July is sarcoma and bone cancer awareness month and although a quite rare group of diseases, sarcomas and bone cancers affect some sixteen thousand people in the United States every year. Sarcomas are a group of cancers that affect the bones and soft tissues of the body.
The American Cancer Society estimates that about 13,190 new soft tissue sarcomas will be diagnosed and about 3,190 new cases of bone cancers will be diagnosed in 2022. This includes both children and adults as typically cancer of the bones and joints are diagnosed among teenagers while soft tissue affect those 55 years or older. Some 5,350 and 2,060 people are expected to die from soft tissue and bone sarcomas, respectively. For those diagnosed with sarcoma, the five-year survival rate for soft tissue sarcomas is 65 percent, while the survival rate is 66.8 percent for bone sarcomas making sarcomas some of the most challenging cancers to combat.
Types of Sarcomas
Soft tissue sarcomas form in the cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. There are many types of soft tissue sarcoma and each type of sarcoma look different under a microscope based on the type of soft tissue in which the cancer began. Osteosarcomas develop in the bone and usually start in osteoblasts, which are a type of bone cell that become new bone tissue. Osteosarcoma is the most common type of bone cancer and is most common in teenagers.
Rhabdomyosarcoma is a cancer that forms in the muscle tissue and is a rare form of sarcoma that is typically diagnosed in children and can begin in many places in the body. There are three main types of rhabdomyosarcomas: embryonal, which occurs most often in the head and neck area or in the genital or urinary organs; alveolar, which occurs most often in the arms or legs, chest, abdomen, genital organs, or anal area; and anaplastic, which is rare in children.
In addition to the most common types of sarcomas there are a number of rare sarcomas including liposarcoma which occurs in the fat cells in any part of the body, and Ewing sarcomas which are a rare type of sarcoma typically found in teenagers and young adults and affect some 9 to 10 per million teens per year.
What Causes Sarcoma?
Unlike many common cancers, smoking, diet and exercise are not linked to the risk for soft tissue sarcoma. This is one of the many reasons why sarcoma is both hard to identify and treat. Still, current research has identified some risk factors for sarcoma especially radiation given to treat other cancers, and family cancer syndromes.
Radiation exposure accounts for less than 5% of sarcomas. Patients who undergo radiation treatment for certain cancers such as breast cancer or lymphoma may develop sarcoma as what is called a second cancer. The average time between the radiation treatments and the diagnosis of a sarcoma is about 10 years. Radiation therapy techniques have improved steadily over several decades. Treatments now target cancers more precisely, and more is known about selecting radiation doses. These advances are expected to reduce the number of second cancers caused by radiation therapy.
Family cancer syndromes are disorders caused by gene defects that people are born with that are linked to a high risk of getting certain cancers such as soft tissue sarcoma. Certain syndromes that have been directly linked to sarcoma include: neurofibromatosis, gardner syndrome, li-fraumeni syndrome, retinoblastoma, werner syndrome, gorlin syndrome and tuberous sclerosis. Thos diagnosed with these conditions or a family history of these conditions have a higher risk for developing sarcoma.
In addition, exposure to certain chemicals especially vinyl chloride (a chemical used in making plastics) are known for developing sarcoma of the liver. Arsenic has also been linked to a type of liver sarcoma but this and vinyl chloride are not connected to development of soft tissue sarcoma. Exposure to dioxin and to herbicides that contain phenoxyacetic acid at high doses (such as those who may work on farms) may also be at risk for developing sarcoma however, more research is needed to determine whether this is a definitive cause.
The Challenges of Sarcoma and Bone Cancer
Sarcomas remain to be one of the most challenging cancers to detect and treat. Sarcomas do not share many of the common risk factors associated with other cancers like breast or colo-rectal cancer making it very tough to detect early. Quit often those diagnosed with sarcoma have no visible symptoms. People who have a strong family history of sarcoma or who have had other cancers when they were younger may talk to their doctors about the benefits and disadvantages of genetic testing for sarcoma. Currently, there are no screening tests and exams recommended for those who have no family history of sarcoma or other sarcoma risk factors. For these people, the best approach to early detection is to tell their healthcare provider about any unexplained lumps or growths or other symptoms that may be caused by sarcoma.
Signs and Symptoms of Sarcomas
Nearly half of sarcomas start in an arm or leg and most people will notice a lump that’s grown over time. When sarcomas grow in the back of the abdomen this may cause other symptoms such as blockage or bleeding of the stomach or bowels. They can press on nerves, blood vessels, or nearby organs and can cause pain should they grow large enough to impact other organs. In more rare cases, sarcomas can start in the chest or in the head or neck.
As the exact risk factors and symptoms of sarcoma remain unclear to medical research you should always be diligent especially if you exhibit any of the following symptoms:
- A new lump or a lump that’s growing (anywhere on your body)
- Abdominal pain that’s getting worse
- Blood in your stool or vomit
- Black, tarry stools (when bleeding happens in the stomach or bowels, the blood can turn black as it’s digested, and it might make the stool very black and sticky)
These symptoms are more often caused by things other than sarcoma, but they still need to be checked by a doctor to rule out sarcoma as a possible cause.
The only way to prevent some soft tissue sarcomas is to avoid exposure to risk factors whenever possible. However, most sarcomas develop in people with no known risk factors. Currently, there are no known ways to prevent these types of cancers. Furthermore, risk factors for sarcomas remain very unclear and more research is required to fully understand how these cancers develop in the body. Remaining aware of the symptoms, and getting regularly checked by your doctor especially when certain symptoms arise is the best way to prevent or allow for early detection of sarcoma.
The Forgotten Cancer
Sarcoma and bone cancer awareness month is observed to bring awareness to these very rare types of cancer. Although not many people are likely to be diagnosed with these cancers it also does create a challenge for research and drug development due to the lack of awareness and understanding. Though our lives may not be impacted by sarcomas or bone cancer in the same way that more common cancers such as breast or colorectal cancer have, there are still many thousands living with these cancers in the U.S. today who deserve a fighting chance. Through spreading awareness this July we can create hope for the many thousands of families who are relying on the groundbreaking cancer research being done to treat and prevent sarcomas and bone cancer.
For more information on how you can help spread awareness or donate to cancer research check out these links below:
Sarcoma Foundation of America - Sarcoma Awareness Month