What is Sarcoma? Symptoms, Causes, & Treatment

Sarcoma is a type of cancer that develops in your body's soft tissues or bones. Unlike more common cancers that start in organs like the breast or lung, sarcomas grow in the connective tissues that support and connect different parts of your body.

These cancers can appear almost anywhere in your body, from your muscles and fat to your blood vessels and nerves. While sarcomas are relatively rare compared to other cancers, understanding them can help you recognize when something needs medical attention.

What is Sarcoma?

Sarcoma is actually a group of over 70 different types of cancer that share one key feature. They all start in what doctors call mesenchymal tissue, which is the structural framework of your body.

Think of your body like a house. While other cancers might start in the "rooms" (organs), sarcomas begin in the "building materials" like the framework, insulation, or wiring. This includes your muscles, tendons, fat, blood vessels, lymph vessels, nerves, and bones.

Sarcomas make up about 1% of all adult cancers and about 15% of childhood cancers. Though they're uncommon, they require specialized care because they behave differently from other types of cancer.

What are the Types of Sarcoma?

Doctors divide sarcomas into two main categories based on where they develop. This classification helps determine the best treatment approach for each person.

Soft tissue sarcomas grow in the soft, supportive tissues of your body. These include your muscles, fat, blood vessels, nerves, tendons, and the lining of your joints. Common types include liposarcoma (in fat tissue), leiomyosarcoma (in smooth muscle), and synovial sarcoma (near joints).

Bone sarcomas develop in the hard tissues of your skeleton. The most common types are osteosarcoma (which often affects teenagers), Ewing sarcoma (also more common in young people), and chondrosarcoma (which typically occurs in adults and grows in cartilage).

Each type has its own characteristics, preferred locations in the body, and response to treatment. Your medical team will identify the specific type through testing, which guides your personalized treatment plan.

What are the Symptoms of Sarcoma?

Sarcoma symptoms can be subtle at first, which is why many people don't realize they need medical attention right away. The signs often depend on where the tumor is growing and how large it has become.

For soft tissue sarcomas, you might notice:

• A new lump or mass anywhere on your body, especially if it's larger than a golf ball
• A lump that's growing or changing in size
• Pain in the area, particularly if it's getting worse over time
• Swelling in an arm or leg
• Numbness or tingling if the tumor presses on nerves
• Difficulty moving a joint or limb normally
• Abdominal pain or feeling full quickly when eating (for sarcomas in the abdomen)

Bone sarcomas often cause different symptoms:

• Persistent bone pain that may worsen at night or during activity
• Swelling near a bone or joint
• A hard lump on or near a bone
• Broken bones that happen with minor injuries
• Difficulty with normal activities like walking or lifting
• Fatigue or general feeling of being unwell

Many of these symptoms can have other, less serious causes. A lump might be a harmless cyst, and bone pain could be from an injury or arthritis. However, any persistent or growing lump, especially one larger than a golf ball, deserves medical evaluation.

What Causes Sarcoma?

The exact cause of most sarcomas remains unknown, which can feel frustrating when you're looking for answers. In most cases, sarcomas develop due to random genetic changes that happen as cells divide and grow throughout your life.

However, researchers have identified several factors that may increase the risk:

Genetic conditions play a role in some cases. Certain inherited syndromes like Li-Fraumeni syndrome, neurofibromatosis, or retinoblastoma can increase sarcoma risk. These conditions are present from birth and affect how cells grow and divide.

Previous radiation treatment for another cancer can sometimes lead to sarcoma years later. This happens in a small percentage of people who received radiation therapy, typically 10-20 years after treatment.

Chemical exposure to certain substances has been linked to sarcoma development. This includes exposure to vinyl chloride, arsenic, or certain herbicides like Agent Orange.

Chronic swelling in an arm or leg, often called lymphedema, can rarely lead to a type of sarcoma called angiosarcoma. This most commonly occurs in women who have had breast cancer treatment.

In rare cases, certain viruses like the Epstein-Barr virus or human herpesvirus 8 have been associated with specific types of sarcoma, particularly in people with weakened immune systems.

It's important to remember that having risk factors doesn't mean you'll develop sarcoma. Most people with these risk factors never develop the disease, and many people with sarcoma have no known risk factors at all.

When to See a Doctor for Sarcoma?

