Sarcoma at a glance

• Sarcoma is a rare form of cancer that, instead of forming in organ tissue, begins in connective tissue such as the bones, nerves and muscles.
• A common gynecological sarcoma is a uterine sarcoma, which originates in the muscles of the uterus.
• The causes of sarcomas are generally unknown, but having a family history of sarcomas, certain genetic syndromes or previous exposure to radiation may increase the chance of sarcoma.
• Symptoms of sarcomas are hard to identify, but most commonly a painless bump emerges and begins to grow, at which point a biopsy confirms sarcoma.
• Sarcomas are most frequently (and successfully) treated with surgery, but radiation or chemotherapy may be prescribed depending on the location and development of the sarcoma.

What is sarcoma?

A sarcoma is a rare form of cancer that originates in the body’s connective tissue—the bones, tendons, nerves, muscles, fat and blood vessels. Connective tissues support the other types of tissues in the body, such as organ tissue. Gynecological cancer sarcomas begin in the reproductive tract tissues. Uterine sarcomas form in the uterus muscles or supportive tissues surrounding the uterus. Cancers that start in the tissues of organs are carcinomas.

More than 50 types of sarcomas exist, but all can be grouped into two primary types:

• Soft tissue sarcoma — present in about 1 out of 100 adult cancer cases, this sarcoma begins in soft tissue such as muscle, fat, nerves, tendons and blood vessels.
• Bone sarcoma — also known as osteosarcoma, this is an extremely rare form of sarcoma where the cancer begins inside the bones.

Causes of sarcoma

Causes of sarcoma remain undetermined. Risk factors that increase the chances of sarcoma include a family history of sarcoma, radiation exposure during a former cancer treatment, having the bone disorder Paget’s disease and having various genetic disorders such as Gardner syndrome or neurofibromatosis.

Symptoms of sarcoma

Soft tissue sarcoma symptoms are hard to identify, as they can grow throughout the body. Usually a patient will first notice a growing, painless lump. The lump may become uncomfortable or affect breathing, at which point a biopsy can confirm or rule out a sarcoma. A bone sarcoma produces more obvious symptoms such as painful bones or if the sarcoma is in the legs, a limp. In the case of uterine sarcoma, a woman may experience abnormal vaginal bleeding.

Children are more susceptible to bone sarcomas and the diagnosis is often delayed because the symptoms are mistaken for growing pains or a sports injury. A doctor will diagnose sarcoma after sampling cells during a biopsy, CT scan or bone scan.

Treating sarcoma

Sarcoma treatment will depend on the sarcoma location, how advanced the tumor is and whether or not it has metastasized (spread). Surgery to remove the cancer cells is the most common treatment course. Robotic surgery is a common surgical method to remove uterine sarcoma, most often through a hysterectomy procedure.

Radiation therapy is another form of treatment that may shrink the tumor before a surgery or destroy any remaining cancerous cells following surgery. Chemotherapy drugs may also be used as a first–line treatment when the cancer has already spread.

For low–grade tumors (those unlikely to spread) surgery alone will likely completely remove and cure the sarcomas. Aggressive sarcomas and those prone to, or that have already, spread prove much harder to treat surgically or by any other manner.

At CU Anschutz Gynecologic Oncology, experts provide advanced diagnosis and care, from surgery to radiation and chemotherapy.