Soft Tissue Sarcoma

Our sarcoma experts at the UofL Brown Cancer Center customize your care to deliver the most successful treatment, while focusing on your quality of life.

Overview

Our sarcoma experts at UofL Brown Cancer Center customize your care to deliver the most successful treatment, while focusing on your quality of life. Our expertise and experience can make a difference in your outcome.

Diagnosis of sarcomas can be challenging, but accurate diagnosis is essential to successful treatment. Since sarcomas are complex and can develop in many places in the body, they can be difficult to diagnose. Our specialized surgeons and pathologists use the latest, most sophisticated tests to pinpoint the type and extent of the cancer.

Using a team approach that brings together specialists from many areas, we offer everything you need for diagnosis and treatment in one location. Our treatments draw upon the latest technology to save limbs, as well as function and appearance. Your sarcoma treatment is customized specifically for you by the region’s foremost teams of experts.

Because sarcoma is rare, most oncologists treat few if any patients in their careers. Statistics show that sarcoma patients have better outcomes when they are treated at comprehensive cancer centers like UofL Brown Cancer Center where specialized oncologists have more experience with the disease.

Like all surgeries, sarcoma surgery is most successful when performed by a specialist with a great deal of experience in the procedure. Our recognized surgeons specialize in sarcoma treatment, using the least-invasive and most advanced techniques.

At UofL Brown Cancer Center, we are committed to providing you with the most advanced treatments for sarcoma with the least impact on your body. We offer the most up-to-date and advanced chemotherapy options, and new radiation therapy techniques allow our doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

We also participate in many clinical trials.

According to the American Cancer Society, more than 10,500 cases of sarcoma, or 2 percent of all cancers, are diagnosed in the United States each year. Slightly more than half of these are in males.

Sarcomas can start anywhere in the body. Typically, they develop in the soft tissues that surround, connect or support the body’s structure and organs. This includes muscles, joints, tendons, fat, blood vessels, nerves and tissues. They also can begin in the body’s organs.

Sarcoma Types

Some soft-tissue sarcomas are benign (not cancer), and others are malignant (cancer). There are more than 30 types of sarcoma, making each extremely rare. Sarcomas are classified into groups that have similar types of cancer cells and symptoms. They usually are named for the type of tissue where they start. Sarcomas within a classification often are treated the same way.

The main types of soft-tissue sarcoma begin in:

  • Muscle tissue
  • Peripheral nerve tissue
  • Joint tissue
  • Blood and lymph vessels
  • Fibrous tissue
  • Sarcomas of uncertain tissue type: In this type of sarcoma, doctors are not able to determine the exact type of tissue where the cancer began.

Risk Factors

Anything that increases your chance of getting cancer is a risk factor. For sarcoma, risk factors include:

Inherited genetic conditions such as:

  • Von Recklinghausen disease
  • Li-Fraumeni syndrome
  • Gardner syndrome
  • Inherited retinoblastoma
  • Werner syndrome
  • Gorlin syndrome
  • Tuberous sclerosis

Other risk factors include:

  • Damage or removal of lymph nodes during previous cancer treatments.
  • Exposure to vinyl chloride, a chemical used in making plastics.
  • Previous radiation treatment for another cancer.

Not everyone with risk factors gets sarcoma. However, if you have risk factors, it’s a good idea to discuss them with your health care provider.

Some cases of soft tissue sarcoma can be passed down from one generation to the next. Genetic counseling may be right for you.

Signs of sarcoma vary from person to person. Many times sarcoma does not have symptoms in the early stages. Only about half of soft-tissue sarcomas are found in the early stages before they spread.

The location of the sarcoma makes a difference in the symptoms. For instance if they start:

  • On the arms or legs, you may notice a lump that grows over a period of weeks to months. It may hurt, but it usually doesn’t.
  • In the retroperitoneum (the back wall inside the abdomen), they may cause problems that have symptoms, such as pain. Tumors may cause blockage or bleeding of the stomach or bowels. They may grow large enough for the tumor to be felt in the abdomen.

If you have any of the following problems, talk to your doctor:

  • A new lump or a lump that is growing anywhere on your body
  • Abdominal pain that is getting worse
  • Blood in your stool or vomit
  • Black, tarry stools (this may mean there is internal bleeding)

These symptoms do not always mean you have sarcoma. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.

Our team of specialized surgeons and pathologists is one of the most experienced and skilled in diagnosing sarcomas.

