Sarcoma (also known as bone and soft tissue cancer) is a rare type of malignant (cancerous) tumour that develops in bone and connective tissues, such as fat, muscle, blood vessels, nerves and the tissue that surrounds bones and joints.
There are two broad types of sarcoma: soft tissue sarcoma and bone sarcoma. However, there are more than 100 different subtypes of sarcoma.
Soft tissue sarcoma
Soft tissue sarcoma can start almost anywhere in the soft tissue of the body. It is more common in people over 65 and in those who have previously received radiotherapy.
The most common symptom of soft tissue sarcoma is a lump somewhere on the body. It is often found deep under the skin and you may feel it before you see it. The lump is usually firm, painless and difficult to move under the skin. It will continue to grow and as it does, it may become painful.
Other symptoms depend on where in the body the sarcoma is located and can include:
- abdominal pain and constipation if the sarcoma is in the abdomen
- a persistent cough if the sarcoma is near the lungs
The most common types of soft tissue sarcoma include:
- liposarcoma
- leiomyosarcoma
- undifferentiated pleomorphic sarcoma
- gastrointestinal stromal tumour (GIST)
Bone sarcoma
Bone sarcoma, also known as primary bone cancer, can start in any of the 206 bones in the human body that form the skeleton, but it most commonly affects the legs.
Common symptoms of bone sarcoma include:
- pain or tenderness most of the time, even when resting
- swelling, but it is not always possible to see or feel a lump
- difficulty moving around
- fractures caused by weakened bones
- feeling tired (fatigue)
Most common types of bone sarcoma include:
- chondrosarcoma
- osteosarcoma
- Ewing sarcoma
- undifferentiated pleomorphic sarcoma of the bone
- chordoma
Treatment for sarcoma at CUH
The treatment you have depends on several factors, which include:
- the type and size of the cancer
- where the cancer is located
- your general health
- whether the cancer has spread
A team of specialists at CUH will meet to discuss your condition and to make a recommendation about the best possible treatment for you.
You, along with your clinician, will then discuss your treatment recommendations at the clinic appointment and decide on the right treatment plan for you. Your clinician will explain the different treatment options and possible side effects.
The treatment for sarcoma can include:
- surgery
- chemotherapy
- radiotherapy
- targeted therapy
Surgery is the main treatment for sarcoma and aims to remove as much of the cancer as possible. The type of surgery you might have depends on the size of your cancer and whether it has grown into nearby tissues or spread elsewhere in the body.
Depending on where the sarcoma is in your body, surgery is either done at CUH or at other hospitals. This is because surgeons with specialist skills are needed for sarcoma surgery. For example, surgery for chest sarcoma is often done at the Royal Papworth Hospital, whereas sarcomas in the abdomen and limbs are removed at hospitals in Birmingham or London. Examples of surgery performed at CUH include sarcomas of the breast, womb, and head and neck region.
If you have sarcoma in one of your arms or legs, the surgeon will try to remove the cancer without removing the limb. This is known as limb-sparing surgery.
Rarely, the surgeon may recommend removing the arm or leg (amputation). This is usually only considered if the sarcoma has come back after limb-sparing surgery.
If the cancer has spread, you may be offered further surgery.
At times, you may require more than one treatment or a combination of different treatments to give the best chance of long-term cure. For some patients, treatment may be given with the aim of curing the cancer.
You may be given radiotherapy and/or chemotherapy to shrink the cancer before surgery. Sometimes radiotherapy and/or chemotherapy are given after surgery to help reduce the risk of the cancer coming back.
For some patients, treatments are given to help control the cancer, prolong life and improve symptoms.
Your clinical team will discuss with you what to expect.