A rare class of cancers known as sarcomas develops in the body's connective tissues, which include the bones, muscles, fat, blood vessels, nerves, and fibrous tissues. Sarcomas form in the tissues that support and connect various body parts, as opposed to carcinomas, which originate from epithelial cells (such as those in the breast, lung, or colon).
Sarcomas can develop practically anywhere in the body due to their origin. They are frequently divided into two primary categories: soft tissue sarcomas and bone sarcomas, each of which has several subtypes. Although some types are more prevalent in one age group than the other, sarcomas can affect both adults and children.
Sarcomas are broadly divided into:
There are more than 70 distinct subtypes of sarcoma, and they can differ significantly in how they behave. While some are indolent and grow slowly over many years, others are aggressive and grow quickly.
The cause of sarcoma is typically unknown. Nonetheless, a few risk factors have been found:
That said, most people who develop sarcoma have no identifiable risk factor.
In their early stages, sarcomas frequently show few symptoms, which makes diagnosis difficult. The most typical presentations consist of:
These symptoms are occasionally disregarded or initially misdiagnosed because they can mimic benign conditions like lipomas or muscle strains. Any deep, firm, and growing lump needs to be examined further.
Sarcoma diagnosis necessitates a combination of imaging, biopsy, and clinical evaluation:
Following diagnosis, the tumor is staged and graded (low, intermediate, or high grade) to determine its aggressiveness, size, depth, and spread.
A multidisciplinary team comprising surgical oncologists, medical oncologists, radiation oncologists, radiologists, and pathologists is frequently needed for the highly individualized treatment of sarcoma.
The mainstay of treatment for the majority of localized sarcomas is surgery. Removing the tumor while leaving a visible margin of healthy tissue is the aim. When it is feasible, limb-sparing surgery is preferred to amputation for extremity sarcomas.
To lower the chance of recurrence, radiation therapy can be administered either before or after surgery. It's particularly useful when getting precise surgical margins is challenging.
Chemotherapy can be administered either before (neoadjuvant) or after surgery and is frequently used for aggressive or high-grade sarcomas. Rhabdomyosarcoma and Ewing's sarcoma are two sarcoma subtypes that are especially sensitive to chemotherapy.
According to tumor genetics and receptor status, more recent therapies like immunotherapy (e.g., immune checkpoint inhibitors in specific subtypes) or targeted therapy (e.g., pazopanib, trabectedin) may be taken into consideration in cases of advanced or metastatic disease.
Following major surgery or radiation therapy, recovery from sarcoma treatment may entail:
Because sarcomas can recur or spread even years after initial treatment, long-term follow-up is essential. Ongoing surveillance includes routine physical examinations and imaging.
Prognosis in sarcoma depends on multiple factors:
When treated promptly, localized sarcomas have good survival rates, frequently exceeding 70–80%. Although advanced disease is more difficult to treat, many patients are finding that new treatments are giving them hope and extending their survival.
It is crucial to be assessed and treated at a facility with experience in treating sarcomas due to their complexity and rarity. A sarcoma specialist can be consulted early to prevent misdiagnosis and guarantee the best possible treatment planning right away.
Medical oncologist Dr. Amit Badola actively treats sarcomas systemically. For soft tissue and bone sarcomas, he specializes in chemotherapy, targeted therapy, and immunotherapy, all of which are provided as a part of an all-encompassing, team-based approach that emphasizes evidence-based and customized care.
