Sarcomas are large group of malignant tumors that can be found almost anywhere in the body and can strike young and old alike. Soft tissue sarcomas can develop in every type of soft tissue in the body, including nerves, fat, muscle and blood vessels. Sarcomas can also occur in almost any organ, including the lungs, heart, gastrointestinal tract, liver, kidney and the extremities.
More than half of soft tissue sarcomas—about 60% —occur in the arms and legs. Other common sarcoma sites include the trunk (20% of cases), the abdomen (15%) and the head and neck region. For more information on sarcomas that occur in cartilage and bone
What is Sarcoma?
Soft tissue sarcomas are Malignant tumors that can develop from fat, muscle, nerve, fibrous tissues surrounding joints, blood vessel, or deep skin tissue and can occur in almost any organ, including the lungs, heart, gastrointestinal tract, liver,, kidney and the extremities. Several inherited genetic conditions can be risk factors for soft tissue sarcoma, as well as previous cancer treatment and specific environmental exposures. There are more than 50 distinct subtypes that can be distinguished on the molecular level.
Sarcomas close to the surface of the skin may be easily detected, but those deeper in the body may not become apparent until they get large. Only about half of sarcomas are detected in the early stages before they spread. Sarcoma Symptoms may include:
-A new lump
-A lump that appears to be growing in size
-Abdominal pain (when the tumor becomes large enough to affect nearby organs)
-Blood in the feces or vomit
-A new pain
-After some type of injury
Having one or more of the symptoms listed above does not necessarily mean you have a soft tissue sarcoma. However, it is important to discuss any symptoms with your doctor, since they may indicate other health problems.
You can always learn more about Sarcoma Cancer at the MD Anderson Website.
(Information provided by The University of Texas M.D. Anderson Cancer Center and the American Cancer Society.)
Ewing’s sarcoma is a cancer that has recently been in the ESPN news because several athletes have developed it. It is named for James Ewing, who first described the tumor in the 1920’s. He discovered that the disease was separate from lymphoma and other types of cancer know at that time. He was also a pioneer in the use of radiotherapy in the treatment of cancer.
Genetics of Ewing’s Sarcoma
Every cell of the body contains the genetic information needed to create a new person. This information is contained in millions of genes encoded on a large densely-packed molecule called DNA. At a specific stage of cell division the DNA becomes visible under a microscope as a set of 23 chromosomes, each pair consisting of one chromosome copy from the father and another from the mother. The chromosome pairs differ in length and structure. Based on their individual sizes the chromosomes are numbered from 1 to 22. The 23rd pair is the sex determining (X and Y) chromosomes.
In a cancer cell, the genetic information might contain mistakes and rearrangements. Some of these defects can be seen under the microscope as altered chromosome structures. In Ewing’s sarcoma, a piece of chromosome 11 has moved to chromosome 22 and a piece of chromosome 22 has moved to chromosome 11. This translocation forms a novel gene that appears to be involved in the abnormal regulation of other genes. Ewing’s sarcoma’s unique 11;22 translocation can, therefore, be used to help in its diagnosis. We do not know exactly what kind of cell gives rise to a Ewing’s sarcoma cell. It has some features that resemble early cells that would normally develop into part of the nervous system.
Ewing’s sarcoma can start in bone or in soft tissues. The most common sites are the pelvis, the thigh and the trunk of the body. Most patients develop it when they are between 10 and 20 years, but younger children and older adults can also get it.
Ewing’s sarcoma & young people
In young people, the development of the tumor appears to be in some way related to periods in life with rapid growth, so the average age of the sarcoma victim is 14 to 15 years. The relationship to growth may also be part of the explanation why Ewing’s sarcoma is slightly more common in boys than in girls. However, Ewing’s sarcoma remains an extremely rare disease, so there is no extra cause for concern in rapidly growing teenagers. The relationship between bone growth and Ewing’s sarcoma is thought to be due to an increased vulnerability of rapidly growing cells to damage caused by chance or by as yet unidentified factors.
Sometimes the person with Ewing’s sarcoma or his parents relate a previous injury or trauma to the development of the tumor. However, medical research has not found any proven relationship between such injury and the risk of subsequently developing the sarcoma.
Symptoms & Treatment
Symptoms of Ewing’s sarcoma vary from person to person and depend on the location and size of the cancer. The most common symptoms are pain and swelling or tenderness in the affected area. Pain may become very intense when the tumor is located near important nerves, like in the sacrum, pelvis or spine.
Sometimes the tumor can interfere with movement and can weaken the bones, occasionally leading to a fracture. Other symptoms of Ewing’s sarcoma might include tiredness, fever, weight loss and anemia.
Even when the tumor is detected while it is very small, there may be evidence of microscopic spread. For this reason, Ewing’s sarcoma always requires treatment to the whole body. This treatment includes chemotherapy after local therapy. The choice of local treatment depends on the size and location of the tumor, if the cancer has spread or not, and other individual factors. Due to progress in limb-salvage surgery, called endoprosthesis, and awareness of problems associated with radiotherapy, surgery is the most frequent type of local therapy.
An endoprosthesis is an artificial bone replacement within the body, for example a metal rod replacing a bone, while leaving the surrounding tissues, like muscle, skin, blood vessels or nerves, in place. Radiotherapy is usually reserved for tumors that are difficult to reach surgically or locations associated with surgical complications, like the spine, pelvis and skull.
The overall chance of long-term survival with Ewing’s sarcoma is currently about 60%. This is a composite figure. Survival is about 75% for patients with localized tumor, particularly if the tumor is located below the elbow or below mid calf, and about 25-30% with tumor that has spread.