Have you or a family member been diagnosed with sarcoma? Here is some information you may find helpful.
What is sarcoma?
Sarcoma is a complex type of cancer. In general, cancers form when a person’s DNA mutates (changes). As a result, abnormal cells grow rapidly and form a tumour. Over time, cells may also break away and spread (metastasize) to other parts of the body. Most cancers arise in the lining of organs (such as in the lining of the skin, the breasts, the colon, the prostate and the lungs). However, sarcoma is different. Sarcoma develops inside of tissues. For example, sarcomas may develop inside of muscles, blood vessels, nerves, fat, or bones. There are over 100 types of sarcomas, and 2 main categories: bone and soft-tissue sarcomas. The McGill Sarcoma team specializes in care and treatment for all types of sarcoma.
Sarcoma is a type of cancer of the bone and connective tissues (such as muscles, fat, blood vessels, tendons and fibrous tissues).
Sarcoma is very rare in adults – it makes up about 2% of all cancers
Sarcoma is more common in children than adults (about 10% of all cancers in children, vs 1% of all cancers in adults)
There is over 100 types of sarcoma, which makes diagnosis, expertise and knowledge about Sarcoma challenging. Treatment options will vary according to the type of Sarcoma, how advanced it is and its location.
Survival rates vary depending on the type
Bone sarcoma
Osteosarcoma
Osteosarcoma arises in the bones. It is most often found in the lower limbs. It tends to affect teenagers and young adults. Elderly people with Paget’s disease can also develop this kind of sarcoma. Osteosarcoma is treated with chemotherapy and surgery.
Ewing’s Sarcoma
Ewing’s sarcoma often occurs in the bones, and sometimes in soft-tissues. It usually begins as a lump in the limbs or in the pelvis. It occurs most often in children and teenagers. It can spread quickly to the lungs and bones. The treatment for Ewing’s sarcoma includes chemotherapy and surgery, and sometimes radiation.
Chondrosarcoma
Chondrosarcomas arise in bone and looks somewhat like cartilage. They are most frequently found in the hip, shoulder and pelvis. They are usually managed by surgery only. Complete removal of the tumor gives best chance for cure. Some chondrosarcoma grow slowly and cure is thus frequently achieved but, in other instances, they may grow more aggressive and spread rapidly.
Chordoma
Chordomas are rare tumours that can involve the spine, the sacrum or the skull. It usually occurs in middle-aged individuals. The treatment is usually surgery. Sometimes, radiation may be useful as well.
Soft-tissue Sarcoma
Undifferentiated Pleomorphic Sarcoma (UPS)
UPS is a type of sarcoma where tumour cells are undifferentiated. This means that UPS tumour cells look completely different than any other cells in the body. UPS usually grows in the upper or lower limbs, and often spreads to the lungs. It usually affects the older population. UPS are usually treated with radiation and surgery. Chemotherapy or immunotherapy may also be considered.
Leiomyosarcoma
In leiomyosarcoma the cancer cells resemble smooth muscle cells. It is often found in limbs and abdomen, but can also involve the uterus, bladder, stomach and blood vessels. Further, it can also be found in the uterus, which can make it hard for doctors to tell the difference between fibroma or leiomyoma (non-cancerous) and leiomyosarcoma (cancerous). It may cause pain, weight loss, nausea and/or vomiting. The main treatment is surgery.
Liposarcoma
A family of soft-tissue sarcomas where the tumour cells look similar to fat cells. It usually occurs in people 40 and older. It is often found in arm or leg muscles, or in the abdomen. The treatment is usually radiation, and surgery. There are several kinds:
- Well-differentiated liposarcoma: not really cancerous, grows slowly, usually does not spread and depending on its location it may come back. In about 3% it eventually transforms into a real cancer.
- Dedifferentiated Liposarcoma: usually suggests an advancement (worsening) of a previously diagnosed well-differentiated liposarcoma. It is less common but can spread to other parts of the body.
- Myxoid liposarcoma: grows slowly and usually responds very well to radiation. Following such management, it is unlikely to come back in the same location but may spread to other parts of the body. It is categorized in low-grade myxoid liposarcoma and high-grade myxoid liposarcoma, a more aggressive form.
- Pleomorphic liposarcoma: a rare type that can spread to other parts of the body very quickly.
Synovial sarcoma
Synovial sarcoma usually occurs in people between 15 and 40 years of age. It is often found near large joints, such as the knee. It does not affect the inside of the joint (synovium) as the name suggests. It usually appears as a deep, slow growing mass that may have been present for many years. It may or may not be tender. Treatment usually includes surgery, and sometimes radiation and/or chemotherapy.
Myxofibrosarcoma
Myxofibrosarcoma grows slowly and usually appears as a painless mass on a limb. It occurs mostly in people aged 50 to 70. It may grow in connective tissues that are right under the skin, or deeper in the body (such as in and around muscles). Further, it tends to extend along and around the muscle envelops, sometimes far from where the tumour bump is felt. Radiation and surgery are usually recommended.
Malignant Peripheral Nerve Sheath Tumour
Malignant Peripheral Nerve Sheath Tumour (MPNST or Neurofibrosarcoma) is a cancer of the lining of nerves that connect the spine to the arms and legs. Neurofibromatosis type 1 is associated with MPNST. Most times, it occurs deep inside of the arms, legs and torso. It may cause weakness and pain, and sometimes may appear only as a growing mass. It is usually treated with radiation, and surgery.
