Common Question about Sarcoma

1. What is Sarcoma?

Sarcoma is the name applied to a variety of malignant tumors that occur in fat, tendon, muscle, bone, cartilage, and nerve cells. Sarcomas are rare in comparison to carcinomas, which develop in the glands and organs of the body such as lung, breast, and prostate

2. Why is it important to know the exact diagnosis of a sarcoma?

The ideal treatment for cancer varies depending on the diagnosis. Some cancers are cured with surgery alone, while others do not require surgical therapy, and many respond best to a combination of surgery, radiation, and chemotherapy.

3. How can you be sure of the diagnosis?

In many cases a presumptive diagnosis can be made on the basis of the physical examination and state-of-the-art imaging studies. However, a tissue sample (biopsy) examined by a trained pathologist is required for a more exact or definitive diagnosis. The biopsy may be done with a needle or by a surgical incision and should be either performed by a surgeon familiar with the approach to definitive management or at least discussed with such a surgeon, in order to avoid complications in eventual management of the tumor.

4. What if the diagnosis is uncertain?

Some sarcomas are very difficult to diagnose, even by an experienced pathologist. In these cases, consultation among your surgeon, oncologist, radiologist and pathologist may be required. In the absence of a consensus on the diagnosis, a second biopsy may be required as well as consultation with experts in sarcomas in treatment centers around North America.

5. What are the next steps after a diagnosis is confirmed?

Accurate staging of the tumor is essential to selecting the appropriate treatment and sequence of treatment.

6. What is staging?

This is the process your doctors use to define the extent and aggressiveness of your tumor. Staging requires an accurate grading by the pathologist as to whether the tumor is a high-grade or low-grade tumor. High-grade tumors have a greater chance of both regrowing in the same area after a previous surgical removal (local recurrence) and spreading to other sites (metastasis) in the body. The next element of staging depends on the type of tumor but is designed to identify the local extent of the original tumor and any distant (metastatic) spread of the tumor. Other factors important for staging include the tumor size and location.

7. Can I be cured of my sarcoma?

The term “recurrence” or “relapse” is used to indicate that a tumor has come back. When a person has a cancer, a “cure” can only be proclaimed after living for a prolonged period of time without having the cancer come back. Therefore, cancer doctors have traditionally looked at the time interval after diagnosis that someone survives without evidence of the tumor recurring and called this the disease-free survival interval. When someone survives for 5 years after diagnosis and treatment for a cancer, without having it return, many physicians would consider this milestone as an acceptable definition of a “cure”.

8. What is the cure rate for sarcomas?

The likelihood of cure is very patient and tumor specific. The population statistics for cure give some indication of risk, dependent upon the tumor stage, but even when disease factors indicate that the risk of progressive disease is high, some patients will survive for long durations of time (several years) with adequate treatment. Your doctors will rely on the stage of your tumor at initial presentation to determine the statistical probability of cure for the individual tumor and therapy selected. In general, the likelihood of surviving for 5 years, after being diagnosed with a sarcoma that has not spread to any sites beyond the original site of growth, is 65% to 80%. When distant disease (metastasis) is present at the time of initial diagnosis, the cure rate is lower.

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