Sarcomas are among the rarest and most challenging cancers, often overlooked in discussions about cancer awareness. Unlike more common carcinomas, sarcomas develop in connective tissues, making them distinct and complex. They can appear in various body parts, such as bones, muscles, tendons, cartilage, nerves, and blood vessels, predominantly affecting the arms and legs.
On this Sarcoma Awareness Month, we reached out to Dr Rohit Lamba, Head of Department and Senior Consultant in Bone, Joint Replacement, and Orthopaedics, SHALBY Sanar International Hospitals, Gurugram, who explained the types, prevalence, symptoms, and advancements in the treatment of sarcomas.
According to the American Cancer Society, sarcoma cases account for approximately 15% of all childhood cancers, but they are much rarer in adults, comprising only about 1% of adult cancer cases.
Types of Sarcomas
Although there are over 50 types of sarcoma, they are generally classified into two main categories: Soft Tissue Sarcoma and Bone Sarcoma or Osteosarcoma.
Soft Tissue Sarcoma
Soft tissue sarcomas (STS) include over 60 types of neoplasms that can develop anywhere in the human body and affect individuals of all ages. These neoplasms can arise from various tissues, including skeletal muscle, adipose tissue, blood and lymphatic vessels, connective tissue, and peripheral nerves. Their clinical presentations vary from benign lipomas to aggressive, metastatic angiosarcomas, as stated in StatPearls.
Also Read: Sarcoma Awareness Month: Expert Explains Bone Sarcoma, Its Symptoms, Causes, And Treatment
Osteosarcoma
According to a 2023 study, osteosarcoma is the most common primary bone malignancy in children, originating from primitive bone-forming (osteoid-producing) mesenchymal cells. It can present in two forms: primary, with no underlying bone pathology, and secondary, which arises from a pre-existing condition that has become malignant.
According to the Indian Council of Medical Research (ICMR), the incidence of osteosarcoma in children in India ranges from 3.6% to 14.8%. Additionally, another ICMR study found that Osteosarcomas are more prevalent in adolescent males compared to females, with a ratio of 1.4:1.
“They impact teenagers and young adults due to their rapidly growing bones. These tumours can occur in your thigh bone, leg, arm or the sites where rapid bone growth takes place,” added Dr Lamba.
Case Study: Recognising Symptoms
Let’s discuss a case to understand the symptoms better. Dr Lamba explained, “An adolescent child develops acute pain after a fall, which intensifies particularly with activity. Over the next few weeks, swelling increases around the injury site, with a prominent appearance of veins.”
“The swelling is warm and tender to the touch. Initially, the parents believe it is just an injury that will subside on its own, but it turns out to be a tumour. In some advanced cases, the tumour can spread to the lungs, causing respiratory problems,” he added.
Also Read: True Story: A Scientific Miracle Saves a Woman From a Rare Cancer(Mesenteric Leiomyosarcoma)
Diagnostic Procedures
“Doctors typically use X-rays, CT, or MRI scans to investigate suspected cases of osteosarcoma. Bone scans or bone biopsies are also conducted for a definitive diagnosis. Bone biopsies must be performed by trained professionals to prevent contamination and spread of the tumour,” added Dr Lamba.
Treatment Options
“Chemotherapy and surgery are the preferred treatments for osteosarcoma, with radiation therapy being less commonly used. The main objective of surgery is to safely and thoroughly remove the tumour. After removing a bone tumour, the resulting defect is typically covered with an implant of similar size,” said Dr Lamba. These tumours often occur near joints, necessitating the creation of an artificial joint or prosthesis. Recent advancements have improved the quality and longevity of these implants, allowing for complete joint mobility while preserving the limbs.
Advances in Surgical Techniques
“In the past, amputation was the only life saving option for osteosarcoma patients. However, surgical innovations, such as limb-sparing procedures have now become the standard treatment due to advances in chemotherapy and sophisticated imaging techniques,” highlighted Dr Lamba.
Limb salvage surgery aims to remove the tumour with a wide margin of normal tissue while preserving the blood and nerve supply to the extremity. This approach provides rates of local control and long-term survival comparable to amputation.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]