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Soft Tissue Sarcoma

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What is adult soft tissue sarcoma?

Adult soft tissue sarcoma is a disease in which cancer (malignant) cells are found in the soft tissue of part of the body. The soft tissues of the body include the muscles, connective tissues (tendons), vessels that carry blood or lymph, joints, and fat.

A lump or swelling in part of the body may appear if a person has a soft tissue sarcoma. The lump may not be painful. If there are symptoms, a doctor may cut out a piece of tissue from the swollen area. This is called a biopsy. The tissue will be looked at under a microscope to see if there are any cancer cells. A patient may need to go to the hospital for this test.

The chance of recovery (prognosis) and choice of treatment depend on the size and stage of the cancer (how far the cancer has spread), and the patientís age and general health.

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Stage Explanation

Stages of adult soft tissue sarcoma

Once adult soft tissue sarcoma is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This testing is called staging. A doctor needs to know the stage of the disease to plan treatment. Unlike most other cancers, the size of a soft tissue sarcoma is not as important as how the cancer cells look under a microscope. The more different the cancer cells look from normal cells, the higher the stage. The following stages are used for adult soft tissue sarcoma:

Stage I

The cancer cells look either very much like or somewhat different from normal cells (well-differentiated or moderately well-differentiated). The cancer is either near the surface or deep and may be any size. The cancer has not spread to lymph nodes or other parts of the body (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).

Stage II

The cancer cells look very different from normal cells (poorly differentiated or undifferentiated). The cancer is either near the surface or deep and may be any size, but it has not spread to lymph nodes or other parts of the body.

Stage III

The cancer cells look very different from normal cells (poorly differentiated or undifferentiated). The cancer is deep and is more than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.

Stage IV

The cancer may have spread to lymph nodes in the area or may have spread to other parts of the body, such as the lungs, head, or neck.

Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the tissues where it first started, or it may come back in another part of the body.

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Treatment Option Overview

How adult soft tissue sarcoma is treated

There are treatments for all patients with adult soft tissue sarcoma. Three kinds of treatment are used:

  • Surgery (taking out the cancer in an operation).
  • Radiation therapy (using high-dose x-rays to kill cancer cells).
  • Chemotherapy (using drugs to kill cancer cells).

Surgery is the most common treatment of adult soft tissue sarcoma. A doctor may remove the cancer and some of the healthy tissue around the cancer. Sometimes all or part of an arm or leg may have to be removed (amputated) to make sure that all of the cancer is taken out. If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection).

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the blood stream, travels through the body, and kills cancer cells throughout the body. Chemotherapy that is given after surgery when no cancer cells can be seen is called adjuvant chemotherapy. In soft tissue sarcoma, chemotherapy is sometimes injected directly into the blood vessels in the area where the cancer is found. This treatment is called regional chemotherapy.

Chemotherapy and/or radiation therapy may be used to shrink the cancer so it can be removed without taking off an entire arm or leg.

Treatment by stage

Treatments for adult soft tissue sarcoma depend on the stage of the disease, and the patientís age and general health.

Patients may consider standard therapy, because of its effectiveness in past studies, or participation in a clinical trial. Not all patients are cured with standard therapy, and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information.

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Stage I Adult Soft Tissue Sarcoma

Treatment may be one of the following:

  1. Surgery to remove the cancer.
  2. Surgery with radiation therapy, before or after the surgery.
  3. High-dose radiation therapy followed by surgery and radiation therapy.

If cancer is found in the head or neck or in the abdomen or chest, treatment may be one of the following:

  1. Surgery to remove the cancer possibly followed by radiation therapy.
  2. Radiation therapy followed by surgery.
  3. Radiation therapy.

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Stage II and III Adult Soft Tissue Sarcoma

Treatment may be one of the following:

  1. Surgery to remove the cancer.
  2. Surgery to remove the cancer followed by radiation therapy.
  3. Radiation therapy alone.
  4. Radiation therapy and/or chemotherapy before surgery, possibly followed by radiation therapy.

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Stage IV Adult Soft Tissue Sarcoma

If the cancer has spread to the lymph nodes, treatment may be one of the following:

  1. Surgery to remove the cancer and removal of the lymph nodes where the cancer has spread (lymph node dissection), possibly followed by radiation therapy.
  2. Radiation therapy before and after surgery to remove the cancer and lymph node dissection.
  3. A clinical trial of surgery and/or radiation therapy followed by chemotherapy.

If the cancer has spread to the lungs, treatment may be one of the following:

  1. Surgery to remove the primary cancer followed by radiation therapy followed by surgery to remove the cancer from the lungs.
  2. Surgery to remove the primary cancer.
  3. Surgery to remove the primary cancer followed by radiation therapy.
  4. Radiation therapy, possibly followed by chemotherapy.

If the cancer has spread to other parts of the body, treatment may be one of the following:

  1. Surgery to remove the cancer with radiation therapy before or after the surgery, possibly followed by chemotherapy.
  2. Chemotherapy to reduce the pain and discomfort caused by the cancer.

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Recurrent Adult Soft Tissue Sarcoma

Treatment depends on the kind of treatment the patient had before. Treatment may be one of the following:

  1. Surgery to remove the cancer.
  2. Surgery to remove the cancer followed by radiation therapy.
  3. Chemotherapy alone.

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Soft Tissue Sarcoma