‘This Is a Curable Cancer’: New Treatment Options for Sarcoma
July 9, 2018
| by Kevin Chesley
Brooke Crawford, M.D.
— or musculoskeletal cancer
— affects the connective tissues of the body. These are uncommon cancers, and are split into two types: osteosarcoma (bone cancer) and over 50 classifications of soft tissue sarcomas, ranging from cancers of the muscles, fat, blood and lymph nodes to tumors in the nerves and deep skin and joint tissue.
The Road to Sarcoma
Typical cancers, like lung
, occur in glandular organs. Sarcomas are different, including what creates them.
“The biggest risk factor for sarcoma is radiation exposure,” Crawford explained. “This could be someone treated with radiation for cancer, or a secondary sarcoma due to lung cancer traveling to the bone. Others at risk include anyone who once worked in a nuclear power plant. Exposure to X-rays without the appropriate safety protection, like leaded aprons, is also of concern.”
The first sign of sarcoma is often felt by the patients themselves.
If it’s a bone, you feel pain because it weakens the bone, or grows into a hard lump. A sarcoma can create more bone, then eats it away. They tend to grow slowly. People find them accidentally — perhaps doing a certain stretch, or they put their clothes on and they fit funny.”
Diagnosis and Action
Once a sarcoma is suspected, specialists like Crawford have many tools for further examination. “Biopsies are important. X-rays help for bone tumors, MRIs for soft tissue tumors,” she said. “A little piece of tissue is needed to analyze under a microscope to see if tumors are benign or malignant.”
Should a sarcoma be diagnosed, however, there is some good news: “This is a curable cancer that is treated with surgical resection and, perhaps, chemotherapy. Some soft tissue tumors or microscopic cells also require radiation therapy, especially if it’s around a vital structure, nerve or blood vessel.”
Continual watchfulness is needed, however, even after a sarcoma has been treated. “People survive sarcomas for many years, but they do have a recurrence rate both locally, meaning in the same place, and systematically, occurring elsewhere in the body — most often in the lung,” she said. “Negative margins and the biology of the tumor are the biggest risk factors. We see people for years after, taking X-rays and MRIs [to monitor their condition]. It can be stressful, but the recurrence rate goes down as the years go by.”
Therapies to Target Sarcomas
Crawford and her dedicated team of health professionals have a host of different ways to treat sarcoma once it is diagnosed. “We use targeted therapies, immunotherapies and gene testing,” she said. “There are many genes and antigens on these tumors, and we test them all so that we can narrow down our chemotherapy for each specific person’s genetic defect and the antigen that should be targeted.”
The Future of Sarcoma Treatment
Crawford is encouraged by recent treatment advancements. “We can take somebody who 30 years ago would require an amputation, and we can reconstruct their limbs over 90 percent of the time. We can go into a bone and scoop out the tumors to replace them with graft or cement. We’re trying methods using robotic to make surgery less invasive and easier for the patient to recover from. These are amazing advancements.”
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