We are very grateful to Sarah Massey, Sarcoma Clinical Nurse Specialist at The Royal Liverpool & Broadgreen University Hospitals NHS Trust who has kindly put together to following info blog for us on Sarcomas. Sarah treated our mum Nicola whose story will be shared later today at 4;30.
We hope you will take to read this info blog and then share it with family, friends and colleagues so that we can heighten awareness.
WHAT IS A SARCOMA
Sarcomas are malignant tumours that develop in the supporting or connective tissues of the body such as muscle, bone, nerves, cartilage, blood vessels and fat.
- There are around 3800 new cases of sarcoma diagnosed each year in the UK. Around 120 new cases seen annually here in Merseyside and surrounding areas.
- Sarcomas account for about 11% of childhood cancers and about 14% of cancers in teenagers.
- Most sarcomas (about 55%) affect the limbs, most frequently the leg. About 15% affect the head and neck area or are found externally on the trunk, while the remainder will be found internally in the retroperitoneum (abdominal area).
TYPES OF SARCOMA
- Fibrosarcoma – starts in the fibrous tissues of the bone. Commonly found in the arms, legs or trunk.
- Myxofibrosarcoma – a fibrous sarcoma that can affect any part of the body, most commonly found in older people.
- Liposarcoma – starts in the body’s fat cells. Some can grow very slowly and others more quickly.
- Leiomyosarcoma – starts in the smooth muscle of the body that is not under our conscious control. It can occur anywhere in the body.
- Rhabdomyosarcoma – starts in the active muscles of the body known as skeletal or striated muscle. Can occur mostly in head, neck and pelvis.
RISK FACTORS AND CAUSES OF SOFT TISSUE SARCOMAS
The causes of most sarcomas are unknown.
Sarcomas can occur at any age but are more common in people over 30.
- Genetic conditions
Most sarcomas are not caused by an inherited faulty gene that can be passed on to other family members.
- Previous radiotherapy treatment
Very rarely, soft tissue sarcomas may occur in a part of the body that has previously been treated with radiotherapy for another type of cancer. The sarcoma will not usually develop until at least 5-10 years after the radiotherapy treatment.
There is no evidence that an injury can cause a soft tissue sarcoma to develop. It’s possible that an injury may draw attention to a sarcoma that was already there and not causing any symptoms.
- Usually soft tissue sarcomas don’t cause any symptoms until they are quite large and pressing on an organ in the body or on a nerve or muscle.
- Criteria for referral to soft tissue sarcoma centre are:
- Size >5cm
- Any lump that is painful and tender
- Any lump that is increasing in size
- Any lump that is deep to the fascia
- Recurrence after previous excision
The aim of surgery is to remove as much of the tumour as possible with clear margins. Occasionally it may be necessary, depending on the size and position of the tumour, for the surgeon to perform reconstructive/plastic surgery to make the area look and function as naturally as possible. For patients requiring limb amputation, the provision of high-quality prostheses and rehabilitation is another important aspect of care.
Radiotherapy treats cancer by using high energy x-rays to destroy the cancer cells while doing as little harm as possible to normal cells. If it is advised by the consultant, it can be given after surgery or occasionally before surgery in order to shrink the tumour.
Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. Certain types of sarcomas are treated this way and for other types, it is rarely used. Bone sarcomas are more responsive to chemotherapy and a number of clinical trials are offered to those patients and is delivered at Clatterbridge Cancer Centre.
- Palliative/Supportive Care
For a number of patients, treatment options such as surgery, radiotherapy of chemotherapy are not advisable/suitable. Referral to the palliative care team and community based Macmillan nurses ensure that quality care is provided.
- The main purpose of the Sarcoma MDT(Multidisciplinary Team) meeting is to ensure a high quality patient centred service for those patients and their families who have a suspected or working diagnosis of sarcoma based on current local and national guidance such as Improving Outcomes Guidance (IOG) and Network Guidelines.
- All sarcoma patients, either new or follow up, are discussed, including imaging, pathology and diagnosis. Treatment plans are put in place, outcomes are made and recorded on the Trust’s Somerset Cancer Registry.
- A number of shared care pathways are in place for site specific sarcoma presentations including head and neck, skin, urology, gynaecology, lung, GIST, retroperitoneal as well as potential soft tissue sarcomas of the extremities or trunk wall