Sarcoma 101

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Haven’t heard of sarcoma? You’re not alone. Although there are more than seventy different types of sarcoma, it is a rare form of cancer. Sarcoma is the general term used to describe cancers that form in connective tissues, which are the cells that connect and support other kinds of tissue in your body.

Sarcoma most commonly appears in muscles, fat, nerves, or the lining of your joints, though it can also appear in other parts of the body. Generally, sarcoma is separated into two main types: soft tissue sarcoma and primary bone sarcoma, with soft tissue being more common. Primary bone sarcoma is distinct from other types of bone cancers because it starts in the bone, rather than spreading to the bones from other locations in the body. Many bone sarcomas are diagnosed in people under the age of 35 and children. However, soft tissue sarcoma, or cancers that begin in muscles or connective tissues, primarily occurs in adults.

Like other forms of cancer, researchers do not know what causes a healthy cell to become cancerous or become sarcoma. In general, sarcoma forms when immature bone or soft tissue cells change their DNA and divide uncontrollably. Untreated, the cancer can travel to other organs in a process called metastasis, which makes it more challenging to treat. There are also certain risk factors that increase your likelihood of developing sarcoma. Exposure to arsenic and certain chemicals such as vinyl chloride monomer (found in plastics), phenoxyacetic acid (found in herbicides), or chlorophenols (found in wood preservatives) can all put you at risk. Other risk factors include exposure to high doses of radiation, lymphedema, and certain genetic conditions such as Gardner syndrome or Werner syndrome.

Sarcoma symptoms vary widely depending on where the tumor is located. Some sarcomas cause long-lasting pain while others may not have noticeable symptoms until the disease has progressed. Common symptoms include lumps on the skin, pain in the arms or legs, trouble moving limbs, or back pain. Children and young adults are more prone to pain and swelling in the arms or legs because they are more likely to get osteosarcoma than adults.

Sarcoma can be treated in multiple ways depending on the type of sarcoma, its size and location, and your general health. Radiation therapy uses high-energy X-rays to target cancer cells while avoiding healthy cells. The therapy may be conducted by an external machine or placed inside your body. Surgery may remove cancerous cells and sometimes involves limb salvation or using metal replacements for joint construction if needed. Chemotherapy, one of the most common treatments, uses drugs to kill or slow the growth of cancer cells. Chemotherapy is usually given orally or intravenously and is sometimes used in conjunction with radiation therapy. Immunotherapy, or biologic therapy, builds up your immune system so that it can better defend itself against cancer cells. The immune system often has a difficult time identifying and fighting off cancerous cells because cancer cells are able to hide from the immune system or deactivate the immune response all together.

Soft tissue sarcoma is usually only curable by surgery alone. The survival rate for osteosarcoma is around 75% if the cancer is localized and has not spread outside the area it started in. Most sarcomas are localized, and on average, have a five year survival rate of 81%. Luckily, only 18% of sarcomas are found in more advanced stages where the survival rate is lower at 51%. As with most cancers, the earlier the cancer is detected, the more likely treatments are to be successful.

— Chaya Tong

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