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Some of the conditions treated by the Sarcoma Service are benign
(non-cancerous) while others are malignant (cancerous). While the
non-cancerous types of tumors are much more common, they still can
mimic sarcomas and should also be managed by a team of
specialists dedicated to these types of conditions.
What is Sarcoma?
Etiology of Musculoskeletal
Diagnosis
Treatment Information
Recommended Resources
Additional Links
Information Sources
What is Sarcoma?
NEXTTOP
The malignant tumors of soft tissue and bone are
called sarcomas. The Greek word "sarcoma" means fleshy tumor.
Sarcomas are relatively rare compared to other forms of cancer (e.g.
breast, prostate, lung). Sarcomas arise from connective tissue
including muscle, fat, blood vessels, nerves, bone and other
structures and are classified according to the part of the body from
which they arise.
Sarcomas are divided into two main groups, bone and soft tissue
sarcomas. They are further sub-classified based on the type of cell
found in the tumor. They all share certain microscopic
characteristics and have similar symptoms. For example, osteosarcoma
arises from bone, liposarcoma from fat, rhabdomyosarcoma from muscle.
There are approximately 100 different types of sarcomas, some of
which are relatively more common. However, compared to other types of
cancers they are very rare. Sarcoma tumors account for about 1% of
all cancers in adults but about 15% of all cancers in children. In
the U.S., approximately 9,800 cases are diagnosed each year or about
1 case in 28,000 individuals.
While people of all ages can develop a sarcoma, different types of
sarcomas are more common in certain age groups. Men, women,
boys, girls and individuals of all races are susceptible. Patients
who are diagnosed with a sarcoma may require a treatment regimen that
involves surgery, radiation therapy or chemotherapy. Coordinating
these treatments requires close co-operation among health care
providers.
Because these soft tissue and bone tumors are uncommon and
potentially very serious, they require expert management. In fact,
because so many physicians are unfamiliar with these diseases,
dilemmas can arise in terms of diagnosis and treatment of these
conditions. To minimize this, it is highly recommended that patients
in whom a soft tissue or bone tumor is suspected, have an evaluation
at a medical center with experience in managing these conditions.
Etiology of Musculoskeletal Tumors
PREVIOUSNEXTTOP
The human body is composed of numerous different
types of tissues that in turn make up your organs (e.g. heart, lung,
kidney) and connective tissue. Connective tissue is the substance in
the body that holds the body together and allows it to move. For
example, ligaments, tendons, bones and muscles are types of
connective tissue. All of these tissues in turn are made up of cells.
Cells are the basic unit of life.
Tumor formation is a complex, multi-step process by which normal
tissue changes into an abnormal group of proliferating cells. Such a
process may progress into a benign tumor growth; which tends not to
invade other structures. However, some tumors can become aggressive
turning instead into a cancerous growth capable of invading other
parts of the body. How this occurs is multifactorial. In general,
direct environmental causes are infrequent in sarcomas unlike
other forms of cancer (e.g. tobacco and lung cancer). However, cancer
causing viruses, radiation and chemical agents can affect these
processes, ultimately compromising certain cells in the body,
predisposing a person to tumor formation. Somehow the genetic
material (a cells "instruction manual") is disturbed. Usually this is
not hereditary. While much remains a mystery, many factors that are
involved in tumor formation are understood. Control of this process
is a function of numerous regulatory proteins and checkpoints in the
life of a cell. The checkpoints allow for the monitoring and
correction in the genetic instruction manual. The regulatory proteins
are encoded by two basic gene types: oncogenes and suppressor genes.
Oncogenes, encoding a variety of growth factors, promote cell growth.
Suppressor genes act to stop cell growth. A complex array of
molecules can serve to either start or stop cell growth. This process
is actually much more complex. We can provide you with further
information if you so desire.
Diagnosis
PREVIOUSNEXTTOP
Soft tissue and bone tumors can present in a
variety of ways. Most often, a person will notice a mass in the limb
that may or may not be painful. While they are most commonly seen in
the leg or arm they can arise anywhere in the body. Other than
noticing a mass, most people feel normal. Sarcomas generally continue
to grow over weeks to months. Not all sarcomas grow rapidly however.