Rhabdomyosarcoma
Rhabdomyosarcoma appears in muscle (in the limbs, head and neck), or in organs (such as in the prostate and the uterus). It affects children more often than adults. Chemotherapy and surgery are usually combined for its management. Radiation may also be suggested, depending on the tumour’s characteristics.
Angiosarcoma
Angiosarcoma is a growth of cancer cells similar to those lining blood vessels. It can occur anywhere in the body, but often appears in the skin of the head and neck. It usually causes a raised, purplish bruise that grows over time and may bleed when scratched. It may be seen in people who have had prior radiation or chemotherapy for a previous cancer. Angiosarcoma can also affect an organ’s functionality and cause pain. Treatment usually involves surgical removal, and sometimes the addition of radiation and/or chemotherapy.
Solitary Fibrous Tumour (SFT)
Solitary fibrous tumours arise in soft-tissues, most frequently in the lungs (pleural solitary fibrous tumour) or in the brain (hemangiopericytoma). It usually grows slowly. Some are indolent, while others are frankly malignant. The treatment includes surgery, and possibly radiation as well.
Dermatofibrosarcoma Protuberans (DFSP)
DFSP is a rare cancer that begins in the middle layer of the skin (dermis). It can cause lumps on the skin similar to a thick scar; mostly on the arms, legs and torso. It grows slowly and rarely spreads elsewhere. The treatment usually includes surgery and sometimes radiotherapy.
Epithelioid sarcoma
Epithelioid sarcoma is a soft-tissue cancer that grows slowly. It usually starts in forearm or leg as a small, firm, painless growth. Sometimes, it presents as a small ulcer that does not heal over time. It mainly occurs in teenagers and young adults. A variant affects mainly adults and tends to be more aggressive. Epithelioid sarcoma is more likely to come back in other areas of the same limb , and spread to other parts of the body (especially to the lymph nodes.) Treatment involves surgery, and/or radiation.
Desmoid Tumour
Desmoid tumours are benign aggressive (non-cancerous) fibrous tumours. They usually arise in the shoulder or pelvic girdles. They may not require treatment if they do not grow or cause major symptoms. However, when they require treatment they are managed somewhat like cancer with aggressive surgery, modified chemotherapy or radiation. Sometimes, after many years, they may spontaneously regress.
Gastrointestinal Stromal Tumour (GIST)
GIST tumours occur in the abdomen. They are often found incidentally (by accident) through an endoscopy or CT scan. They may also spread to other parts of the body. The main treatment is surgery. Targeted therapy (a type of cancer medication, different from chemotherapy) has also proven to be very helpful.
Desmoplastic Small Round Cell Tumours (DSRCT)
DSRCT usually begins in the abdomen, specifically in the peritoneum (tissue) that lines the inside of the abdomen and pelvis. It quickly spreads to other structures in the abdomen. Treatment usually includes surgery, chemotherapy and/or radiation therapy.
Kaposi’s sarcoma
Kaposi’s sarcoma forms in the lining of blood and lymph vessels. It is caused by a virus called Human Herpesvirus 8 (HHV-8). This is a virus that can be found in people with weakened immune symptoms, such as people with HIV or organ transplants. It usually appears as painless, purplish spots on the legs, feet or face. In severe cases, Kaposi’s sarcoma may develop in the digestive tract or in the lungs. It is usually addressed without surgery.
Testimonials
“Dear team,
I want to thank you for saving my life 20 years ago. I will never forget your dedication, your efforts and your cheerfulness which helped me to go through this tough part of my life. Thank you!” – M.P., Gatineau
“Dear nurses,
For many years you were involved with caring for my cousin who passed away in November.
I want to take the opportunity during nurses week to thank you for supporting her and her family during the many challenges that she faced. You were a trusted resource and even if there were times when she was reluctant to go to the hospital or if she had questions, your guidance was always something she could count on.
Please know that everything that you did along her journey was really appreciated.” – M.S.
“Thank you for going above and beyond for us. We appreciate everything you do.” – G. and L.
”Dear team,
I wanted to take this opportunity to say a very heart felt thank you for all that you have done. I could never do what you do but I am extremely thankful, grateful and respectful that you do it, at such an excellent level. Much appreciation and gratitude…Always!” – C.O.
“Thank you to the entire team for the gift you have given me.” – M.S.
”To the team,
With grateful appreciation and heartfelt thanks for the past wonderful 11 years of life.
My family and I shall always remember your extraordinary kindness and compassion and your outstanding medical expertise and care.
Most sincerely” – R.F.
“Thank you for taking care of me, always.” -S.T.
“Thank you for everything!” – D.B.
Cancer weighs heavy on the heart, but you were able to make it light and make me feel as though I was in the best hands I could be in.
Your compassionate attention and professional care saved my life. There are not enough words for me to express my appreciation.
Thank you so much for the great care and surgery you performed on me. You and your team have made such a huge difference for me.
I will be forever greatful to you.
Sincerely,
R.A.Z
Sarcoma patient
In my sky, you have been a reassuring star over the past ten years.
I celebrate with you.
Thank you
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