Sarcoma is a family of cancers that begins in the body’s connective tissues, which include muscles, bones, tendons, cartilage, nerves, fat, or blood vessels.

Sarcoma can start anywhere in the body but often forms in the arms, legs, chest, or abdomen. There are more than 50 distinct types of sarcomas, each with its own characteristics and treatment approaches.

Many adults are unfamiliar with this rare form of cancer – leading to delays in seeking diagnosis and treatment.

That’s why it’s critical to know the signs, symptoms, and treatment options for sarcoma – and the benefits of a multidisciplinary approach to care.

UPMC Hillman Cancer Center’s sarcoma team comprises specialists from different areas who review your specific condition and work together to determine the most appropriate and successful treatment plan tailored to your needs.

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What Does a Sarcoma Lump Feel Like?

Sarcoma symptoms vary based on the size of the tumor, its stage, and where it’s located.

There may be no apparent signs of soft tissue sarcomas at their early stages. Or you may notice a soft, painless lump under your skin that you can’t easily move around. Over time, it gets larger and begins to hurt.

Other signs of soft tissue sarcoma include swelling in the soft tissue. Sometimes, there are no signs or symptoms until the tumor is large enough that it begins to press on nerves or other areas of the body.

A sarcoma tumor on or near the heart can cause chest pain, shortness of breath, and fatigue.

Bone and soft tissue cancers may cause symptoms like swelling, pain, stiffness, weight loss, and fractures.

Sarcomas that start in the belly can cause belly pain or changes in your eating.

A proper – and early – diagnosis is key to successful treatment of bone and soft tissue cancers.

What Is Sarcoma Staging?

Staging allows doctors to determine the exact type, size, location, and spread of sarcoma cancers to develop the best treatment plan for you.

A care team will conduct tests and procedures to classify the type and stage of your sarcoma using four factors based on the American Joint Committee on Cancer system:

  • Tumor: Its size and location.
  • Nodes: Whether the cancer has spread to lymph nodes.
  • Metastasis: Whether the cancer has spread to distant organs.
  • Grade: How abnormal the cancer cells look under a microscope.

Each factor gets a stage number and is added to assign an overall stage to the cancer. Stage I sarcoma is the least invasive, and Stage IV is the most advanced and may mean cancer has spread from where it first started.

How Is Sarcoma Treated?

Doctors often will use imaging tests and biopsies to diagnose sarcoma. Treatments depend on your age, cancer stage, tumor type, and other health factors.

Your treatment plan may involve a blend of chemotherapy, radiation, drug therapy, and surgery. Chemo and radiation can help shrink the tumor before surgery or help prevent it from spreading after surgery.

Combined treatments, such as surgery, radiation, and chemotherapy, maximize the chance of long-term success.

Surgery for sarcoma

Surgery most often is used to remove the tumor and a small piece of the healthy tissue around it.

For smaller soft tissue sarcomas that haven’t spread, surgery to remove the tumor is often the first step. Doctors will prioritize minimally invasive methods to remove tumors using the smallest incisions possible.

Most people benefit from these less-invasive approaches, but some tumors are too large or hard to reach. In cases that require open surgery, surgeons try to keep incisions minimal.

This may involve using highly specialized technologies like regional therapy for treating sarcoma and newer sarcoma treatments, including:

  • Isolated hepatic perfusion: This treats metastatic cancers that have spread to the liver. Surgeons separate the blood supply of the liver from the circulatory system and disperse chemo solution through the liver.
  • Laparoscopic surgeries for metastatic disease: This is a surgical technique that uses a long, thin instrument with a tiny camera to make small incisions and may be appropriate for those with certain soft tissue sarcomas.
  • Limb and pelvic reconstruction.

Radiation

Radiation uses high-energy rays such as x-rays to kill cancer cells.

It may be used to help shrink a tumor so that it’s easier to take out during surgery, or it may be used after surgery to kill any cancer that’s left behind.

Radiation also can help treat symptoms like pain and swelling if the sarcoma has spread.

The latest sarcoma treatments include newer systems that provide a targeted dose of radiation to spare more healthy tissue near the sarcoma. Sarcoma radiation therapies offered at UPMC include:

  • 3D radiotherapy: This uses targeting data to focus on the tumor and avoid the healthy tissue around it. This targeting allows for higher levels of radiation in treatment, which is better for shrinking and killing tumors.
  • Intensity-modulated radiation therapy (IMRT): This gives radiation therapists the ability to “sculpt” the edges of a tumor, minimizing the damage to nearby healthy tissue. It allows for more precision and accuracy, resulting in the potential for fewer side effects and higher cure rates.
  • Image-guided radiation therapy (IGRT): This uses advanced imaging to track changes through all stages of cancer treatment and adjust your treatment plan as needed.
  • Stereotactic radiosurgery (SRS): This doesn’t involve actual surgery, but rather focused radiation beams are used to treat cancer without a surgical incision.
  • High-dose rate (HDR) brachytherapy: Cancer cells left after surgeons remove the tumor can form new tumors. That’s why doctors may use high-dose-rate (HDR) brachytherapy at the surgical site to prevent tumor recurrence. This helps prevent tumor regrowth, reduces injury to healthy tissue, and can aid in recovery.

Chemotherapy for sarcoma

Chemotherapy drugs are often given through a needle into a vein.

Chemo may be used before surgery to help shrink a tumor or after surgery to try to kill any cancer cells left behind.

It also can be used as the main treatment if the cancer has spread and is typically given in rounds.

Targeted drugs

Targeted drugs address changes in cells that cause cancer.

These drugs may work even if other treatments are less effective.

They often are taken as pills at home or in-office and may have different side effects from chemotherapy.

An Interdisciplinary Approach to Sarcoma Care

A cancer diagnosis affects not just the individual, but their entire support network.

UPMC takes a comprehensive approach to providing support services and resources that promote better outcomes and enhanced quality of life.

UPMC Hillman Cancer Center brings together experts to find the right sarcoma treatment for you.

UPMC’s holistic approach addresses the many needs of patients and their loved ones, from psychological support and counseling to assistance with navigating insurance and financial concerns.

Support groups and educational programs offer patients and families opportunities to connect with others facing similar challenges, fostering a sense of community.

Sarcoma specialty care at UPMC Hillman Cancer Center brings together a multidisciplinary team of leading experts in:

  • Surgical, medical, and radiation oncology.
  • Behavioral medicine.
  • Nutrition.
  • Pathology.
  • Pain management.
  • Palliative care.
  • Social work.

By combining cutting-edge medical treatments with compassionate support services, UPMC strives to treat the disease and empower those affected by it, guiding them through their journey with strength, dignity, and hope.

About UPMC Hillman Cancer Center

When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.