It is important to point out that a new mass or bump does not mean
cancer. Benign masses (non-cancerous conditions) are 200 times more
common than sarcomas. If you do notice a new mass on your body it is
best to have it evaluated by a physician who can better determine if
there is anything to be concerned about.
Treatment Information
PREVIOUSNEXTTOP
At Huntsman Cancer Institute, diagnosis and
treatment of these unusual conditions is readily available. The
Sarcoma Service is a comprehensive, interdisciplinary service
comprised of surgical, medical and pediatric oncologists, radiation
therapists, pathologists, radiologists, pain and palliative care
specialists, basic scientists, physician assistants, and social
workers.
Depending upon the type of tumor, a variety of treatments are
available. If the tumor proves to be a sarcoma, it will usually
require surgical removal. Some sarcomas may also be treated with
radiation therapy. Chemotherapy is a very important modality that may
be necessary in certain cases. New treatments are always in
development with experimental medications available for select types
of tumors as well.
Recommended Resources
PREVIOUSNEXTTOP
Huntsman Cancer Institute has designed the HOPE Guide as an
online tool to help you find information and resources about cancer -
including information about
sarcoma. Click on the Hope Logo to enter.
Below are some examples of the type of information available in
the HOPE Guide.
Soft Tissue Sarcoma
Bone Cancer
Osteogenic Sarcoma (Osteosarcoma)
Parosteal osteogenic sarcoma
Multifocal Sclerosing osteogenic sarcoma
Osteogenic Sarcoma of the Jaw and Skull
Osteogenic Sarcoma in Paget's Disease
Postirradiation Osteogenic Sarcoma (Radiation Induced)
Additional Links
PREVIOUSNEXTTOP
Ewing's Sarcoma X-ray
Ewing's Sarcoma Chat
Frequently Asked Questions about Ewing's Sarcoma
List of Questions/Answers on Bone Cancer
List of Questions/Answers on Osteosarcoma
This is Fibrous Dysplasia Support Online
The National Leiomyosarcoma Foundation
The Paget Foundation
Multiple Myeloma Research Foundation
The Sarcoma Alliance
The Life Raft Group
The Liddy Shriver Sarcoma Initiative
The Liddy Shriver Sarcoma Initiative - Newsletter
Information Sources
PREVIOUSTOP
Abeloff, Martin D., et al., eds.
Clinical Oncology.
Philadelphia, PA: Churchhill Livingstone, 2000.
Berkow M.D., Robert and Fletcher ,M.B., Andrew J., et al.,
eds.
The Merck Manual of Diagnosis and Therapy.
15th Edition, Rathway, N.J.,
Merck Sharp & Dohme Research Laboratories, 1987.
DeVita, Vincent T. , et al., eds.
Cancer: Principles and Practice of Oncology.
Philadelphia, PA: Lippincott-Raven, 1997.
Johnston, J.O., Randall, R.Lor.;
Chapter Six: Tumors in Orthopedic
Skinner, H.B. Editor: Current Diagnosis & Treatment in
Orthopedics.
2nd Edition, New York, McGraw-Hill Inc., 2000.
National Cancer Institute.
"Questions and Answers About Bone Cancer."
CancerNet from the National Cancer Institute.
Jan. 1999. CancerNet. July 2000.
http://cancernet.nci.nih.gov
National Cancer Institute
CancerNet from the National Cancer Institute.
April 1995. CancerNet. July 2000.
http://cancernet.nci.nih.gov
Pisters M.D., Peter W. T., Casper M.D., Ephraim S.
and Soffen M.D., Edward M. "Soft-tissue Sarcomas."
Cancer Management: A Multidisciplinary Approach.
Ed. PRR Inc. Aug. 2000. Cancer Information Network. Aug. 2000.
Wilson, M.D., Jean D. et al., eds.
Harrison's Principles of Internal Medicine.
12th Edition., New York, McGraw-Hill Inc., 1991.
Yasko M.D., Alan W. and Somlo M.D., George.
"Bone Sarcomas."
Cancer Management: A Multidisciplinary Approach.
Ed. PRR Inc. Aug. 2000. Cancer Information Network. Aug. 2000.
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