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What is Sarcoma? Sarcoma, from the (Greek
sarcoma, fleshy tumor) is an uncommon cancer, originating from
the structural tissues of the body such as bone, cartilage and
muscle, in which the cells making up those tissues begin to grow
out of control.
Sarcomas often attack men and women in their most productive years
(30-60), and in a few cases may be result of identifiable familial
genetic factors, radiation, toxic chemicals, or infection with
the HIV virus. Usually the etiology is unknown.
Sarcomas characteristically first present as painless enlarging
tumor masses found on physical examination or X-ray, usually without
other symptoms. However, these tumors soon exhibit progressive
growth, which produces pressure against adjacent normal structures,
infiltration and damage of nearby organs, and/or widespread dissemination
of the cancer to liver, bone and brain.
How serious is it ? Sarcoma , like some other cancers,
must be regarded as a serious and potentially life-threatening
tumor. The magnitude of the danger depends upon (1) where the
tumor began, (for example, the head/neck area, trunk, thigh, elbow,
hand or foot), (2) whether the tumor can be removed with a substantial
surrounding zone of normal tissue, (3) whether the tumor has infiltrated
adjacent organs (bone, arteries, nerves) preventing its timely
surgical removal, or has metastasized (spread via the blood stream
or via lymphatic channels) to vital organs, (4) how intrinsically
aggressive the tumor is, how rapidly it is growing, and how effectively
it can infiltrate into surrounding tissues. Unremovable growing
tumors are almost always fatal if effective treatment cannot be
found.
How are sarcomas diagnosed? In all cases, the diagnosis
of sarcoma must first be unquestionably established by biopsy
of affected or suspicious tissues, and by definitive microscopic
examination by a trained pathologist. Often, the removed tissues
are treated with special biological or chemical stains are used
to help in establishing a firm diagnosis. The pathologist usually
also comments upon the degree of local infiltration or invasion
of surrounding tissues, rate of growth, and biological virulence
of the tumor.
Second, the tumor must be carefully staged by X-ray, CAT scan,
MRI or other types of scans to establish its location(s) within
the body, and to estimate the likelihood of its curability. Often
the distribution of a soft tissue sarcoma is only fully appreciated
after exploratory surgery is done.
How are sarcomas treated? A treatment plan is devised depending
upon the tumor type, aggressiveness, primary location, and its
dissemination to areas distant from the primary site. Treatment
with surgery, radiation therapy or chemotherapy used alone or
in combination may be proposed, depending upon the potential benefits
and risks of each modality. Surgery is sometimes used alone when
a tumor is completely removable and a large cuff of normal tissue
can be taken with it. Often, this is not possible, and the tumor
can only be removed with a thin margin of safety; in those cases,
radiation therapy is often used to help prevent the tumor from
growing again at the surgical site. Sometimes, chemotherapy is
used to shrink the tumor to facilitate its removal, or to help
prevent the tumor cells from entering the bloodstream and spreading
widely.
Because sarcomas represent less than one percent of cancers and
and are infrequently seen in the practice of most community oncologists,
finding the correct treatment can be very difficult. Proper management
of sarcomas often requires evaluation at larger tertiary hospitals
or Comprehensive Cancer Centers by specialists in medical, surgical
and radiation oncology with experience in all aspects of the clinical
care of sarcoma patients, including the newest experimental treatments.
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