Cancer, Soft Tissue Sarcoma

Soft tissue sarcomas are cancers that begin in the soft parts of your body. Imagine a growth starting in the muscle of your thigh, just above your knee – that's an example of a soft tissue sarcoma.

These cancers are uncommon. They form when cells in the soft tissues of your body grow out of control. These soft tissues are the connective, supportive, and protective layers that surround and hold together other parts of your body. Think of muscles, fat, blood vessels, nerves, tendons, and the linings of your joints as examples of soft tissues.

Soft tissue sarcoma can develop anywhere in your body, but it's most often found in the arms, legs, and abdomen (belly area).

There are many different types of soft tissue sarcomas – over 50 in fact! Some types are more common in children, while others mostly affect adults. Because these cancers can look like other kinds of growths, they can be tricky to identify. A doctor needs to do tests to be sure it's a sarcoma.

Treatment for soft tissue sarcoma usually involves surgery to remove the growth. Other treatments, like radiation therapy (using focused beams of energy to kill cancer cells) and chemotherapy (drugs to kill cancer cells), might also be used. The best course of treatment depends on several things: how big the cancer is, what kind of sarcoma it is, where it's located, and how fast it's growing. Doctors will carefully consider all these factors to create a personalized treatment plan.

Sometimes, a soft tissue sarcoma doesn't cause any problems at first. But as the cancer grows, it often creates a noticeable lump or swelling in the body. This lump can be felt or seen.

If you're experiencing any health concerns, please schedule a visit with your doctor or other healthcare provider.

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Soft tissue sarcomas are a group of cancers that start in the soft tissues of the body, such as muscle, fat, tendons, and blood vessels. Unfortunately, the exact cause of most of these cancers is unknown.

These cancers begin when cells in the connective tissues have changes in their DNA. DNA is like a set of instructions that tells a cell what to do. These changes turn the normal connective tissue cells into cancer cells. Crucially, these changes make the cancer cells grow and multiply uncontrollably. Healthy cells naturally die off as part of a normal process, but cancer cells ignore this instruction, continuing to grow and divide.

These abnormal cells form a mass called a tumor. In some types of soft tissue sarcoma, the cancer cells stay within the original area, causing the tumor to enlarge. However, in other types, the cancer cells can break away and spread to other parts of the body, a process called metastasis. This spread can make the cancer much harder to treat.

The type of cell that has the DNA changes determines the specific type of sarcoma. For example, angiosarcoma starts in the cells that line blood vessels, while liposarcoma begins in fat cells. There are many different types of soft tissue sarcomas, each with its own characteristics. These include:

• Angiosarcoma: Starts in blood vessel lining cells.
• Dermatofibrosarcoma protuberans: A type of sarcoma that often grows on the skin.
• Epithelioid sarcoma: A less common type of sarcoma.
• Gastrointestinal stromal tumor (GIST): Often found in the digestive system.
• Kaposi's sarcoma: A type of sarcoma that can be linked to a viral infection.
• Leiomyosarcoma: Starts in smooth muscle cells.
• Liposarcoma: Starts in fat cells.
• Malignant peripheral nerve sheath tumor: Begins in the nerves.
• Myxofibrosarcoma: A type of sarcoma that can be difficult to diagnose.
• Rhabdomyosarcoma: Starts in muscle cells.
• Solitary fibrous tumor: A rare type of sarcoma.
• Synovial sarcoma: A type of sarcoma that often occurs in the arms or legs.
• Undifferentiated pleomorphic sarcoma: A type of sarcoma that has a varied appearance under a microscope.

It's important to remember that this is not an exhaustive list, and there can be other, less common types of soft tissue sarcomas. If you have concerns about any unusual growth or lump, it's crucial to consult a doctor.

Some things can make it more likely you'll get a type of cancer called soft tissue sarcoma. Here are some of them:

1. Family History (Inherited Syndromes): Sometimes, a tendency to get certain cancers, including soft tissue sarcoma, can be passed down through families. This happens because of specific gene problems. Some of these inherited conditions include:

• Hereditary retinoblastoma: A rare eye cancer that can sometimes be linked to a higher risk of sarcoma.
• Li-Fraumeni syndrome: A condition where people have a greater chance of developing many different cancers, including sarcoma.
• Familial adenomatous polyposis: A condition where polyps (small growths) form in the colon and rectum, and can also increase sarcoma risk.
• Neurofibromatosis: A condition that causes tumors to grow along nerves. This can sometimes lead to sarcoma.
• Tuberous sclerosis: A condition that causes tumors to grow in various parts of the body, including the soft tissues, and can increase sarcoma risk.
• Werner syndrome: A rare genetic condition that causes premature aging and increases the risk of various cancers, including sarcoma.