You should contact your doctor if you notice any lump or mass that's new, growing, or larger than a golf ball. While most lumps turn out to be harmless, it's always better to have them evaluated by a healthcare professional.

Seek medical attention more urgently if you have:

• A lump that's growing rapidly or has doubled in size
• Severe pain that's getting worse or interfering with sleep
• A lump that's hard, fixed in place, or attached to underlying tissue
• Numbness, tingling, or weakness in an arm or leg
• Persistent bone pain that doesn't improve with rest
• Unexplained fractures or bones that break easily

Don't worry about bothering your doctor with concerns. They're trained to distinguish between concerning symptoms and normal variations. Early evaluation can provide peace of mind and, if needed, lead to earlier treatment.

What are the Risk Factors for Sarcoma?

Understanding risk factors can help you and your doctor stay alert to potential concerns. However, having risk factors doesn't mean you'll develop sarcoma, and many people without any risk factors do develop the disease.

The most significant risk factors include:

Age affects risk differently for different types. Soft tissue sarcomas can occur at any age but are slightly more common in people over 50. Bone sarcomas like osteosarcoma and Ewing sarcoma are more common in children and young adults.

Inherited genetic conditions increase risk significantly. Li-Fraumeni syndrome, caused by mutations in the TP53 gene, greatly increases the risk of multiple cancers including sarcoma. Neurofibromatosis type 1 can lead to nerve-related sarcomas.

Previous cancer treatment can create long-term risk. People who received radiation therapy have a small increased risk of developing sarcoma in the treated area, usually many years later.

Certain medical conditions may contribute to risk. Chronic lymphedema, Paget's disease of bone, or having a weakened immune system can increase susceptibility to specific types of sarcoma.

Environmental and occupational exposures to chemicals like vinyl chloride, arsenic, or certain herbicides have been linked to increased sarcoma risk, though this accounts for only a small percentage of cases.

Most people with sarcoma have no identifiable risk factors, which reminds us that these cancers often develop due to random genetic changes that can happen to anyone.

What are the Possible Complications of Sarcoma?

Like other cancers, sarcomas can cause complications both from the disease itself and from treatment. Understanding these possibilities can help you work with your medical team to prevent or manage them effectively.

Complications from the tumor itself may include:

• Spread to nearby tissues or organs, making treatment more complex
• Metastasis to distant parts of the body, most commonly the lungs
• Nerve damage if the tumor presses on or grows into nerves
• Bone fractures if the tumor weakens bone structure
• Organ dysfunction if the tumor affects vital organs
• Chronic pain that may require specialized management

Treatment-related complications can vary depending on the approach used:

• Surgical complications like infection, bleeding, or loss of function
• Radiation side effects including skin changes, fatigue, or tissue damage
• Chemotherapy effects such as nausea, fatigue, or increased infection risk
• Long-term effects on growth and development in children
• Secondary cancers that may develop years after treatment

Your medical team will discuss these risks with you and work to minimize complications while maximizing treatment effectiveness. Many complications can be prevented or managed successfully with proper care and monitoring.

How is Sarcoma Diagnosed?

Diagnosing sarcoma requires several steps to confirm the presence of cancer and determine its specific type. Your doctor will start with a thorough evaluation and then order specific tests as needed.

The diagnostic process typically begins with a physical examination where your doctor will feel the lump or affected area. They'll ask about your symptoms, medical history, and any family history of cancer.

Imaging tests help visualize the tumor and its relationship to surrounding tissues. Your doctor may order an X-ray, CT scan, MRI, or PET scan. MRI is particularly useful for soft tissue sarcomas because it shows detailed images of muscles, fat, and other soft tissues.

Biopsy is the definitive test for diagnosing sarcoma. During this procedure, a small sample of tissue is removed and examined under a microscope. This can be done with a needle (needle biopsy) or through a small surgical incision (surgical biopsy).

Laboratory tests on the biopsy sample help identify the specific type of sarcoma. These may include special stains, genetic testing, or molecular analysis that guide treatment decisions.

Additional tests may be needed to determine if the cancer has spread. These might include chest X-rays, CT scans of the chest and abdomen, or bone scans.

The entire diagnostic process can take several weeks, which can feel overwhelming. Your medical team will keep you informed about each step and what the results mean for your care.

