Soft Tissue Sarcoma

The term sarcoma refers to the malignant cancer that develops from certain tissues, like bone or muscle. Accordingly there are 2 main types of sarcoma:

1. Bone sarcomas

2. Soft tissue sarcomas

The soft tissue sarcoma is a cancer that can be found in any part of the body. It mostly develops in the arms or legs and also from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. Sarcomas are not common tumors. There are many types of soft tissue tumors, and not all of them are cancerous. Soft tissues are meant to connect, support and surround the different structures of the body.

What causes soft tissue sarcoma?

As there are many soft tissue sarcomas the cause for most of them remains unknown. Only for one type of soft tissue sarcoma i.e. kaposi’s sarcoma, the cause is known. It mainly occurs in people with defective immune systems or by a human herpes virus 8 (HHV-8). The other known risk factors are radiation exposure and chemical exposure to high doses of chemicals like vinyl chloride, dioxin or herbicides that contain the chemical, phenoxyacetic acid.

Besides, some sarcomas may be hereditary, such as in:

  • Basal cell nevus syndrome
  • Inherited retinoblastoma
  • Li-Fraumeni syndrome
  • Gardner's syndrome
  • Neurofibromatosis
  • Tuberous sclerosis
  • Werner's syndrome

Symptoms of soft tissue sarcoma

Based on the location of tumor the symptoms may vary. In the early stages of soft tissue sarcoma, there are no signs but as the tumor grows the noticeable symptoms are:

  • Formation of lump or swelling
  • Pain (if it presses on nerves or muscles)
  • Blockage in the stomach or intestines or gastrointestinal bleeding

If soft tissue sarcoma is in the upper body then the symptoms are:

  • Uneven posture
  • Pain in the trapezius muscle
  • Cervical inflexibility (difficulty in turning the head)

How to diagnose soft tissue sarcoma

Unlike other cancers, there isn’t requirement of different tests and procedures to diagnose soft tissue sarcoma. The only reliable method to determine the benign or malignant soft tissue sarcoma is through a biopsy.

Biopsy: Removal of a tissue sample to determine the cancerous tumor, two methods may be performed for cytopathological analysis;

  • Needle Aspiration, via biopsy needle
  • Surgically, via an incision made into the tumor

Once the biopsy is done, a pathologist examines the tissue under a microscope and determines the type of cancer and its grade. Grading helps the doctor to analyze the growth rate of tumor and its tendency to spread to various parts of the body and accordingly determines the treatment required. The grades that identify the cancerous sarcomas growth are:

  • Stage I or Low-grade sarcomas: The tumor is small (less than 5 cm or about 2 inches across) and less likely to metastasis
  • Stage II and III sarcomas or High-grade sarcomas: More likely to spread to other parts of the body and they might have already spread to lymph nodes
  • Stage IV sarcoma: It has spread to distant sites which is rarely curable

Treatment for soft tissue sarcoma

For any cancer treatment, the diagnostic results determine the treatment based on size, type, location and stage of the sarcoma, your overall health and whether it has spread to the lymph nodes or other parts of your body. The preferred treatment options for soft tissue sarcomas include surgery, radiation therapy and chemotherapy.

1. Surgery: The first and the most common treatment for stage I soft-tissue sarcomas. It involves the removal of the cancerous tumor and surrounding healthy tissue.

2. Radiation therapy: It uses high energy beams to kill cancer cells. It may be used either before surgery or after surgery to shrink the tumors or to kill the left over cancer kills. In some cases, if removing the tumor through surgical procedure becomes difficult or impossible then radiation therapy alone can be used.

3. Chemotherapy: It is the drug treatment of cancer used with radiation therapy either before or after surgery to shrink the tumor or to kill any remaining cancer cells. It reduces the pain and discomfort but is unlikely to eradicate the disease.

What are the possible side effects of soft tissue sarcoma?

Every treatment will have some short term and long term side effects and this varies from treatment and health of the individual and also the area that is being treated. Some of the known side effects include:

  • Fatigue
  • Skin problems
  • Headache
  • Swelling
  • Weakness
  • Nausea
  • Vomiting
  • Hair loss
  • Mouth sores
  • Increased risk of infection
  • Increased bleeding

Can soft tissue sarcomas be prevented?

As there are no definite risk factors, it is difficult to prevent most cases of soft tissue sarcomas. To prevent soft tissue sarcomas avoiding the exposure to risk factors is the only possible way.