Comprehensive, Compassionate Care for Sarcoma
The experts at University Hospitals Seidman Cancer Center offer advanced care to patients diagnosed with soft-tissue sarcoma and bone sarcoma. Our team consists of nationally recognized orthopedic oncologists, surgical oncologists, radiation oncologists, pathologists, pediatrics, and medical oncologists, who aim to deliver advanced, personalized care to each patient to treat the disease successfully.
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Sarcoma Team Provides Advanced Care for Patients
At University Hospitals Seidman Cancer Center, a team of physicians leads the way in providing comprehensive, innovative care for patients diagnosed with sarcoma. Our nationally recognized team uses the latest technology and procedures to diagnose and treat adults and children with all types of sarcoma.
UH Seidman Cancer Center is recognized by the National Cancer Institute and is part of the Case Comprehensive Cancer Center at the Case Western Reserve University School of Medicine, which belongs to an elite group of 50 comprehensive cancer hospitals nationwide. Here, doctors are involved in groundbreaking research that aims to develop methods to diagnose and treat soft-tissue sarcoma and bone sarcoma. We acknowledge that each patient is unique. Hence, our multidisciplinary team meets every week to evaluate the case of each patient and develop a plan that is personalized according to the patient.
What is Sarcoma?
Sarcoma is a rare type of cancer that accounts for 20 percent of all pediatric malignancies and 1 percent of all adult malignancies. It arises from the connective tissues of the body. Connective tissue includes mesenchymal cells, which include muscles, fat, blood vessels, or bony structures like bone and cartilage. Despite being rare, sarcomas are an extremely varied group of cancers with over 70 different subtypes. Undifferentiated pleomorphic sarcoma, leiomyosarcoma, and liposarcoma are some of the most common subtypes of soft-tissue sarcoma.
Due to the rarity of the tumor, many oncologists in the community never take care of a patient diagnosed with sarcoma. Research has consistently shown that patients diagnosed with sarcoma when treated at a tertiary care center – by a multidisciplinary team with expertise in sarcoma – have better outcomes compared to those who are treated at non-academic centers. At UH Seidman Cancer Center, we regularly provide multidisciplinary care to patients diagnosed with sarcoma and are counted amongst one of the top hospitals in the United States to provide cancer care.
Types of Sarcoma
Sarcomas are divided into two main sub-groups:
Soft-tissue sarcomas: They start in the soft tissues that include muscles, tendons, fibrous tissues, fat, blood vessels, nerves, and synovial tissues (tissues around joints).
Bone sarcoma: They start in the bones or cartilages.
Histology is defined as a microscopic examination of the tumor sample. Sarcomas are divided into 70 different subtypes, and treatment differs based on the histology. It is important to have a tumor sample examined by a pathologist who is an expert in sarcoma to correctly identify the type of sarcoma. At UH Seidman Cancer Center, we have pathologists with expertise in sarcoma subspecialty. We also have Next Generation Sequencing available with us, which helps in identifying critical genetic rearrangements, which in turn can lead to an accurate diagnosis.
Types of sarcoma include:
- Alveolar soft part sarcoma (ASPS)
A malignant soft tissue tumor that starts in the soft connective tissues of the body such as fat, muscles or nerves. ASPS is slow-growing and usually starts in the legs or arms, although it can also be found in the head and neck.
A rare sarcoma that forms in the lining of the blood vessels and lymph vessels.
A rare type of cancer that occurs in the bones of the skull base and spine. Chordomas account for about 3 percent of all bone tumors and about 20 percent of primary spinal tumors.
- Dermatofibrosarcoma protuberens
A soft tissue sarcoma that develops in the deep layers of skin. It is sometimes described as having tentacles that can grow into surrounding fat, muscle and even bone.
- Desmoid sarcoma
Also called deep fibromatosis, a desmoid sarcoma is a type of non-cancerous fibrous growth that frequently begin in the arms, legs or torso. Desmoid tumors are not a cancer because they do not spread to other parts of the body.
- Ewing's sarcoma
A rare type of cancerous tumor that grows in the bones or the soft tissue around bones, such as cartilage or the nerves. Ewing’s sarcoma mostly affects children, adolescents and young adults.
A rare cancer that affects cells known as fibroblasts, which are responsible for creating the fibrous tissue found throughout the body.
- Gastrointestinal stromal tumor (GIST)
A type of tumor that occurs in the gastrointestinal tract, most commonly in the stomach or small intestine.
- Non-uterine leiomyosarcoma
A cancer of smooth muscle cells; smooth muscle cells make up the involuntary muscles, which are found in most parts of the body: in the stomach and intestines, walls of all blood vessels and skin.
- Uterine leiomyosarcoma
A smooth muscle tumor that arises from the muscular part of the uterus.
A rare soft-tissue sarcoma derived from fat tissue. It can arise in various locations throughout the body, although it is most frequently found in the extremities, particularly in the thigh, as well as the abdomen.
- Malignant fibro histiocytoma (MFH)
A sarcoma that originates in fibrous tissue, the tough tissue that forms tendons and ligaments. MFH is the most common type of soft tissue sarcoma of the extremity, while MFH of bone is fairly rare.
- Malignant peripheral nerve sheath tumor (MPNST)
A rare tumor that develops in the protective lining that covers nerves. Approximately 25-50 percent of MPNSTs are associated with the genetic condition neurofibromatosis type 1.
The most common type of bone cancer, osteosarcoma is a type of cancer that produces immature bone. Most commonly diagnosed in people under the age of 25, it is usually found at the end of long bones, often around the knee.
A type of sarcoma made up of cells that normally develop into skeletal (voluntary) muscles, which we control to move parts of our body. This cancer it is much more common in children, although it does sometimes occur in adults.
- Synovial sarcoma
A rare soft-tissue sarcoma that most commonly starts in the legs or arms, but it can appear in any part of the body. It can occur at any age, but it is more common among teenagers and young adults.
Sarcoma Causes and Risk Factors
Some risk factors are common to all cancers. Environmental factors like exposure to certain chemicals (herbicides, plastics, phenoxy-acetic acid, chlorophenols, vinyl chloride, etc.) increase the risk of sarcoma. Behavioral risk factors like smoking, alcohol consumption and drug abuse have been found to increase the risk of sarcoma.
Some patients receive radiation therapy as part of their treatment for other cancers. Exposure to radiation therapy can potentially lead to the development of sarcoma in the long run.
Certain genetic syndromes are also related to the development of sarcoma:
- Beckwith-Wiedemann syndrome
- Enchondromatosis: Ollier disease and Maffucci syndrome
- Li-Fraumeni syndrome
- McCune-Albright syndrome
- Multiple osteochondromas
- Neurofibromatosis type 1
- Retinoblastoma syndrome
- Rothmund-Thomson syndrome
- Werner syndrome
We have a team of dedicated geneticist at University Hospitals that takes a special interest in exploring these syndromes and determining the risk factors for the patients.
Symptoms of Sarcoma
Based on location, sarcomas can either arise in the extremity or in the abdomen (especially in the retroperitoneal space). In women, gynecological sarcomas can originate in the uterus and other organs located in the pelvis. Rarely, they may also originate from visceral organs such as the liver, spleen, and kidneys. The symptoms are usually dependent on the location of the sarcoma and may include:
- Pain in the affected area, which may be worse at night
- Swelling, which may start weeks after the pain
Although most of the lumps and bumps are benign, you should report them to your primary care physician in order to get this further checked by a specialist. At University Hospitals, we have an extensive network of primary care physicians who regularly refer patients to our sarcoma team for further evaluation and management.