Unless you or a loved one has been diagnosed with a sarcoma, you may be unfamiliar with these uncommon cancers. “Sarcomas are tumors that develop in the bones or connective tissues, such as fat, muscle, tendons or nerves,” explains Eric Henderson, MD, an orthopaedic oncology surgeon who treats pediatric and adult patients with bone and soft-tissue sarcomas at Dartmouth-Hitchcock Norris Cotton Cancer Center (NCCC). Here are 10 things you may not know about sarcomas:
- Sarcomas are rare. The American Cancer Society estimates there will be about 13,000 new soft tissue sarcomas and 3,000 new bone sarcomas in the U.S. in 2020. “Because sarcomas are uncommon, research shows that patients treated at National Cancer Institute (NCI)-designated cancer centers with specialized sarcoma programs, such as NCCC, have better outcomes,” notes Henderson.
- There are many types of sarcoma. There are at least 50 types of soft-tissue sarcoma, more often found in adults, and about seven major types of bone sarcomas, more commonly occurring in children.
- The causes of sarcoma are mainly unknown. Unlike many cancers that have characteristic risk factors associated with them, such as tobacco smoking and lung cancer, the causes of most sarcomas are unknown.
- Sarcomas are treatable. Most patients with sarcoma will be cured following multidisciplinary care with a specialized team.
- Limb-sparing surgery is possible for most sarcomas. “In earlier decades, amputation, or removal of the affected limb, was required for most sarcomas. Today, however, because of advancements in sarcoma treatments at specialized centers, limb-sparing surgery is possible in more than 90 percent of cases,” says Henderson.
- Appropriate treatment is the key to the best outcomes. Because they are rare, sarcomas are often mistaken for more common tumors such as lipomas, a fatty lump just under the skin that is usually not cancerous. “Surgical removal of a sarcoma without appropriate pre-surgical work-up can lead to a worse outcome and be more likely to require amputation,” says Henderson.
- Recognition is important. Research shows that any soft tissue mass that is larger than a golf ball should be approached as a potential sarcoma. “Masses of this size should be referred to a specialist and undergo appropriate testing and imaging before any surgery is undertaken,” advises Henderson.
- A common symptom of bone sarcoma is bone pain. “Bone pain that is not explained by a recent trauma should be evaluated with an X-ray,” notes Henderson. “Because bone sarcomas are rare, recognition is often delayed by weeks or months, which allows more time for the tumor to grow.”
Trials of new technology are underway. “Researchers here at NCCC are conducting a first-in-human trial of fluorescence-guided surgery,” says Henderson. “The technique will allow surgeons to ‘see’ the cancer through surrounding tissues by using special molecules that bind to sarcomas and identify individual cells (see photo). This technology will lead to improvements in our ability to completely remove sarcomas surgically.”
- NCCC is a leader in limb-sparing surgical research. NCCC investigators just published the largest-to-date scientific outcomes paper of patients receiving total femoral replacement for bone sarcomas, as an alternative to lower limb amputation. NCCC investigators have also published the world’s largest series of other limb-sparing operations.
Each person’s medical history, genetics, environment and behaviors are different. Your providers can discuss your individual sarcoma risk factors and make recommendations that are appropriate for you.