There are more than 150 different types of soft tissue sarcomas. These cancers can arise in a variety of cells that form structural support in our bodies. Many soft tissue tumors originate in the arms or legs, while others are discovered in the torso. Rarely, they may be found in your head or neck, or inside other organs, including the liver, kidney, uterus, breast, lung, gastrointestinal tract, or the abdominal cavity.
Some of the most common types of soft tissue sarcomas include:
Angiosarcoma
These resemble blood vessels and can occur in an area that had received radiation therapy. They commonly occur on the breast. They may be confined to the skin only or can arise as tumors anywhere in the body.
Gastrointestinal Stromal Tumors (GIST)
Gastrointestinal stromal tumor, the most common sarcoma of the gastrointestinal tract, affects about 5,000 people a year in the United States. This is the most common type of sarcoma and treatment and there have been major advances in treatment over the past 20 years.
Kaposi Sarcoma (KS)
Kaposi sarcoma (KS) is the main type of cancer that affects people with HIV/AIDS. In KS, cancer develops from the cells that line lymph or blood vessels. The cancer cells can also grow in the mucous membranes in the nose, mouth, lung, and anus. KS causes purple, brown, or red patches (lesions) on the skin and can spread to other organs in the body, like the liver and lungs. There are also variants of KS not associated with HIV/AIDS
Leiomyosarcoma
These sarcomas arise in smooth muscle that forms the walls of organs or blood vessels, either in the extremities or inside the abdominal cavity.
Liposarcoma
This is a rare type of cancer of the connective tissues that resembles fat tissue when seen under a microscope. These sarcomas may arise in fat cells almost anywhere in the body, but typically involve the thigh, leg, or knee.
Solitary Fibrous Tumors (SFTs)
SFTs are rare but aggressive tumors that typically develop in older individuals. They can occur anywhere in the body. The signs and symptoms of solitary fibrous tumor vary based on the location and size of the tumor.
Synovial Sarcoma
These cancers often affect adolescents and young adults. The tumors resemble normal synovium, the lining of joints.
Undifferentiated Pleomorphic Sarcoma
One of the most common types of soft tissue sarcoma is the undifferentiated type. These resemble a very primitive cell that has not yet turned into an obvious structural cell type. Many times, with additional pathology testing, we can determine a likely line of differentiation.
Uterine Sarcoma
Uterine sarcomas are rare cancers that form in the uterine muscles, or in tissues that support the uterus. These tumors are treated by both medical and gynecologic oncologists.
Other diseases treated by the sarcoma group
Desmoid fibromatosis
Resembling overgrown scars, these tumors most commonly occur in the extremities or trunk, or can occur inside the abdomen.
Tenosynovial Giant Cell Tumor (formerly known as Pigmented villonodular synovitis)
This is a rare disease in which the lining of joints (synovium) overgrows and results in significant arthritis. These tumors are managed in consultation with our orthopedic oncologists. We have new clinical trials to treat this disease.
Tests
X-Ray
Doing an X-ray of bones and organs in the region of symptoms can provide important information.
Computed Tomography (CT or CAT) Scan
CT scans are a procedure in which detailed pictures are taken inside the body from different angles. A colorful dye helps the organs or tissues to show up clearly.
Magnetic Resonance Imaging (MRI)
An MRI is an advanced imaging test that uses magnets, radio waves, and a computer to show the inside of the body and any abnormalities.
Bone Scan
Allows us to see any rapidly dividing cells, such as cancer cells, in the bone. A safe, very small amount of radioactive material is injected into a vein. The radioactive material collects in the bones and is detected by a scanner.
Positron Emission Tomography (PET) Scan
Similar to a bone scan, the PET scan uses a slightly radioactive sugar, which is injected into the blood. These sugars are collected by tumors, where it can be detected with a special camera. PET scans can help locate tumors and determine if cancer cells are spreading.
Biopsy
In nearly all cases, the doctor will remove (biopsy) a sample of cells and tissue from your tumor to confirm the diagnosis. A pathologist, or cellular expert, will look at the sample under a microscope to check for cancer.
- Tumor biopsy: A tumor biopsy occurs when the biopsy and the surgery to remove the tumor are planned together.
- Light microscopy: The pathologist looks for certain changes in your cells. Your surgeon can measure what tissues and length of bone are involved, decide what has to be removed, and what can be saved.
Bronchoscopy
A thin, flexible tube, called a bronchoscope, is equipped with a light and a camera lens. The doctor inserts the tube into your windpipe to look for lesions inside your trachea, or windpipe. If you have a bleeding lesion, your doctor can stop the bleeding and retrieve tissue for biopsy during this test.
