Sarcomas refer to malignant (cancerous) tumors that develop in the soft tissue or bones. Soft tissue is tissue that connects or supports other organs in the body. Soft tissue sarcomas are different from bone sarcomas, which develop in the bone and cartilage.

At the Wake Forest Baptist Comprehensive Cancer Center, we treat both soft tissue sarcomas and bone sarcomas.

Soft tissue sarcomas, no matter where they originate, have similar characteristics and are diagnosed and treated similarly. Generally, the specific type of cancer is named after the body part in which it was found.

The second group of sarcoma is bone sarcomas or bone cancer. There are three types of bone sarcoma: osteosarcoma; Ewing’s sarcoma; and chondrosarcoma. Bone sarcomas are very rare and are likely to be diagnosed in children.

Sarcoma Symptoms

There are very few symptoms associated with bone sarcomas. The most common is pain and sometimes swelling at the site of the tumor. These tumors can also weaken the bones, causing fractures. Other symptoms may include weight loss, fatigue and or anemia.

Often, the only symptom of a soft tissue sarcoma is a lump or mass. More than half of sarcomas start on the arm or leg; perhaps you noticed a lump growing there. The lump may be painful, but it may not hurt at all because a sarcoma may not cause any symptoms. That is why it is crucial to see a doctor right away if you feel a lump or a change in your body.

If the sarcoma begins in the abdomen, it may cause pain or bleeding. See your doctor if you experience any of the following:

  • A growing lump anywhere on your body
  • Abdominal pain that worsens
  • Blood in stool or vomit
  • Black, tarry stools

Because there are so few symptoms in the early stages, most soft tissue sarcomas are only found after they metastasized (spread to other organs).

Sarcoma Diagnosis

If you have a lump or mass on your body, your doctor may want to order different tests to see if it is a sarcoma. These tests will involve imaging and biopsies.

Before you have imaging or biopsies, your doctor will perform a thorough physical examination and ask you about your medical history.

Sarcoma Imaging Studies

In general, imaging studies are painless procedures. They may cause slight discomfort because you often have to lie very still, which can sometimes take up to an hour.

The goal of these scans is to obtain a clear, accurate and detailed picture of the inside of your body. The images help the doctor determine the size of the tumor, its location and if it has spread to other organs.

  • Xray uses radiation technology to capture a detailed picture of the inside of your body.
  • Computed tomography (CT) scans are similar to Xrays. The machine rotates around you, providing your doctor with a crosssectional image of your body.
  • Magnetic resonance imaging (MRI) uses powerful magnetic waves to create an image of your body.
  • Ultrasound uses sound waves to produce pictures. The technician moves a probe, called a transducer, over your body to obtain the images.
  • Positron emission tomography (PET) scan uses a small amount of radioactive material to find cancer cells. The radioactive material concentrates around the cancer, allowing your doctor to pinpoint the tumor.

Sarcoma Biopsies

Biopsies are more invasive than imaging studies, but they offer a definitive diagnosis. Your doctor removes cells from the mass and sends them to a lab for analysis. A trained pathologist studies the cells and determines if they are cancerous. Depending on the type of biopsy, either you will receive a local anesthetic to numb the area, or you will receive general anesthesia.

Types of biopsies include:

  • Fine needle aspiration (FNA). Your doctor inserts a very thin needle to remove small amounts of tissue from the mass. If the doctor cannot find the tumor by feeling the area, then a CT scan will be used to help locate the tumor.
  • Core needle biopsy. This is similar to FNA but uses a larger needle to remove a bigger piece of the tumor.
  • Surgical biopsy

Sarcoma Alliance Designation

Wake Forest Baptist has been recognized by the Sarcoma Alliance as a designated Sarcoma Center. An acknowledgment given to leaders in sarcoma research and treatment, we are one of only two institutions in North Carolina and 52 in the country to hold this designation. The Sarcoma Alliance strives to improve the lives of people affected by sarcoma through accurate diagnosis, improved access to care, guidance, education and support.

Sarcoma Treatment Options

At Wake Forest Baptist, a team of cancer specialists will work together with you to provide the most advanced personalized treatment available.

Once you have diagnostic imaging and biopsies complete, one of our oncologists will discuss a treatment plan with you. Typically, the treatment for these types of tumors is surgery, radiation and perhaps chemotherapy.

Our physicians are known as experts in removing tumors and performing reconstruction. Part of our expertise extends to limb sparing surgery and we perform this surgery when possible.

Some of our additional surgical techniques include:

  • Resection of tumors
  • Reconstruction
  • Latest and state of the art allografts
  • Limb resection techniques

Soft Tissue Sarcoma Reconstructive Surgery

If your surgeon needed to remove a large amount of tissue, you may need reconstructive surgery following the procedure. The reconstruction surgery will be performed at the same time as the surgery to remove the cancer. A specially trained plastic surgeon works carefully to restore the area of your body to how it looked and functioned precancer. The exact type of operation depends on which area of the body had the sarcoma.

Because of our multidisciplinary approach to treatment for all cancers, Wake Forest Baptist has been designated by the National Cancer Institute as a Comprehensive Cancer Center, one of only 41 in the country.