Sarcoma Awareness Month

July is Sarcoma Awareness Month, an important opportunity to help raise awareness about this rare cancer. In support of this activity, we sat down with Mr Amit Kumar, Consultant Orthopaedic Sarcoma Surgeon at The Christie Private Care and The Wilmslow Hospital, both part of HCA Healthcare UK, to understand more about sarcoma, the signs and symptoms to be aware of and treatment options available.

If asked to name a type of cancer, most people would likely reply with one of the more common cancers like bowel, breast or prostate.

It’s very unlikely they would say sarcoma, which is probably because it’s so rare compared to other types of cancer, accounting for just 1% of all adult cancers. As a result, awareness of sarcoma is equally low and is often referred to as the ‘forgotten cancer.’

However, despite its comparative rarity to other, more prevalent cancers, it’s still important to be aware of sarcoma cancers and their signs and symptoms; as is the case with many other cancer types, the sooner sarcoma is diagnosed, the easier it is to treat, with better expected outcomes.

What is sarcoma?

Sarcoma is a broad term for rare cancers that develop in the body’s connective tissues, which includes the muscles, bones, fatty tissues, cartilage, tendons, blood vessels or any other supportive tissue.

They can affect almost any part of the body, on the inside or the outside, but most commonly affect the arms, legs and trunk. They can also appear in the stomach and intestines as well as behind the abdomen. Sarcoma can affect both adults and children, but are slightly more common in children.

There are around a hundred different subtypes of sarcoma which fall into three main categories: soft tissue sarcoma, bone sarcoma and gastrointestinal stromal tumours (GIST).

Soft tissue sarcomas, as their name implies, are found in soft tissues like fat, muscle, nerves and tendons. They commonly present as a soft tissue lump on the trunk or limbs. Other common soft tissue sarcomas include gynaecological and retroperitoneal sarcomas.

Gynaecological sarcomas develop in the female reproductive system which includes the uterus (womb), ovaries, vagina, vulva and fallopian tubes.

Retroperitoneal sarcomas develop in the retroperitoneum, this is the area behind the peritoneum, the lining of the abdominal space that covers the abdominal organs.

Non-soft tissue sarcomas form in the bone. The most common type of bone cancer is osteosarcoma, which usually forms in the large bones of the arm or leg. Bone sarcomas affect less than 500 people in the UK each year, making it a very rare form of cancer (and just 0.2% of sarcomas).

GIST is a common type of sarcoma which occurs in the gastrointestinal (GI) tract, which is a long tube that runs through the body from the oesophagus to the anus (back passage) and includes the stomach and intestines.

What are the signs and symptoms of sarcoma?

In the earlier stages, soft tissue sarcomas will often appear as a painless lump under the skin of the arm or the leg. As the sarcoma gets bigger, it may begin to press on nearby organs, nerves or muscles, and this can cause pain or difficulty breathing.

Pain is the most common symptom of bone cancer (particularly at night), but not all bone cancers cause pain. Other symptoms include fever or a lump which can feel soft and warm, and a bone that breaks unexpectedly; meaning that there was no accident or impact that would normally result in a breakage. Commonly they are found on incidental imaging for another reason.

Any patient with a lump that’s painful, getting bigger (particularly larger than 5cm deep) or looks suspicious on initial imaging should be referred to a Sarcoma specialist for further assessment.

How are sarcomas diagnosed?

Diagnosis of a sarcoma will usually start with a physical examination, alongside imaging tests such as an X-ray, CT scan, ultrasound, MRI or PET scan. A biopsy and/or blood tests may also be used to confirm the diagnosis and stage the cancer. 

When sarcoma is diagnosed early it is less likely to have spread to other parts of the body, and treatment is likely to be more effective. It is important that people with a confirmed sarcoma diagnosis are referred to a sarcoma specialist at the earliest opportunity.

Generally, people diagnosed with a soft tissue or bone sarcoma are younger than the majority of other cancer patients. Over 30% of bone or soft tissue sarcomas are diagnosed in people under the age of thirty.

How are sarcomas treated?

There are many different types of sarcoma, which will be diagnosed at various stages. Each person’s individual treatment plan will depend on the type, size, location and stage of their cancer.

Broadly speaking, sarcoma treatment plans will usually include surgery, chemotherapy, radiation therapy,  targeted therapy, or a combination of these.

What should I do if I experience any symptoms of sarcoma?

Experiencing symptoms of cancer is an incredibly worrying time, but it’s very important to get your symptoms investigated by a doctor as soon as possible. An early sarcoma diagnosis provides a wider range of treatment options, and often improved treatment outcomes.

If you have any new, persistent, or unusual symptoms, or you feel something is wrong, even if it is not covered in this article, do not delay in speaking to your GP.

If you are diagnosed with sarcoma, at HCA Healthcare UK you’ll have access to a whole team of cancer specialists, led by our expert Consultants, who have extensive experience in treating sarcoma and will work together to ensure you receive a personalised treatment plan, without delay.

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