September 15, 2022 by KiKi Bochi
Painless Isn’t Necessarily Harmless: What You Should Know About Sarcoma
A painless bump that has popped up on your leg appears to be getting larger. But it still doesn’t hurt, so you ignore it. That could be a big mistake, according to Juan Pretell, M.D., chief of musculoskeletal oncology surgery at Miami Cancer Institute, part of Baptist Health.
“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,” Dr. Pretell says. It’s one of the common misperceptions he hears from newly diagnosed soft tissue sarcoma patients.
National Sarcoma Awareness Month is an opportunity to dispel the myths and raise awareness about this rare cancer. 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.
Children and adults alike can develop sarcoma and while there are some genetic mutations and conditions ― and risk factors such as chemical exposure and prior radiation therapy ― that can predispose some people to the disease, most who develop it do not have one of these known risk factors.
“Ask the average person on the street what sarcoma is and most can’t tell you,” Dr. Pretell says. “Although it’s rare, it can be very aggressive, so the sooner it is detected the better the chance of survival.”
There are many subtypes of sarcoma and they can occur anywhere in the body. They often metastasize, or spread. Soft tissue sarcomas are most commonly found in the fat, muscle, nerves and blood vessels in the arms, legs and abdomen. Bone sarcomas begin in the bones and are typically found in the thigh, upper arm or shin.
Symptoms of Sarcoma
A patient with bone sarcoma may feel pain in the area of the tumor. “This can be associated with swelling and functional limitation,” Dr. Pretell says. Other 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
- Abdominal pain
- Weight loss
Treatment for sarcoma usually involves surgery. Sometimes chemotherapy is given before and/or after surgery, and the vast majority of patients also have radiation therapy.
“If you have sarcoma, it’s important to be treated and followed at a specialty center like Miami Cancer Institute,” Dr. Pretell says. “We have a multidisciplinary team that includes oncology orthopedic surgeons, radiation oncologists, medical oncologists, plastic surgeons and rehabilitation experts. Because sarcomas are rare, you want to ensure you are receiving care from an experienced team.”
Miami Cancer Institute physicians offer complex limb salvage procedures which allows for removal of a tumor while maintaining function. And, as Florida’s only member of the Memorial Sloan Kettering Cancer Alliance, the Institute has access to the most innovative clinical trials.
Although sarcoma receives less research funding than many other cancer types, there are some promising diagnostic tools and treatments on the horizon. “Molecular testing that identifies specific mutations in sarcoma patients is leading to more-accurate and earlier diagnoses, as well as helping drive treatment decisions,” says Dr. Pretell.
In addition, immunotherapies are increasingly being used and are showing benefits in patients with certain types of sarcomas. Immunotherapy drugs help the body’s own immune system target and kill cancer cells. Other advances include 3-D printing, leading to better implants and prosthetics, and navigation systems that are being developed to improve outcomes in surgery.
Sarcoma is not curable once it has spread, so Dr. Pretell emphasizes the importance of having any lump or mass evaluated. “It’s better to find out that it is nothing to worry about than to discover your cancer has spread,” he says.