Adult Soft Tissue Sarcoma

In the early stages, soft tissue sarcomas usually have no symptoms and might go unnoticed. As they grow and spread, they can cause pain and interfere with the body's normal functions.

Common symptoms of soft tissue sarcoma include

• A painless lump under the skin, often on an arm or a leg
• A new lump that is growing
• Chronic, degenerative pain in the abdomen
• A feeling of fullness after eating small meals
• Blood in your vomit or stool
• Black, sticky bowel (due to internal bleeding in the stomach)
• Trouble breathing

Other symptoms will vary depending on where the sarcoma is in the body. A soft tissue sarcoma can sometimes be mistaken for a benign fatty tumor (lipoma) or bruise (hamatoma), leading to a delay in diagnosis. However, you should see your doctor if you notice the lump is getting bigger, is the size of a golf ball or larger, or is painful or tender. Approximately, 60 percent of these sarcomas start in an arm or leg, 30 percent in the trunk (torso) or abdomen, and 10 percent in the head or neck.

The specific etiology of soft tissue sarcomas is unknown and still being researched. However, some risk factors have been found, and the majority of these are hereditary disorders caused by gene mutations that alter the genes in soft tissue cells.

Potential risk factors for soft tissue sarcoma in adults include

Radiation therapy

• People who received large doses of radiation therapy at an early age are more at a risk of soft tissue sarcoma. People who have received radiation therapy to treat other types of cancer are at very low risk.

Genetic factors

• Some rare, hereditary disorders can increase a person's risk of soft tissue sarcoma. Most individuals can pass one of these extremely uncommon disorders to their offspring if one of these conditions runs in their family. These genetic disorders may include
  • Von Recklinghausen disease (also known as neurofibromatosis)
  • Li-Fraumeni syndrome
  • Retinoblastoma
  • Gardner syndrome
  • Werner syndrome

Chemicals

• Some sarcomas may be associated with exposure to chemicals such as vinyl chloride (used to manufacture plastic) and high-dose herbicides (weedkillers).
• Exposure to polycyclic hydrocarbons, asbestos, and dioxin can increase the risk.

Diseases or conditions

• People with a compromised immune system are more likely to develop sarcoma. This includes individuals living with HIV, those born with an immune deficiency, and those using immunosuppressive medicines following an organ transplant.

Other

• Long-term lymphedema (swelling from a buildup of lymph fluid) 

Several types of soft tissue sarcomas are inherited. Sarcomas are frequently connected with other malignancies, particularly those of the gastrointestinal system and brain. Instead of inheriting a defective gene, a small percentage of people acquire sarcoma as a result of genetic alterations that take place during their lives

There are four stages of soft tissue sarcoma in adults. Staging is an important part of diagnosis and treatment planning. 

Four stages of soft tissue sarcoma include

• Stage I: Divided into stages IA and IB:
  • Stage IA
    • The tumor is low-grade (grows and spreads slowly) and 5 cm or smaller in size
    • Can be superficial or in subcutaneous tissue with no spread into connective tissue or muscle below)
    • Deep in the muscle and may be in connective or subcutaneous tissue
  • Stage IB
    • The tumor is low-grade and larger than 5 cm in size. It might be superficial or deep. 
• Stage II: Divided into stages IIA and IIB:
  • Stage IIA
    • The tumor is either mid-grade (likely to grow and spread fast) or high-grade (likely to grow and spread quickly), and it is 5 cm or smaller in size. It might be either superficial or deep.
  • Stage IIB
    • The tumor is mid-grade and larger than 5 cm in size. It might be superficial or deep. 
• Stage III: The tumor is either:
  • High-grade larger than 5 cm and superficial or deep
  • Can be of any grade or size and has spread to nearby lymph nodes. Stage III cancer that has spread to the lymph nodes is called advanced stage III.
• Stage IV
  • The tumor at stage IV might be of any grade or size, and it may have spread to adjacent lymph nodes. Cancer has spread to other regions of the body, including the lungs.

Recurrent adult soft tissue sarcoma

• Adult soft tissue sarcoma that has recurred (came back) after treatment is known as recurrent adult soft tissue sarcoma.
• The cancer may reappear in the same soft tissue or elsewhere in the body.

Adults with soft tissue sarcoma might get various therapies. Some therapies are mainstream (already used), whereas others are being investigated in clinical trials. Your doctor may advise you on treatment choices based on the size of the tumor, its location, your age, and any underlying health concerns. 

Treatment options for soft tissue sarcoma in adults include

Surgery

• Most types of soft tissue sarcoma are treated primarily by surgery. It frequently entails removing the malignancy and some good tissue around it—a procedure known as a wide local excision. 
• The healthy tissue is removed to help limit the likelihood of cancer returning to that place. The type of procedure is determined by the location of the sarcoma. 
• Most sarcomas occur in the arm or leg, necessitating limb-saving surgery. Amputation is less common although it can happen.

Radiation therapy

• Uses high-energy beams to kill cancer cells. It is not painful and is generally administered in small dosages over time to minimize adverse effects. 
• Radiation treatment is known to be quite effective against sarcoma. It can be used before or after surgery or if the cancer is in an area of the body that is difficult to reach with surgery.
• Radiation treatment helps reduce the size of the cancer, which may make surgery easier. Chemotherapy is sometimes used in addition to radiation therapy to assist make the treatment more successful. This is determined by the kind of sarcoma.

Chemotherapy

• Uses chemicals to destroy cancer cells or inhibit their development. Because various medications can attack or shrink cancer cells in different ways, you may receive one chemotherapy treatment or a combination of drugs. 
• Your therapy will be determined by your circumstances and the type of sarcoma you have. It may also be used to help prevent sarcoma from returning following surgery.
• Chemotherapy is often administered in treatment cycles that might be daily, weekly, or monthly. 

Targeted therapy

• Uses medications that target particular genes and proteins important in cancer cell growth and survival. 
• Targeted treatment targets particular chemicals within cells and frequently inhibits cell growth. 
• People with soft tissue sarcoma may be provided tailored therapy to limit tumor development. 

Complementary therapies

• Intended to be used in conjunction with traditional medical treatments and can help you feel more in control, reduce tension and anxiety and enhance your mood. 
• Some cancer centers in America have established integrative oncology programs, in which evidence-based complementary medicines are coupled with conventional treatments to improve both wellness and clinical results

Clinical trials

• Research studies are designed to enhance current medicines or gather information on novel treatments for people with cancer. 
• When clinical studies demonstrate that a novel therapy outperforms the conventional treatment, the new treatment may be adopted as the standard treatment. 
• People may choose to consider participating in clinical studies after discussing them with doctors.

Individuals with localized soft tissue sarcomas generally have a very excellent prognosis and a high rate of cure. The fundamental element of a favorable prognosis is a tumor that has been entirely excised by surgery and has not spread beyond the initial borders. Children have a better prognosis than adults for both localized and spread tumors.