Sarcoma Cancer Treatment in India

Sarcoma cancer is a rare type of cancer that develops in the connective tissue (bones, muscles, tendons, cartilage, or blood) or soft tissues of the body.

Associated Anatomy of Sarcoma Cancer

Bones, muscles, blood, and nerves

Sarcoma Cancer Causes

The exact causes of sarcoma cancer are not well known, but some of the causes can be:

• Genetics: DNA mutations at the cellular level can modify the oncogenes to cause sarcoma.
• Age: Older people above age 65 are more likely to have sarcoma than younger adults and children.
• Environmental factors: Exposure to certain chemicals like arsenic, dioxin, or herbicides and having a previous history of radiation therapy (for cancer) increase the chances of sarcoma.
• Swelling: People with swelling in their limbs for longer durations are at more risk of sarcoma.
• Compromised immunity: HIV/Aids patients or those who have undergone an organ transplant have weaker immunity and are at higher risk of sarcoma.

Sarcoma Cancer Symptoms and Signs

Symptoms associated with sarcoma cancer vary as per the size of the tumour and its location in the body. Early signs of the disease are:

• Pain and swelling in the arms and legs for a longer duration.
• Difficulty in moving.
• Fever for a very long time.
• Sudden occurrence of a lump, recurrence of a lump after removal, or increased size of the lump accompanied by pain or without pain.
• Unreasonable pain in or breaking of the bones.

Stage of Sarcoma Cancer

If the tumour has increased in size and spread to other body parts, it is more difficult to treat. Bone sarcoma and soft tissue sarcoma can occur in the following four stages:

Stage 1

The mass is benign and small in size (5-8 centimetres).

Stage 2

The tumour is present in the gastrointestinal tract, arms and legs, or the neck region and is smaller in size (~8 centimetres).

Stage 3

The tumour has increased in size and the cells are infecting the lymph nodes. It can spread further from the lymph nodes to other parts of the body.

Stage 4

In this stage, metastasis of the cancer cells occurs, and it spreads to distant parts like the lungs.

Sarcoma Cancer Diagnosis

Doctors can determine the stage of sarcoma by studying the medical history and closely monitoring the signs and symptoms. A detailed physical examination is done to rule out other causes of pain and swelling. Certain tests like X-rays and MRI scans offer a detailed view of the bones and tissues and determine abnormalities. In some cases, imaging techniques like CT-scan or PET scan can also be ordered to diagnose the underlying problems. If the lump is growing in size, then a biopsy can be done to determine the type of cancer and the specified line of treatment.

Sarcoma Cancer Treatment

The scope of treatment varies from patient to patient and depends on the type of cancer, and to which extent it has spread in the body. If the tumour is benign, the line of cancer treatment is surgery. The cancer mass is removed from the bone instead of the whole arm or leg.

If the tumour has metastasized, a combination of the below-mentioned treatments is carried out:

Radiation therapy

Radiation therapy, the cancer cells remaining after the surgery are killed using powerful rays.

Chemotherapy

Medications or drugs can be used along with radiation to slow down the growth of cancerous cells if surgery is not a feasible option. Chemotherapy is given along with radiotherapy as chemoradiotherapy before surgery to reduce cancer or after surgery to prevent cancer from coming back.

Targeted therapy

In Targeted therapy, artificial antibodies are used to block the growth of cancerous cells at the cellular level without damaging healthy cells.

Ablation therapy

In Ablation therapy, high energy ultrasound waves, electricity, or cold liquid is used to heat and freeze the cancer mass, which destroys the cells.

Risk Factors of Sarcoma Cancer

The causes of sarcoma cancer cannot be specified, but the following groups of people are more likely to develop sarcoma:

• People with a family history of sarcoma or cancer.
• People undergoing radiation therapy for any type of cancer in the body.
• People diagnosed with a bone disease like Paget’s disease or genetic disorders like Li-Fraumeni syndrome, Gardner syndrome, basal cell carcinoma, or retinoblastoma.

Complication of Sarcoma Cancer

There are chances of reoccurrence of the tumour if it has developed to later stages. If the mass is removed surgically, then it is possible that it can grow again. Side-effects like delayed wound healing, chronic swelling, and limited movement due to surgery and from chemotherapy and radiation therapy can affect the quality of life of the patient.

Sarcoma Cancer Prevention

Primary Prevention

• Sarcomas can be prevented by minimizing exposure to carcinogens.
• Lifestyle improvement (Dietary changes, quitting smoking, and exercising) can limit the environmental factors to trigger the disease at a genetic level.
• Getting vaccinated can prevent infections from microorganisms and viruses, which is one of the contributing factors to cancer.

Secondary Prevention

To date, there is no known method to prevent bone sarcoma, but early detection can help treat the disease better. Those with a family history of cancer or genetic disorders should go through regular screening and doctor visits to detect sarcoma at an earlier stage.

Epidemiology of Sarcoma Cancer

• Sarcoma is more common in children than in adults. 15% of cancers in children are generally sarcoma cancer.
• In more than 60% of cases, sarcoma occurs in the bones and limbs.
• Osteosarcoma has a survival rate of 70-75% if it is benign and has not spread to other body parts.

Expected Prognosis of Sarcoma Cancer

The survival rate of an individual is almost 5 years from the time of detection of cancer. If the cancer is localized, the survival rate increases by 81% for soft tissue sarcoma. If it has spread to the lymph nodes (stage 3), the survival rate reduces by half.

Natural Progression of Sarcoma Cancer

If the sarcoma is not detected early and left untreated, the cancerous cells can also metastasize to distant body parts. These include the lymph nodes, neck, gastrointestinal tract, lungs, and so on.

Pathophysiology of Sarcoma Cancer

Sarcoma occurs due to the abnormal growth of connective tissue (bones, cartilage, fat cells, and blood). The genetic mutation can occur in any cell line, like blood, bone, or muscles, resulting in either bone sarcoma or soft tissue sarcoma.