What is a sarcoma?
A sarcoma is a cancer (malignant tumour) arising from bone, cartilage, or soft tissues such as fat, muscle, connective tissue or blood vessels. Sarcomas are rare cancers and occur in approximately 1% of the Australian population.
Sarcomas are often diagnosed late as they are very uncommon in general practice and there are many benign diseases that may have similar symptoms. They need to be managed by a multidisciplinary team as even the biopsies need to be handled in specific ways. The biopsy should be done after consultation with sarcoma surgeon if a sarcoma is suspected.
How is a diagnosis made?
To accurately diagnose a sarcoma a sample (biopsy) is required and tissue needs to be taken both fresh and fixed in formalin for microscopic analysis. The first question for the pathologist is whether a sarcoma is present, and if so, what type. There are many different types of sarcoma, some of which may be offered different kinds of treatment. Some examples are osteosarcoma (bone), chondrosarcoma (cartilage), liposarcoma (fat), fibrosarcoma (connective tissue), angiosarcoma (blood vessels), leiomyosarcoma or rhabdomyosarcoma (smooth muscle or skeletal muscle).
In some tumours it is not possible to tell what tissue is involved and diagnosis requires the use of special stains (immunohistochemical stains) that show some of the characteristic changes of these tissue types at the chemical level. Other tests that can be helpful include electron microscopy and genetic analysis, looking for specific genetic mutations that occur in some types of sarcoma.
How are sarcomas treated?
What treatment a person is given depends on the size, location, grade and subtype of sarcoma. The size influences the risk of tumour spread and the chance that the surgeon will be able to remove the tumour completely. The location determines what other structures are close to the tumour and may limit the ability to completely remove the tumour eg blood vessels and nerves, and also is important in determining how to best reconstruct the area after surgery, and what other procedures will be required to give the patient good function. The grade of the tumour is important in determining the risk of tumour recurrence.
Generally surgery is the treatment of choice if possible and this may be followed by radiation in some cases and chemotherapy. For some sarcomas, chemotherapy or radiotherapy is used first to shrink the tumour. This has the benefit of improving the chances of removing a tumour surgically that may not be possible otherwise.
These tumours are best managed by a multidisciplinary team which includes a surgeon, a radiation oncologist, a medical oncologist, a pathologist, and a radiologist.
Because each individual tumour has unique considerations depending on the site, grade, etc this is best discussed directly with your doctors.
New Sarcoma Fact Sheets
Please click on the links below to download the newest Sarcoma factsheets:
Soft tissue sarcoma info sheet - Cancer Council Victoria
Click here to download
Primary bone cancer info sheet - Cancer Council Victoria
Click here to download