What is the Treatment for Sarcoma?

Sarcoma treatment is highly individualized based on the type, location, size, and stage of your cancer. Your medical team will develop a personalized treatment plan that may include one or more approaches.

Surgery is the primary treatment for most sarcomas. The goal is to remove the entire tumor along with a margin of healthy tissue around it. For limb sarcomas, surgeons work hard to preserve function while ensuring complete removal of the cancer.

Radiation therapy uses high-energy beams to destroy cancer cells. It may be given before surgery to shrink the tumor, after surgery to eliminate remaining cancer cells, or as the main treatment when surgery isn't possible.

Chemotherapy involves medications that travel through your bloodstream to fight cancer cells. It's more commonly used for certain types of sarcomas, particularly in children and young adults, or when the cancer has spread.

Targeted therapy is a newer approach that attacks specific features of cancer cells. These treatments are available for certain types of sarcomas and may cause fewer side effects than traditional chemotherapy.

For bone sarcomas, treatment often involves a combination of chemotherapy and surgery. The chemotherapy is typically given both before and after surgery to improve outcomes.

Your treatment plan will be discussed in detail with your oncology team, which may include surgical oncologists, medical oncologists, radiation oncologists, and other specialists who work together to provide comprehensive care.

How to Take Home Treatment During Sarcoma?

Managing sarcoma at home involves supporting your body through treatment while maintaining your quality of life. Your medical team will provide specific guidance, but there are general strategies that can help most people.

Pain management is often a priority. Take prescribed pain medications as directed, and don't wait until pain becomes severe. Heat or cold therapy, gentle stretching, and relaxation techniques can also provide relief.

Nutrition support helps your body heal and maintain strength. Eat small, frequent meals if you're experiencing nausea. Focus on protein-rich foods, fruits, and vegetables. Stay hydrated, and consider nutritional supplements if recommended by your team.

Activity and exercise should be adapted to your abilities and treatment phase. Gentle movement, stretching, or physical therapy can help maintain strength and flexibility. Rest when you need to, but try to stay as active as safely possible.

Wound care after surgery requires following your surgeon's instructions carefully. Keep the area clean and dry, watch for signs of infection, and attend all follow-up appointments.

Emotional support is equally important. Connect with family, friends, or support groups. Consider counseling if you're struggling with anxiety or depression. Many cancer centers offer social work services and support groups.

Monitor for concerning symptoms like fever, unusual pain, bleeding, or signs of infection. Keep a list of when to call your doctor, and don't hesitate to reach out with questions or concerns.

How Should You Prepare for Your Doctor Appointment?

Preparing for your doctor appointments can help you get the most out of your time together and ensure all your concerns are addressed. Good preparation also helps your medical team provide the best possible care.

Gather your medical information including previous test results, imaging studies, and pathology reports. Bring a list of all medications, supplements, and vitamins you're taking, including doses and frequency.

Write down your questions before the appointment. Start with your most important concerns in case time runs short. Questions might include treatment options, side effects, prognosis, or how treatment will affect your daily life.

Bring a support person if possible. Having a family member or friend can provide emotional support and help you remember important information discussed during the appointment.

Document your symptoms including when they started, how they've changed, and what makes them better or worse. Note any new symptoms or side effects from treatments.

Prepare for practical matters by arranging transportation, especially if you'll receive treatments that affect your ability to drive. Bring insurance cards, identification, and any required copayments.

Consider bringing a notebook or asking if you can record the conversation to help you remember important details later. Don't be afraid to ask your doctor to repeat or explain anything you don't understand.

What's the Key Takeaway About Sarcoma?

Sarcoma is a rare but serious type of cancer that can develop in your body's soft tissues or bones. While the diagnosis can feel overwhelming, advances in treatment have significantly improved outcomes for many people with sarcoma.

Early detection and treatment by a specialized team offer the best chance for successful outcomes. If you notice any persistent lumps, growing masses, or unexplained bone pain, don't hesitate to seek medical evaluation.

Remember that sarcoma treatment is highly individualized. Your medical team will work with you to develop a plan that considers not just fighting the cancer, but also maintaining your quality of life and function.

Living with sarcoma involves both medical treatment and emotional support. Connect with resources, ask questions, and remember that you're not alone in this journey. Many people with sarcoma go on to live full, active lives after treatment.