Adam C. Berger, MD, FACS, highlights the challenges and advancements in diagnosing and treating sarcoma, a rare and diverse group of cancers originating from mesenchymal tissues.
Adam C. Berger, MD, FACS
Chief of Melanoma and Soft Tissue Surgical Oncology
Rutgers Cancer Institute
RWJBarnabas Health
Sarcoma, often dubbed "the forgotten cancer," encompasses a rare and heterogeneous group of malignancies originating from mesenchymal tissues, including bone, muscle, fat, and connective tissues. The American Cancer Society1 estimates that approximately 13,590 new cases of soft tissue sarcomas will be diagnosed in 2024.
Despite its rarity, the diverse presentation of sarcoma poses significant challenges for timely diagnosis and effective treatment. To enhance awareness and understanding of sarcoma among healthcare professionals, we must focus on the epidemiology, clinical presentation, risk factors, and current advancements in treatment modalities for the disease.
Sarcomas can arise from any part of the body, from the head to the toes, involving bones, muscles, tendons, cartilage, and other connective tissues. This underscores the difficulty in detecting sarcoma due to its potential to develop in various (often deeply situated) locations and its often subtle symptoms. Although sarcoma can affect individuals of all ages, certain types, such as Ewing sarcoma, predominantly occur in children and adolescents during periods of rapid growth.
The clinical manifestations of sarcoma are contingent upon the tumor’s size, location, and aggressiveness. Often, sarcomas present as a painless lump or swelling, which may become painful if the tumor compresses adjacent nerves or muscles. Other symptoms include restricted range of motion and systemic signs such as weight loss or fatigue if the disease has progressed significantly. The most frequent sites of tumor growth include the extremities, neck, chest, shoulders, abdomen, and hips.Educating patients about the signs and symptoms of sarcoma and the importance of early medical evaluation can facilitate timely diagnosis and treatment.
Tumor microenvironment background with cancer cells, T cells, nanoparticles, molecules and blood vessels. Oncology research concept: © rataosk - stock.adobe.com
Certain risk factors have been associated with an increased likelihood of developing these malignancies. The primary risk factors for sarcomas include:
Understanding these risk factors is crucial for healthcare professionals in identifying individuals at higher risk and implementing appropriate surveillance and preventive strategies.
The treatment strategy for sarcoma is highly individualized, based on the tumor’s histological subtype, location, size, and stage, as well as the patient’s overall health. Treatment options include:
It is important to seek specialized care for sarcoma due to its complexity and rarity. At Rutgers Cancer Institute and RWJBarnabas Health, ongoing precision medicine initiatives are tailored to individual patient profiles, focusing on personalized treatment strategies for metastatic sarcoma and improving early detection methods. Clinical trials at Rutgers Cancer Institute2 are exploring innovative approaches, including targeted therapies and immunotherapies. These trials aim to enhance the efficacy of treatments and expand the therapeutic arsenal available to combat this diverse group of cancers.
Sarcoma, although rare, demands heightened awareness and a multidisciplinary approach to improve outcomes. By understanding the risk factors, clinical presentation, and evolving treatment options, healthcare professionals can play a crucial role in early detection and management. Raising awareness and fostering research are essential to ensuring sarcoma no longer remains the "forgotten cancer."
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