Medicines for Soft tissue sarcoma

What it is

Soft tissue sarcomas are a rare group of cancers that develop in the "soft" supporting tissues of the body — such as muscle, fat, blood vessels, nerves, tendons, and the tissues around joints. Because these tissues are found throughout the body, a soft tissue sarcoma can develop almost anywhere, though they are most common in the arms, legs, and trunk. They are uncommon and can affect people of any age. The most common way a soft tissue sarcoma shows itself is as a lump or swelling. Certain features of a lump raise more concern and should prompt assessment: a lump that is getting bigger, is larger than about 5cm (roughly the size of a golf ball), is deep in the body tissues (rather than just under the skin), is painful, or has come back after being removed. Many soft tissue lumps are painless, at least at first. Because most lumps are not sarcomas — the great majority are harmless (for example fatty lumps called lipomas or cysts) — a lump does not usually mean cancer; but because sarcomas are best treated when found early, a lump with any of the concerning features (growing, large, deep, or painful) should be checked promptly. Depending on where a sarcoma is, it may also cause other symptoms related to its location. Soft tissue sarcomas are diagnosed and treated by specialist teams (in specialist sarcoma centres), and treatment usually centres on surgery to remove the tumour, sometimes with radiotherapy and/or chemotherapy. The key messages are awareness of the warning features of a lump, and prompt assessment, as early diagnosis improves the treatment options and outcome.

How it is treated

Soft tissue sarcomas are diagnosed and treated by specialist teams in dedicated sarcoma centres, and because they are rare and best treated when found early, prompt and appropriate assessment of a suspicious lump is important. When a lump has concerning features (growing, larger than about 5cm, deep, painful, or recurring after removal), it should be assessed — this usually involves imaging (such as ultrasound and MRI) and, if a sarcoma is suspected, a biopsy (taking a sample), ideally arranged through a specialist centre so that it is done in a way that does not compromise later treatment. Confirming the diagnosis and the type and extent of the sarcoma guides treatment. The main treatment is usually surgery to remove the tumour completely (with a margin of surrounding tissue), aiming to remove all the cancer while preserving as much function as possible; reconstruction may be part of this. Radiotherapy is often used before or after surgery to reduce the risk of the cancer coming back, and chemotherapy is used in certain types and situations. The specific approach depends on the type, size, location, and grade of the sarcoma, and is planned by the specialist team; follow-up is arranged to watch for recurrence. Because outcomes are better when sarcomas are found and treated early, and because they are managed best in specialist centres, the key messages are awareness and prompt, appropriate assessment: a lump that is growing, large (over about 5cm), deep, painful, or has come back should be checked promptly, ideally leading to referral to a specialist centre. It is worth keeping perspective — the vast majority of soft tissue lumps are harmless and not sarcomas — but a lump with the warning features should not be ignored. The reassuring message is that most lumps are not cancer, that soft tissue sarcomas are rare, and that specialist treatment (usually centred on surgery) is available, with better outcomes when they are found early.