Sarcoma

Diagnosis

Sarcoma diagnosis typically begins with a physical exam, especially since this cancer can develop in both bones and soft tissues. The tests used depend on which part of the body is affected. Evaluation often includes imaging tests and a biopsy to confirm the diagnosis and determine the type of cells involved.

During the physical exam, your healthcare professional may ask about your symptoms and personal health history. The exam helps identify signs that may indicate sarcoma and guides decisions about further testing.

Imaging tests provide detailed pictures of the inside of the body and help determine the size and exact location of the sarcoma. The tests used vary based on the suspected tissue involved. X-rays are often used for bone tumors, while MRIs provide clearer images of soft tissues. Additional imaging may include ultrasound, CT scans, bone scans and PET scans to better understand the cancer’s spread or behavior.

A biopsy is needed to confirm the diagnosis. The method used depends on the tumor’s location. A biopsy may be done with a needle inserted through the skin or during surgery. In some cases, the biopsy is performed at the same time as surgery to remove the cancer.

Treatment

Treatment for sarcoma often begins with surgery to remove the cancer. Additional therapies may be recommended depending on the type of sarcoma, how quickly it is growing, its location and whether it has spread. Treatments may include radiation therapy, ablation procedures and medicines such as chemotherapy, targeted therapy and immunotherapy.

Surgery aims to remove all cancer cells. In some cases, removing a limb may be necessary, but surgeons try to perform limb-sparing procedures whenever possible. When complete removal is not possible without affecting critical structures like nerves or organs, surgeons remove as much of the cancer as they safely can.

Radiation therapy uses powerful energy beams, such as X-rays or protons, to target cancer cells. This treatment may be given before, during or after surgery depending on the situation.

Chemotherapy uses strong medicines to destroy cancer cells. Some types of sarcoma respond better to chemotherapy than others. It may be used before surgery to shrink the tumor or after surgery to reduce the risk of recurrence. It is also used for larger sarcomas or those that have spread.

Targeted therapy is designed to attack specific chemicals within cancer cells. These treatments block signals that help cancer grow. Your sarcoma cells may be tested to determine whether targeted therapy is likely to be effective. This treatment may be used for certain sarcoma types, especially if the cancer returns or spreads.

Immunotherapy helps the immune system find and destroy cancer cells. Because cancer cells can hide from the immune system, immunotherapy helps uncover and target them. Tests can show whether a sarcoma is likely to respond to this treatment, particularly in cases of advanced disease.

Ablation therapy directly damages cancer cells using heat, cold or alcohol. Heat-based methods include radiofrequency ablation and microwave ablation, while cryoablation uses extreme cold. Ablation may be an option when surgery cannot be performed or when the cancer has spread to other parts of the body.