Sarcoma, often referred to as “the forgotten cancer,” represents only about 1% of all adult cancers. This rare disease causes tumors to develop in connective tissues such as joints, bones, muscles, fat, cartilage, or nerves. There are over 50 subtypes of sarcoma, each classified by the tissue in which it forms. For example, myosarcoma develops in muscle, while osteosarcoma occurs in bone.
Detection of sarcoma can be challenging, as it is sometimes discovered incidentally during imaging for unrelated health issues. Dr. Niraj Gusani, chief of Surgical Oncology at Baptist MD Anderson Cancer Center, explained that many patients learn about their tumors after undergoing scans for conditions like gallbladder problems or kidney stones. “Sometimes they’re asymptomatic, or sometimes the person will have loss of appetite, subtle weight loss or general malaise (fatigue),” Dr. Gusani said. “Some people will first notice something is amiss when there’s a small change in their body, like pain when they lean back in a chair because the mass is pressing on other structures.”
Sarcomas in the arms or legs are usually more noticeable, presenting as painless, firm, and growing masses that do not move under the skin.
Unlike some cancers where lifestyle changes can reduce risk, sarcoma risk factors are often beyond individual control. Dr. Gusani noted, “Years after a person has radiation to a certain area – like during treatment for breast cancer – he or she can develop a sarcoma in that area. There are some genetic risk factors for sarcomas that run in families or are linked to certain genetic syndromes, but these are very rare.”
Dr. Gusani advised patients to remain vigilant about changes in their bodies. “If something doesn’t feel right, bring it to your physician’s attention. It may not be a sarcoma, but you may find something significant,” he said.
Treatment for sarcoma typically involves a combination of surgery, radiation, chemotherapy, and immunotherapy. Dr. Gusani explained that soft tissue sarcomas are most often treated with surgery and radiation, while bone sarcomas are generally managed with chemotherapy and surgery. “Sometimes we will shrink the tumor using radiation first and then remove it surgically, and sometimes we would do those treatments the other way around. Here at Baptist MD Anderson, we have a team approach in which the surgical oncologist, medical oncologist (who oversees chemotherapy) and radiation oncologist work together to determine the best course of treatment for each individual patient,” he said.
Because of the rarity and complexity of sarcoma, Dr. Gusani emphasized the importance of seeking care from experienced specialists. “Your best chance at treating a sarcoma is getting it right the first time around, because there are so many other organs and structures located around the tumor that we need to preserve,” he said. “You need a group of specialists who can all sit together around the table and make a plan that’s right for you.”
Individuals with questions or concerns about sarcoma are encouraged to consult with their primary care physician or contact Baptist MD Anderson Cancer Center for further evaluation and referral.
