Soft Tissue Sarcoma

What is a Soft Tissue Sarcoma?

Soft tissue sarcoma is a rare type of cancer that begins in the tissues that connect, support and surround other body structures. This includes muscle, nerves, tendons, blood vessels, fatty and fibrous tissues.

Soft tissue sarcoma can occur anywhere in your body, but the most common sites are the arms and legs, and in the abdomen. Surgical removal is the most common treatment, although radiation and chemotherapy also may be recommended.

What are the symptoms of Soft Tissue Sarcoma’s?

The symptoms of soft tissue sarcoma will vary, depending on the size of the cancer and where it is in the body. You may notice a lump or swelling in the soft tissue of the body under the skin, often on the arm, leg or trunk. Symptoms may occur as the tumour enlarges if it pushes on local structures.

Concerning features include:

Size greater than 5 cm.
Rapid growth.

Causes of Soft Tissue Sarcoma

The causes of most soft tissue sarcomas are not known. There are rare genetic factor that can lead to tumour formation, with some inherited conditions that increase the risk of developing a soft tissue sarcoma. Risk factors for developing sarcomas include:

Age - Soft tissue sarcomas can develop in people of all ages, but the risk increases as we get older.
Radiotherapy / Radiation exposure - People who had radiotherapy treatment for other cancers might rarely get a sarcoma in the treatment area. This is because the radiation can affect healthy tissue in the treated area. Sarcomas in this group tend to occur many years after the initial treatment with radiotherapy.
Chemicals - Several chemicals are thought to increase the risk of some types of sarcoma.

Common types of Soft Tissue Sarcoma

There are more than 70 types of soft tissue sarcoma. The most common type in adults is undifferentiated pleomorphic sarcoma (UPS), which is made up of many abnormal spindle-shaped cells. Other common sarcomas include:

Liposarcoma
Leiomyosarcoma
Myxofibrosarcoma
Angiosarcoma
Rhabdomyosarcoma
Synovial sarcoma
Solitary fibrous tumours
Abdominal Sarcoma

What investigations are performed for Soft Tissue Sarcomas?

Sarcomas are usually found by a patient when a lump appears on the leg, arm or trunk. They can also be found during an investigation for other, unrelated problems or during a routine operation.

A specialist doctor will diagnose a soft tissue sarcoma through a series of tests. These may include:

Physical examination – looking at and feeling any lump.
Scans – taking pictures of the body using ultrasound, CT or MRI scan. This gives information regarding the size of the tumour, its extent into local structures and whether the tumour has spread elsewhere (metastasised).
A biopsy – taking a small sample of the lump for pathology testing.

Management of Soft Tissue Sarcoma

Treatment for a sarcoma depends on the type of sarcoma, where it is in the body, whether or not the cancer has spread, and the patient’s age, fitness and general health and preferences.

The main treatments include surgery, chemotherapy and radiation therapy. These can be given alone or in combination. This is called multi-modality treatment. All patients with sarcoma are discussed at our weekly Sarcoma Multi-Disciplinary Team Meeting and a recommendation regarding management is made. At these meetings, each patient’s case is discussed with review of their scan and biopsy investigations.

Surgery

Surgery is the main treatment method used for most sarcoma – sometimes with additional radiotherapy or chemotherapy. The surgeon will remove the tumour and will aim to take out an area of normal tissue around it too, this is known as taking a margin. It allows any cancer cells that are not visible to the naked eye to be removed along with the tumour in order to reduce the risk of the cancer coming back.

Radiotherapy

Radiotherapy, also known as Radiation Therapy, is a treatment that uses high-energy radiation beams to destroy cancer cells. It is used either before or after surgery. The radiation is precisely aimed to accurately target the sarcoma.

Chemotherapy

This treatment uses anti-cancer drugs to destroy cancer cells. It is sometimes used before or after the operation to reduce the risk of the cancer coming back . It can also be used if the cancer has spread to other parts of the body.