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Vanderbilt-Ingram Cancer CenterVanderbilt-Ingram Cancer Center

 

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What is Sarcoma?

Sarcoma is a malignancy primary to the musculoskeletal system and can arise in either bone or soft tissue. Cancer that starts in bone is called skeletal sarcoma and examples include osteosarcoma, Ewing sarcoma, or chondrosarcoma. Cancers that begin in the bone are quite rare and are called primary bone tumors. Tumors that arise elsewhere in the body and travel to the bones are called secondary bone tumors. Secondary bone tumors are more commonly metastases from lungs, prostate, breast or kidney cancer. Sarcomas are rare, constituting 0.5% of the total annual number of new cancers and are 200 times less common than carcinomas. The rarity of sarcomas means most doctors seldom see one which explains why patients are often referred to specialty hospitals where experienced surgeons utilize limb-sparing (no amputation) surgery whenever possible.

Skeletal sarcomas are most often found in legs and arms of children and young adults, but they can occur at any age.

Osteosarcoma is the most common type of bone cancer in young people, usually occurring between ages of 10 and 25 with males more commonly affected than females. It may also occur in the fifth or sixth decades of life. Osteosarcoma starts in the ends of long bones of the arms or legs where new bone tissue rapidly forms.

Ewing sarcoma is usually found in young people between the ages of 10 to 25.This cancer forms in the mid part or shaft of large bones, hip and thigh bones, upper arm and ribs.

Chondrosarcoma forms cartilage growth around joints and is found mainly in adults.

Limb sparing surgery (LSS) which is a special operative procedure performed by oncology orthopedic surgeons has become the accepted standard of care for patients with sarcomas of the extremities. The cancer in the bone or soft tissue is removed surgically without amputation with replacement of bones and joints by metal prostheses and/or reconstruction of the defect. Even though the salvaged extremity looks and moves in a near-normal manner, function rarely returns to 100% normal. Common causes of prosthesis failure include infection, aseptic loosening, bone resorbtion and fracture.

Regular follow-up for several years is very important after treatment for bone or soft tissue cancer. Regular check-ups will include physical exams, x-rays, scans, blood tests and other laboratory tests.

Patients who have limb salvage operations with joint replacements will require physical therapy to help regain optimal use of their operated limb. Patients with amputations will also require physical therapy with prosthetic training.