What Is Sarcoma? Expert Explains Symptoms, Diagnosis For Rare Cancers

Dr Akshay Tiwari Director & Head - Musculoskeletal Oncology, Max Super Speciality Hospital, Saket explains symptoms, diagnosis for rare cancers.

July is the month of Sarcoma awareness month which is dedicated to raising awareness about sarcoma, a rare type of cancer that develops in connective tissues like bones, muscles, and nerves. It aims to educate the public, promote early detection, support patients and their families, and raise funds for research and treatment options. 

Increased awareness can lead to better outcomes for patients and improve overall understanding of this less common type of cancer. But what is Sarcoma? What are its symptoms? How can it be diagnosed? 

Dr Akshay Tiwari Director & Head - Musculoskeletal Oncology, Max Super Speciality Hospital, Saket explains symptoms and diagnosis for rare cancers. 

What Is Sarcoma? 

Dr Tiwari shares that sarcoma is a cancer of connective tissue, that is, bones, muscles, tendons, ligaments, nerves, vessels, etc. The upper and lower limbs are the most commonly affected organs, although they can affect any part of the body. Thus, sarcoma is broadly classified under two types - bone sarcomas and soft tissue sarcomas. That said, there are close to a hundred subtypes of bone and soft tissue sarcoma. 

Symptoms Of Sarcoma

Dr Tiwari explains, sarcomas of bone usually present with swelling and/or pain in the involved bone, which can also have fracture. On the other hand, the majority of soft tissue sarcomas present with painless swelling or mass. 

“Sarcomas form just one percent of all cancers. Because of this rarity, it is common to see delays in the diagnosis and the much-needed referral to a specialised sarcoma unit. In fact, in our sarcoma clinic, a very familiar conversation is "We never knew bones can also have cancer!" or ‘We thought it was just another injury,’” he said. 

Sarcoma Diagnosis 

Dr Tiwari said, “Once clinically suspected, diagnosis of a sarcoma is confirmed with imaging ( including X-ray, MRI, and sometimes CT scan) and biopsy. It is highly recommended that a biopsy of a suspected sarcoma be done at a center where a specialised sarcoma team is available. Once diagnosed, treatment will consist of a surgical "wide excision" in most cases, where the tumor is carefully removed along with a layer of surrounding normal tissue, followed by appropriate reconstruction. “

“This "limb salvage surgery" forms the mainstay of sarcoma surgery in today's times, and is possible only if the patient reaches a sarcoma unit early enough. Patients may also be advised to undergo chemotherapy and/or radiation therapy, depending on the diagnosis. As with all rare diseases, planning, and execution of sarcoma management are best performed by specialized multidisciplinary sarcoma teams,” he further explained. 

What Can Be Done For Sarcoma Awareness? 

As per Dr Tiwari, healthcare providers, patient advocacy groups, NGOs, schools, and colleges should create an environment of awareness about this rare cancer. Any swelling or lump that is more than 5 cm in size (more than the size of a lemon), increasing in size over time, and/or painful, should be considered a sarcoma and investigated accordingly. 

“Once suspected, patients affected by sarcoma should be referred to specialized sarcoma units. Even a biopsy for diagnosis should be performed by a sarcoma surgeon; a wrongly performed biopsy could lead to amputation in an otherwise salvageable limb. Fortunately, NGOs and patient support groups are working closely with sarcoma units, raising awareness and helping patients with treatment,” Dr Tiwari said.