Since sarcomas are complex and can develop in so many places in the body, they can be difficult to diagnose. However, it’s important to have an accurate diagnosis of the type and extent of the sarcoma before you are treated. We have the latest methods and technology to be sure you get the most accurate diagnosis possible.

Getting the wrong diagnosis may actually be harmful and make therapy have less chance for success. A biopsy that is not done correctly can cause the cancer to spread and make your treatment more difficult. It is best for the surgeon who does the biopsy to also remove the tumor.

If you have symptoms that may signal sarcoma, your doctor will examine you and ask you questions about your health and your family medical history.

Diagnostic Tests

The only way to be certain a tumor is sarcoma is a biopsy (removing a small number of cells to examine under a microscope). Imaging tests may be used before or after biopsy to determine the location and extent of the tumor.

The doctor will choose one of the following types of biopsy depending on where the tumor is.

Fine needle aspiration (FNA): A very small needle is placed into the tumor and suction is applied. CT (computed tomography) scans may be used to help guide the needle. Doctors trained to read these types of biopsies then review the small numbers of cells that are drawn into the needle.

If the test shows that the tumor may be a sarcoma, another type of biopsy probably will be done to remove a larger piece of tissue.

Core needle: The doctor uses a needle slightly larger than the one used in an FNA biopsy to remove a cylindrical sample of tissue.

Incisional: An incision (cut) is made in the skin and a small part of tumor is removed

Excisional: An incision (cut) is made in the skin and the entire growth is removed surgically

Imaging tests, which may include:

  • CT or CAT (computed axial tomography)
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans
  • Chest X-ray
  • Ultrasound

Soft tissue sarcoma staging

If you are diagnosed with sarcoma, your doctor will determine the stage (or extent) of the disease.

Staging is a way of determining how much disease is in the body and where it has spread. This information is important because it helps your doctor determine the best type of treatment for you and the outlook for your recovery (prognosis).

Once the staging classification is determined, the stage stays the same even if treatment is successful or the cancer spreads.

At UofL Brown Cancer Center, we are committed to providing you with the most advanced treatments for sarcoma with the least impact on your body. Your sarcoma treatment is customized specifically for you.

Our surgeons use the latest techniques, including limb-sparing surgeries.

Sarcomas usually are treated with a combination of therapies that may include surgery, chemotherapy and radiation. If you are diagnosed with sarcoma, your doctor will discuss the best options to treat it. This depends on several factors, including:

  • The location and type of sarcoma
  • If the cancer has spread
  • Possible impact on your body
  • Your general health
  • Your treatment for sarcoma will be customized to your particular needs. It may include one or more of the following.

Surgery

Like all surgeries, sarcoma surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. Our surgeons specialize in sarcoma treatment, and they use the least-invasive and most-advanced techniques.

Surgery is the main treatment for soft-tissue sarcomas. The surgeon removes the tumor, as well as a margin of healthy tissue around it to take out as many cancer cells as possible. You may receive chemotherapy or radiation therapy before or after the surgery.

Because of a special type of surgery called limb-sparing surgery, which often is followed with radiation therapy, most patients do not have to have arms or legs removed to treat sarcoma.

Chemotherapy

We offer the most up-to-date and advanced chemotherapy options. Chemotherapy may be used as the main treatment for sarcoma or with surgery or radiation. A combination of two or more chemotherapy drugs may be used. Sometimes limb profusion, a special way to give a more focused dose of chemotherapy may be used.

Radiation Therapy

New radiation therapy techniques and remarkable skill allow our doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

Radiation therapy usually is not used as the main treatment for sarcoma, but it may be used before surgery to shrink the tumor or after surgery to destroy remaining cancer cells. If you cannot have surgery, you may receive radiation therapy to help with pain and other symptoms. UofL Brown Cancer Center provides the most advanced radiation treatments, including:

Brachytherapy: Tiny radioactive seeds are placed in the body close to the tumor

3D-conformal radiation therapy: Several radiation beams are given in the exact shape of the tumor

Intensity-modulated radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor

Our doctors at UofL Brown Cancer Center are proudly part of UofL Physicians and the UofL School of Medicine.

We believe knowledge comes from questioning the status quo, discovering more about disease and using that knowledge to improve the health of our community. Our physicians are the teachers and researchers at the UofL School of Medicine, involved in the research and development of new treatments and cures for cancer. This means you receive the most advanced and appropriate treatment, even for complex or rare conditions.

To learn more about the physicians who make the academic difference in treatment for soft tissue sarcoma, visit the UofL Physicians website here.