surgery (Brachytherapy). There is a limited role of chemotherapy in the management of these tumours.

Outcome:

Outcome depends upon several factors like type of cancer, stage of disease, previous surgical treatment, adequacy of treatment and many more.

For Stage I sarcomas, 5 yr survival is between 80-90%. For Stage II/III soft tissue sarcomas, 5 year survival of upto 60-65% can be expected. For stage IV tumours, 5 yr survival is usually <40%.