Rare but Aggressive Sarcomas Require Multidisciplinary Cancer Care

“National Sarcoma Awareness Month is an opportunity for us to raise awareness of these rare cancers – what they are, where they form, who is at risk and what symptoms to watch for,” says orthopedic oncologist surgeon Juan Pretell, M.D.

Sarcomas are cancers that start in bone, muscle, fibrous tissue, blood vessels, fat tissue and some other tissues, and they can develop anywhere in the body, explains Dr. Pretell, chief of musculoskeletal oncology surgery at Baptist Health Miami Cancer Institute.

Juan Pretell, M.D., chief of musculoskeletal oncology surgery at Baptist Health Miami Cancer Institute

According to the American Cancer Society (ACS), each year in the U.S. more than 13,000 patients are diagnosed with a soft tissue sarcoma, and another 4,000 receive a diagnosis of bone sarcoma.

Most adults diagnosed with cancer in the bones actually have bone metastasis, a secondary cancer that originated elsewhere, not primary bone cancer, Dr. Pretell notes.

“When an adult is diagnosed with cancer in the bones, most often it is bone metastasis, which is cancer that developed in the breast or prostate, for example, and then metastasized to the bone,” he explains.

Primary bone cancers, such as bone sarcomas, are those that originate in the bone of the patient. While there are many different types of primary bone cancer – osteosarcomas, chondrosarcomas and Ewing sarcomas, to name a few – Dr. Pretell says they are very rare.

Less than one percent of all cancers are bone cancer, Dr. Pretell notes. “However, primary bone cancers are very aggressive, and sarcoma is not curable once it has spread,” he says. “That’s why it’s so important to have any lump or mass evaluated. It’s far better to find out that it is nothing than to discover your cancer has spread.”

Symptoms of sarcoma

A patient with bone sarcoma may feel pain in the area of the tumor, associated with swelling and functional limitation, according to Dr. Pretell. However, many patients with soft tissue sarcomas experience no pain and are surprised to learn they have a sarcoma.

“One of the common misperceptions I hear from newly diagnosed soft tissue sarcoma patients is that if it doesn’t hurt, it can’t be bad,” says Dr. Pretell. “Most people think that if they develop a ‘bump’ that doesn’t hurt, they are fine, or that because it doesn’t hurt, it isn’t anything bad.”

According to Dr. Pretell, common symptoms of sarcoma include:

·      A painless “bump” that appears for no apparent reason

·      Any lump or mass that grows

·      An unexpected fracture that occurs with little or no injury or known reason

Treating Sarcoma

Treatment for sarcomas usually involves surgery, says Dr. Pretell. “Sometimes chemotherapy is given before and/or after surgery, and the vast majority of patients with soft tissue sarcomas also have radiation therapy,” he says.

Physicians at Miami Cancer Institute offer complex limb salvage procedures which allows for removal of a tumor while maintaining function. And, Dr. Pretell points out, as Florida’s only member of the Memorial Sloan Kettering Cancer Alliance, the Institute has access to the most innovative clinical trials.

“Because sarcomas are rare, you want to ensure you are receiving care from an experienced team at a specialty center like Miami Cancer Institute,” Dr. Pretell says. “We have a multidisciplinary team that includes orthopedic oncology surgeons, radiation oncologists, medical oncologists, MSK pathologist, plastic surgeons and rehabilitation experts.”