2. Exposure to Certain Chemicals: Coming into contact with specific chemicals can raise your chances of getting soft tissue sarcoma. These chemicals include:

• Herbicides: These are chemicals used to kill weeds. Some herbicides have been linked to a higher risk of sarcoma.
• Arsenic: This is a naturally occurring chemical found in the environment. High levels of arsenic exposure can increase cancer risk.
• Dioxin: This is a toxic chemical that can be a byproduct of certain industrial processes. Exposure to dioxin is linked to an increased risk of sarcoma.

3. Radiation Treatment: Having radiation therapy for another cancer can slightly increase your risk of developing soft tissue sarcoma later on. This is because radiation can damage cells and sometimes lead to new cancer growth.

It's important to remember that these factors don't guarantee you'll get sarcoma. They just increase your chance. If you have concerns about your risk, it's crucial to talk to your doctor.

Diagnosing soft tissue sarcoma involves several steps to find out if you have the cancer and learn more about it. Doctors use different tests and procedures.

Seeing Inside Your Body:

Doctors use imaging tests to create pictures of the inside of your body. This helps them see where the cancer is and how big it is. These tests include:

• X-rays: These use beams of energy to create images.
• CT scans (Computed Tomography): These use X-rays and a computer to create detailed cross-sectional images.
• MRI scans (Magnetic Resonance Imaging): These use magnets and radio waves to create detailed images, particularly useful for soft tissues.
• PET scans (Positron Emission Tomography): These use radioactive substances to show areas of high activity in the body, which can sometimes highlight cancer.

Taking a Sample for Testing (Biopsy):

A biopsy is a procedure where doctors take a small sample of the suspicious tissue to examine under a microscope. For soft tissue sarcoma, it's especially important to do the biopsy carefully. This is because the biopsy site might need to be operated on later. It's best to get this procedure at a medical center with doctors who have a lot of experience treating this type of cancer. They'll choose the right type of biopsy.

Different types of biopsies include:

• Core Needle Biopsy: A needle is used to remove small cylinders of tissue from the tumor. Doctors try to collect samples from different spots within the tumor to get a better understanding of the whole area.
• Surgical Biopsy: In some cases, a surgeon might remove a larger piece of tissue for testing. This is done when a core needle biopsy isn't enough to get a clear diagnosis.

Lab Tests for Diagnosis:

The tissue sample is sent to a lab. Doctors called pathologists examine the cells under a microscope. They look for signs of cancer. The lab might also do other tests to learn more about the type of cancer cells and how they might behave. This helps the doctors create a treatment plan.

Treating Soft Tissue Sarcoma: A Guide for Patients

Soft tissue sarcoma is a type of cancer that can develop in various parts of the body, often affecting the arms and legs. The best treatment approach depends on the size, type, and location of the cancer. This guide outlines common treatment options.

Surgery:

Surgery is a frequent treatment for soft tissue sarcoma. The surgeon will typically remove the cancerous tissue and some healthy surrounding tissue to be sure all the cancer is gone. In the past, removing the entire arm or leg might have been necessary. However, modern medicine often allows for less invasive procedures. This is possible when other treatments, like radiation or chemotherapy, can first shrink the tumor, making it easier to remove.

Radiation Therapy:

Radiation therapy uses high-energy beams (like X-rays or protons) to destroy cancer cells. Imagine a machine that moves around you, targeting specific areas of your body with radiation. This treatment can be used:

• Before surgery: Radiation can shrink the tumor, making it easier to remove during surgery.
• During surgery (Intraoperative Radiation Therapy - IORT): IORT allows doctors to deliver a higher dose of radiation directly to the affected area during the operation. This helps target the cancer more precisely and spare healthy tissues.
• After surgery: Radiation can kill any remaining cancer cells.

Chemotherapy:

Chemotherapy uses powerful drugs to kill cancer cells. These drugs are often given through a vein, but some can be taken as pills. Not all soft tissue sarcomas respond equally to chemotherapy. For example, rhabdomyosarcoma is often treated with chemotherapy.

Targeted Therapy:

Targeted therapy uses drugs that attack specific parts of cancer cells. This can help block the cancer's ability to grow and cause it to die. Doctors can test your cancer to see if a targeted therapy might work well for you. Gastrointestinal stromal tumors (GISTs) are one example of cancer that responds well to targeted therapies.

Coping with a Cancer Diagnosis:

A cancer diagnosis is often overwhelming. It's a good idea to:

• Learn about your sarcoma: Discuss your treatment options and prognosis with your healthcare team. Ask questions to understand your condition and treatment choices. The more you know, the more confident you'll feel in making decisions about your care.
• Lean on your support system: Maintaining close relationships with friends and family is crucial. They can provide emotional support and practical help, such as assisting with home tasks while you're undergoing treatment.
• Find a support network: Talk to someone you trust about your hopes and fears. This could be a friend, family member, therapist, counselor, clergy member, or a cancer support group. These people can offer a listening ear and emotional support.

Important Note: This information is for general knowledge and does not constitute medical advice. Always consult with your doctor or other qualified healthcare professional for personalized guidance on your treatment options.