Endoscopy
For lesions in the gastrointestinal tract, the doctor will use a thin, flexible tube called an endoscope, equipped with a light and a camera lens. This tube allows the doctor to see inside your esophagus, stomach, and a portion of your intestines. The doctor can use the endoscope to take biopsies of lesions. Those lesions can also grow in your rectum, usually under the surface of rectal tissue and have to be found with an endoscope.
Ultrasound
Sound waves can help determine whether a lump or mass is solid or if it is filled with fluid. Cysts, or fluid-filled masses, are much less likely to be a sarcoma.
Treatments
Soft tissue sarcomas treatments may be either local or systemic. Local treatments, such as surgery and radiation therapy, remove, destroy, or control the cancer cells in one certain area. Systemic treatments like chemotherapy are used to destroy or control cancer cells throughout the whole body.
Surgery
Decisions are based on the size and stage of the cancer, as well as other individual factors. After the doctor removes all the cancer that can be seen at the time of the surgery, patients are then given chemotherapy to kill any cancer cells that are left, or that have spread to other parts of the body. Types of surgery include:
- Wide Local Excision: In this surgery, your doctor removes the cancer and some healthy tissue around it.
- Limb-Sparing Surgery: In this procedure, your surgeon removes the tumor in an arm or leg without having to amputate, so the use and appearance of the limb are protected. The tumor is extracted by a wide local excision. If the surgeon removes additional tissue and bone, it may be replaced with a graft or with an implant such as artificial bone.
- Amputation: Surgery to remove (amputate) an arm or leg is rarely needed. In some cases, it may be the best option. Today, Sylvester surgeons have the ability to replace any joint in the body, including shoulders, knees, hips, or elbows with custom-designed artificial prostheses or bone grafts. The choice of technique depends on your individual situation.
Radiation Therapy
Precisely targeted to your tumor and delivered from outside the body (called external beam radiation therapy) to treat the cancer or to relieve symptoms.
Chemotherapy
Chemotherapy is usually given in a treatment plan with surgery or radiation therapy to increase its cancer-killing impact. Typically a combination of cancer-fighting drugs is administered intravenously or by pill orally (by mouth).
If you need intravenous (infusion) chemotherapy, you can have it at the Comprehensive Treatment Unit (CTU) at Sylvester’s main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments treatments in the many different satellite locations throughout South Florida.
Targeted Therapy
Designed to attack the molecular changes/alterations that make cancer cells grow and spread. Target therapies are available for select patients, as recommended by your Sylvester oncologist. Some medicines are delivered along with chemotherapy medicines, while others may be used by themselves. The objective of these treatments is to prevent the cancer from growing. It may also be used to direct chemotherapy more effectively to the tumor.
Clinical Trials
Clinical trials may be considered and discussed with you as either as a standalone treatment or as an addition to another therapy. Clinical trials are the newest research studies available, focused on creating the improved next-generation standard of care.
Immunotherapy (Biologic Therapy)
Drugs or combinations tap into the power of the body’s own immune systems to fight cancer.
Ablation Therapy for GIST Tumors
For certain tumors or in cases when surgery may be too risky for you, and for isolated tumors in the liver, this type of treatment uses different techniques to destroy abnormal liver tissue, including:
- Radiofrequency Ablation (RFA): Through special needles inserted directly into the tumor, high-energy radio waves heat the needles and tumor, killing cancer cells.
- Cryoablation: Under ultrasound guidance, a special instrument freezes and destroys cancer cells.
- NanoKnife® (Irreversible Electroporation - IRE): This procedure is an effective treatment for selected GIST tumors that are considered inoperable. While you are under general anesthesia, Sylvester/UMHC’s interventional radiologists use CT or ultrasound imaging guidance to insert electrodes on or near the tumor. Once the electrodes are placed, the NanoKnife generator sends a series of short, intense electric pulses directly to the tumor. This opens the cell walls of the tumor; the cancer cells die; and healthy tissue remains unharmed.
Why Choose Sylvester Comprehensive Cancer Center?
Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.
High volume experience treating many cases of sarcoma, bone, and soft tissue cancers. Because we see so many patients with sarcoma, bone, and soft tissue cancers, we have the experience needed to provide better outcomes with fewer potential complications.
Targeted therapies and clinical trials for patients with tumor mutations. We offer the most advanced treatment options available in South Florida.
Advanced radiation oncology tools. Our RapidArc® radiotherapy system delivers intensity modulated external radiation therapy (IMRT). These tools lead to more efficient and effective treatments, shorter treatment times, pinpoint accuracy in tumor targeting, and less damage to surrounding healthy tissue.
One of only six designated Cancer Centers of Excellence in Florida. You can rest easy knowing you are in the best possible place to treat your cancer.
Comprehensive sarcoma tissue bank and registry. You can help future patients by participating in research that helps create tomorrow’s improved therapies.
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