July 20, 2017 | by City of Hope
Sarcomas are relatively uncommon cancers, and most people don’t know much about them. If you or a loved one has been diagnosed with a sarcoma, also called musculoskeletal tumors, chances are you have a lot of questions about what they are, and how best to treat them.
Sarcomas are cancers that grow in the body’s connective tissue. They can develop in adults and in children. Broadly speaking, they come in two types:
Osteosarcomas develop in bones. They can cause pain and swelling in the affected bone.
Soft-tissue sarcomas affect many types of connective tissues, including cartilage, fat, muscles, nerves, blood vessels or lymph vessels. The first sign of a soft-tissue sarcoma is often a noticeable lump. Usually (but not always), the lump is not painful.
To diagnose sarcomas, doctors use imaging tools such as X-rays or MRIs (magnetic resonance images). Usually, they confirm that diagnosis with a biopsy, said Crawford. “We need a little piece of the tissue to analyze under a microscope because there are a lot of bothbony tumors and soft-tissue tumors that are not actually a malignant cancer.”
While sarcomas are malignant, the good news is that they are treatable. “This is a curable cancer,” Crawford said.
Surgery is the first line of treatment for sarcomas, Crawford explained. After the tumor is removed, doctors may recommend radiation or chemotherapy depending on the type and location of the tumor.
Sarcoma treatments have become much more targeted in recent years. Sarcoma is a broad term. Even within a certain category of sarcomas, the tumors vary from person to person, Crawford said.
Doctors can now test sarcomas for known genetic defects and antigens, or substances produced by the cancerous cells. In many cases, that information offers clues about which treatments are most likely to work for a particular tumor. “We test for [genes and antigens] so that we can narrow down our chemotherapy to a specific person and a specific tumor,” Crawford said.
Surgery to remove sarcomas has improved over the last few decades. In the past, removing the tumor often required amputation of a limb, Crawford said. Today, City of Hope’s team is able to save patients’ limbs 85 percent of the time.
Crawford and her surgical colleagues are also trying to develop new surgical methods, such as robotic surgery, that are less invasive. “If you have a big tumor in your bone and you have to scrape it out, it requires a large incision and a big recovery time,” she said. She’s hopeful that new techniques can reduce the size of the incision and help patients heal faster.
Like many cancer types, sarcomas can sometimes recur. They might return in the same location, or spread to other parts of the body, Crawford said. “For sarcomas, the place they tend to crop up most often is in the lung.”
While it can be stressful to wonder if the cancer will return, patients are often reassured by regular check-ups. For the first few years after treatment, patients can expect regular check-ups every three months or so. “After five years, the recurrence rate goes down quite a bit,” Crawford said.
“People do survive sarcomas for many years,” Crawford added. “They are treatable and they are curable.”
For more information on signs and symptoms, risk factors and other facts, please visit our sarcoma program website. If you are looking for a second opinion about your diagnosis or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.