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Sarcoma is a rare form of cancer that affects the tissue and can be deadly like all other cancers if not detected and treated early. According to the Mayo Clinic, "Sarcoma is the general term for a broad group of cancers that begin in the bones and in the soft (also called connective) tissues (soft tissue sarcoma). Soft tissue sarcoma forms in the tissues that connect, support and surround other body structures. This includes muscle, fat, blood vessels, nerves, tendons and the lining of your joints. There are more than 70 types of sarcoma. Treatment for sarcoma varies depending on sarcoma type, location and other factors." Eat This, Not That! Health spoke with Dr. Juan Pretell, Chief of Musculoskeletal Oncology Surgery with Baptist Health's Miami Cancer Institute who explained what to know about sarcoma cancer and signs to be aware of. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID .
Dr. Pretell shares, "Sarcomas are rare cancers in adults (1% of all adult cancers), but rather prevalent in children (20% of all childhood cancers). More than 16,000 new cases are diagnosed each year, and nearly 7,000 people die each year from sarcoma. Sarcomas are malignant tumors that have the potential to spread to other parts of the body. These tumors origin from the mesenchymal cells so they can arise from different tissue structures (nerves, muscles, joints, bone, fat, blood vessels – collectively referred to as the body's "connective tissues"). There are two main groups including bone sarcomas and soft tissue sarcomas which have different symptomatology; however, the prognosis overall is similar with many cases presenting metastasis at diagnosis or during the surveillance period. In most cases, it's not clear what causes sarcoma. The most common sarcoma in adulthood is Undifferentiated Pleomorphic Sarcoma (UPS); whereas, with children and adolescents, the most common sarcomas are Ewing sarcoma and osteosarcoma (bone tumors), and embryonal rhabdomyosarcoma and alveolar rhabdomyosarcoma (muscle tumors). About 80-90% of childhood sarcomas are Ewing sarcoma or osteosarcoma." 6254a4d1642c605c54bf1cab17d50f1e
According to Dr. Pretell, "The most common symptom of bone sarcomas is pain localized in the tumor area, which is usually around the knee. This can be associated with swelling and functional limitation. In these cases, patients can also present with pathological fractures that can alter the course of disease if not treated properly. "
Dr. Pretell explains, "Painless "bumps" that appear without a "reason" and have a constant growth can be a symptom of soft tissue sarcomas. They are usually in the lower extremities and located in deep tissues. They can be painful if adjacent anatomical structures are involved and can invade vessels and bones requiring extensive surgery for excision and reconstruction. Usually, constitutional symptoms are not present."
"Sarcomas in general are not too symptomatic," Dr. Pretell shares. "Constitutional symptoms are not always present except for sometimes in Ewing's sarcoma. In bone sarcomas pain is characteristic, but soft tissue sarcomas usually are painless. Against what people normally believe, if you have a growing "bump" that is not "hurting," you should be concerned. Also, these tumors are very aggressive and tend to metastasize — mainly to the lungs. A patient won't have respiratory symptoms until advanced disease is present. This is why once you are diagnosed with a sarcoma, you should be followed in a sarcoma center where there is a multidisciplinary team working together."
Dr. Pretell says, "The cornerstone of treatment is a wide local excision. This means to remove the tumor with "normal" tissue around. Because most of these tumors are high grade and have a high probability of "spreading" to other parts of the body, chemotherapy has been used but without global consensus. This treatment can be administered before (neoadjuvant) or after (adjuvant) surgery. Radiation therapy, a form of treatment for local control (decrease local recurrence of sarcoma), is used in a more consistent way throughout sarcoma centers. This treatment modality helps surgeons either to decrease the tumor in size and in some cases, facilitate resection, decreasing the chances for local recurrences. This can also be administered before the surgery (neoadjuvant). Overall, patients with sarcomas should be treated in sarcoma centers following a multidisciplinary approach."
"From the surgical standpoint, there have been advances in the development of endoprosthesis used to reconstruct the bones after resection of bone sarcomas," says Dr. Pretell. "These endoprosthesis (megaprosthesis) have been evolving in their designs helping increase their survival (extended time to failure) but also are better adjusted to the patients' needs with a modular system and even more specific for the treated patients with custom made implants which are 3-D printed. From the medical standpoint, there has been an increase in the use of molecular testing to identify specific mutations which can be used as target treatment when first line treatments fail, or patients need to switch due to intolerable side effects. Also, immunotherapy, which is a way to potentiate your immune system so "your body fights against the cancer cells," has also been introduced in sarcoma treatment."
Dr. Pretell explains, "As in carcinomas, sarcomas don't have specific risk factors for development, but certain subtypes have been associated with previous radiation therapy, genetics, immune system abnormalities, lymphedema and chemicals. There are inherited disorders such as retinoblastoma, NF-1, tuberous sclerosis, familial adenomatous polyposis and li-fraumeni syndrome, that are associated with an increased risk for developing sarcomas."
According to the Mayo Clinic, "Factors that can increase the risk of sarcoma include
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