Sarcoma Cancer
What is Sarcoma Cancer?
Sarcomas are cancers that arise from either the skeletal system or soft tissues, connect, support and surround discrette anotomic structures. basically, they can be categorised into bone sarcoma and soft tissue sarcoma.
How common is Sarcoma?
These are relatively rare cancers. Between 1968 and 1992 there were approximately 700 to 800 cases of soft tissue sarcomas reported in Singapore. During that same period there were about 250 bone cancers reported.
Age of Onset
Different sarcomas are prevalent in different age groups. During childhood and adolescence, the common sarcomas are the osteosarcoma and ewing sacoma.
Risks and Causes
For most patients, no risk factors have been identified.
Patients with familial diseases such as neurofibromatosis who have multiple benign enlargements of nerve sheaths have a higher risk of one of these enlarged nerve sheaths turning cancerous.
Patients with prior radiotherapy have a slightly higher chance of developing a sarcoma within the previously radiated area. This may take up to 10 years to occur.
Symptoms and Signs of Sarcoma
Many patients first consult a doctor because of a lump or mass on the trunk, leg or arm. The lump may or may not be painful. The sarcoma is diagnosed when biopsy (removal of piece of tissue) of a lump on the arm, leg or trunk is examined under a microscope by the pathologist (doctor who specialises in examining tissue under a microscope). Bone cancers are commoner in the shoulder and knee areas compared to other areas of the body.
When the cancer is advanced there may be weight loss, loss of appetite, or prolonged fever. Other symptoms are referable to the site of the sarcoma, such as feeling of fullness on eating, indigestion, and gastric pain when a stomach sarcoma is present and bleeding from the vagina when a uterus sarcoma is present.
Diagnostic Tests
Most sarcomas are diagnosed when biopsy (removal of piece of tissue) of a lump on the arm, leg or trunk is examined under a microscope by the pathologist (doctor who specialises in examining issue under a microscope).
Once a sarcoma is diagnosed, other tests such as magnetic resonance scanning (MRI) of the site of cancer to delineate extent of the cancer and if it is operable, computerised scans (CT) of the lungs and liver to determine if the cancer has spread, are usually arranged.
Treatment of Sarcoma
Patients who have sarcoma localised to the organ of origin have surgical removal of the entire cancer and a rim of surrounding normal tissue where possible. In some patients, additional radiotherapy to the site of cancer is required after surgery to prevent cancer recurrence at the same site. This is especially so if the cancer was large to begin with.
Radiotherapy to arms and legs is associated with redness of the skin and hair loss over the area radiated. Radiotherapy to the head and neck region is associated with temporary redness of the skin, loss of appetite, loss of salivation and dryness of the mouth. There may be some hair loss also. Radiotherapy to the stomach region is associated with temporary nausea and vomiting, loss of appetite, and occasional gastric pain.
Patients with osteogenic sarcoma usually require chemotherapy to prevent cancer recurrence after surgery. This chemotherapy is given into hand veins and may cause nausea and vomiting, temporary hair loss, lowering of the blood counts and occasional numbness of the fingers and toes. Selected patients with localised soft tissue sarcoma of the limb benefit from cheomotherapy given after the surgery.
In patients with advanced stage sarcoma, chemotherapy can slow the course of the cancer. Associated side effects of chemotherapy are temporary complete hair loss, nausea and vomiting, ringing of the ears, numbness of the fingers and toes, and loss of appetite.
Prognosis of Sarcoma
Clinical examinations, x-rays and pathology reports all help the medical team decide what the progress of an individual case of sarcoma may be. Then, the appropriate course of treatment will be put into action. The treatment strategy will vary from person to person. With prompt and appropriate treatment, the outlook for a person with sarcoma can be excellent.
Patients with smaller sarcomas do better than patients with large sarcomas. Patients with early stage, slow growing sarcoma do better compared to patients with fast growing or more advanced stage sarcoma.
Frequently Asked Questions about Sarcoma
1. My 12-year old nephew has a painful shoulder lump. This occurred after a fall. We have been seeing the Chinese physician but there is no improvement. What should we do?
He should seek urgent medical attention. Plain x-ray of the lump may be able to tell if there is possible cancer present. If the x-ray is highly suspicious of cancer, a biopsy will be arranged by the surgeon to confirm the type of cancer.
|
