Soft tissue sarcoma (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Soft tissue sarcoma is a large group of cancer. It origins from soft tissues such as fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues. They can be found in any part of the body. Clinical signs and symptoms depend on the location of the cancer. Usual symptoms include a new lump, abdominal pain, hematochezia or hematemesis, black, tarry stools, etc. Treatments include sutgery, radiation therapy, chemotherapy, or a combination of tnem. General speaking, the prognosis of soft tissue sarcoma is not good.

What are the symptoms of soft tissue sarcoma?
Early soft tissue sarcoma does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:


 * A new lump or a lump that is growing anywhere on your body


 * Abdominal pain


 * Hematochezia or hematemesis
 * Black, tarry stools

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at risk for soft tissue sarcoma?
Clinical data has suggested that the development of soft tissue sarcoma is related to several factors.


 * Radiation exposure:Clinical stidies suggest that patients with other kind of cancers such as lymphoma and breast cancer may develop sarcomas from radiation therapy. The sarcoma often happens in the area of the body that had been treated with radiation.


 * Damaged lymph system: Clinical observations demonstrate lymphangiosarcoma is a very rare complication of chronic lymphedema that is the result of damaged lymph system.


 * Inherited conditions: Some inherited conditions may increase the risk of developing soft tissue sarcomas, such as neurofibromatosis, Gardner syndrome, Li-Fraumeni syndrome, Retinoblastoma,Werner syndrome, etc.

How to know you have soft tissue sarcoma?

 * Biopsy: A biopsy is the most important test for the diagnosis of soft tissue sarcoma. In this procedure, the doctor usually performs a punch biopsy and removes a tiny round piece of tissue. Then, the pathologists can detect the tissues under the microcope.


 * Computed tomography (CT) scan and biopsy: Local CT scans are often used to diagnose soft tissue sarcoma. It can confirm the location of the cancer and show the organs nearby. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.


 * Magnetic resonance imaging (MRI): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.


 * Chest X-ray: This plain x-ray of your chest may be done to see if the cancer has spread to your lungs.


 * Whole Bone Scan: The goal of a whole body bone scan is to show if a cancer has metastasized to your bones.

When to seek urgent medical care?
Call your health care provider if symptoms of soft tissue sarcoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:


 * Severe abdominal pain


 * Hemorrhea in gastrointestinal tract such as hematochezia or hematemesis, or even shock

Treatment options
Patients with soft tissue sarcoma have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: The selection of surgery depends on patient's cancer stage and general health. If permitted, the surgeons prefer surgery for your soft tissue sarcoma.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. The most commonly used drugs for soft tissue sarcoma are ifosfamide and doxorubicin (Adriamycin).

Diseases with similar symptoms
Soft tissue sarcoma needs to differ from soft tissue benige tumors such as:


 * Adenoma


 * Lipoma


 * Fibroma

Where to find medical care for soft tissue sarcoma?
Directions to Hospitals Treating soft tissue sarcoma

Prevention of soft tissue sarcoma
For the risk factors are not clear, the preventive measure for soft tissue sarcoma is unknown.

What to expect (Outook/Prognosis)?
The prognosis of soft tissue sarcoma is poor and it depends on the following:


 * Whether or not the tumor can be removed by surgery


 * The stage of the sarcoma: the size of the tumor, whether the cancer has spread outside the location


 * The patient’s general health


 * Whether the sarcoma has just been diagnosed or has recurred