Sarcoma spotlight: Why too many lumps and bumps are going under the radar

Mr Rob Pollock_1221_07

As many as two in every 10001 of us will develop a lipoma during our lives. In the UK in fact, over 4000 are detected each year2. These very common soft tissue lumps are usually non-malignant, and patients are often reassured to hear that they don’t need treatment. However, consultant orthopaedic surgeon and orthopaedic oncologist at HCA UK’s The Princess Grace Hospital and The Wellington Hospital, Mr Rob Pollock, says the frequent presentation of what appear to be lipomas could be hiding a much more serious concern.

Liposarcomas, or cancerous lumps of soft fatty tissue, need to be identified early, removed promptly and followed up. But, says Mr Pollock, “in the early days, these highly aggressive sarcomas can easily be mistaken for benign lipomas.

“All too often, we’re presented with a sarcoma for urgent removal which is significantly larger than a golf ball – and still growing. This means the key milestones have been missed in terms of early referral. The rule of thumb is if you have a lump that's 3.5cms or more you absolutely can't leave it. The patient needs to have the proper investigations and diagnostics – at the very least they’ll need an ultrasound but ideally we should be offering them an MRI.”

Mr Pollock says many of the patients he sees were initially reassured by primary care that their lump was ‘probably just a lipoma, nothing to worry about’. While the majority will indeed prove to be benign and harmless, he warns that the assumption that all lumps and bumps are ‘just lipomas’ could be a dangerous trend.

Sarcoma is a cancer of the connective tissue and can appear in the bone, muscle, blood vessels, nerves or fat. Although rare, sarcoma is a very serious, high-grade cancer that needs early intervention and proper treatment.

“Once a patient has been told they need to have a lump checked out it can be a very stressful experience, and they usually want an answer very quickly,” says Mr Pollock, who chairs the sarcoma MDT for HCA UK and is recognised as a leading authority on sarcomas in the UK and internationally. 

To help fast-track these referrals, Mr Pollock has joined forces with a leading musculoskeletal radiologist to offer same-day access to sarcoma diagnostics, biopsies and consultation at HCA UK’s The Wellington Hospital Elstree Waterfront, in North London.

“It’s really important that we offer patients the highest quality care possible for sarcoma treatment and management,” he says. “Although they usually initially present as a small benign lump, sarcomas are extremely aggressive, and the more complex cases require serious multidisciplinary, often intensive, care in a highly capable facility.”

Operating on larger tumours can be extremely demanding. The surgical team may include a general surgeon, urologist, plastic surgeon, vascular surgeon and an orthopaedic surgeon. The patient will then need ongoing post-surgery care. Mr Pollock usually shares follow-up treatment with his specialist colleagues at ‘Leaders of Oncology Care’ (LOC), another HCA UK specialist facility. 

Working in close collaboration, this expert multidisciplinary team have formed a highly specialist treatment clinic that can offer world-leading diagnosis and treatment for sarcomas in terms of consultant experience and patient outcomes.

One of Mr Pollock’s greatest concerns in the field of sarcomas is how to improve survival rates in line with improvements that have been made in other, more common, cancers. 

“Sadly, sarcoma hasn’t seen the huge improvements in drug therapies that, say, breast cancer has benefitted from in recent years,” he says. “Survival is still between 60% and 70%, which is where it was about 10 years ago, so we need to really offer our patients the best chance possible – and for that early detection is key.

“The main thing for primary care referrers is to remember that, if a patient presents with a lump they’re not certain about, it absolutely needs to be checked out as soon as possible. It’s much better to get lots of negative scan results back, than risk one positive diagnosis going undetected.”