Sarcoma
REALITIES and OPTIONS
Coming to Terms with Sarcoma
Explanation of the Disease - the term "sarcoma" refers to a cancerous growth, which develops from normal cells of the body, known as "connective tissues," or resembles them (Demetri 2005). It derives its name from the normal connective tissue from which it develops. These connective tissues include fat, muscle, blood vessels, deep skin tissues, nerves, bones and cartilage. Sarcoma can either be benign or malignant (Demetri, Emory Winship Cancer Institute 2006).
Conventional treatment options for sarcoma are surgery, chemotherapy and radiation therapy. Often, chemotherapy and/or radiation therapy is used even after surgery. While the intention is to destroy cancerous growths and restore or prolong the life of the patient, these two treatment modes can even shorten that life. Chemotherapy interferes with cell division and reproduction and eventually kills normal cells. Radiation therapy's high-energy ionizing radiation may damage cancer cells but damages and destroys normal or health cells indirectly.
These treatment modes do not offer encouraging realistic chances of survival to patients.
Main Points
The two main types of sarcomas are bone and soft tissue sarcomas (Emory Winship Cancer Institute 2006). The types of bone sarcoma are osteosarcoma, Ewing's sarcoma and chondrosarcoma. Bone sarcomas are rare and develop most often in children and young adults, although these can occur at any age. Soft tissue sarcomas, on the other hand, develop from fat, muscle, nerves, blood vessels and deep skin tissues. These sarcomas most frequently occur in the arms or legs. Other areas where they occur are the abdomen and pelvis (Emory Winship Cancer Institute). The subtypes are liposarcoma, leiomyosarcoma, rhabdomyosarcoma, synovial sarcoma, angiosarcoma, fibrosarcoma, malignant peripheral nerve sheath tumor, desmoid tumor, and Ewing's sarcoma or peripheral neuroectodermal tumor (Demetri).
Body
Origin and Development
Sarcomas can develop in any part of the body, but most of them grow from bones or soft tissues (Emory 2006). If more than one family member has sarcoma, the rest of the members may have a predisposition to it, although this may be quite rare. The majority of sarcoma patients did not pass the increased risk on to their children. The rules on cancer detection still apply. One should see a physician when unusual lumps or growths are discovered. The symptoms of sarcoma do not appear until it reaches an advanced stage. These increase increasing abdominal pain, bloody stools or vomited matter (Emory).
Sarcomas of the extremities often first show up as a lump, which may not always be painful (Emory 2006). Some of them are not painful. They may begin from the abdomen where pain or problems with blocked intestines is experienced.
Examination
Sarcomas, especially soft tissue sarcomas, are diagnoses through one's medical history, physical examination or biopsy, ultrasound, a computer tomography or CT scan, and magnetic resonance imaging or MRI (Emory 2006). Biopsy removes some tissue from the tumor for examination and the only way to ascertain that it is sarcoma or not. It reveals the type and the grade of the disease, which, in turn, is the basis of the prognosis of the disease. The biopsy may use the fine-needle aspiration, a core needle or an excisional or an incisional technique (Demetri).
Staging and Levels of Metastasis
The tumor or sarcoma is in Stage 1A when it is low-grade, small, superficial, and has no sign of spread (American Cancer Society 2007). It is in Stage 1B when the tumor is low-grade, large, superficial, and has no sign of spread. Stage 2A is low-grade, large but deep. Stage 2B is high-grade, small, superficial, and deep. Stage 2C is high-grade, large and superficial. Stage 3 is high-grade, large and deep. Stage 4 means that the tumor has spread to the lymph nodes or to other organs. Sarcoma has recurred if it has come back from the time it was first treated (American Cancer Society).
The lower the grade and stage, the better the overall outcome is predicted (Emory 2006) and the shorter the duration of treatment. A lower-stage cancer is in an early stage and which has a lower chance of cancer spread or metastasis. A low-grade sarcoma is less likely to spread than a high-grade sarcoma (Emory).
Sarcoma Case
This presents 15 members of a family diagnosed with multiple tumors from the submucosa of the small intestines (Trent 2006). This suggests that this type of tumor runs in the family through a germ-line mutation, which affects all the body cells. The origin remained unknown. The chance of a child inheriting the mutant gene in the family was 50/50. Some may not currently have the tumor but each case in the multiple series of tumors is a separate and entire, primary tumor. Any of them can metastasize (Trent).
Treatments
Surgery removes all or part of the tumor (Emory 2006). If the tumor is small, it is removed with some normal tissue from the affected body part, such as an arm or leg. It is still used even when there is metastasis in order to bolster long-term survival, especially in the absence of an evidence of cancer. Chemotherapy is a medication intended to eliminate cancer cells or weaken them greatly or in support of other types of treatment. It is administered orally or intravenously over a prescribed period. Some are given daily while the others are given weekly. Chemotherapy infusions for sarcomas take a number of days. Chemotherapy is administered to before surgery to make the removal of the tumor easier or minimize the damage on normal tissues. It is also used if the likelihood of metastasis is high or if the surgery does not remove all of the cancer found. It can cause nausea or vomiting. Radiation therapy uses penetrating beams of high-energy waves to treat cancers. It destroys the ability of cancer cells to grow and divide. It is used as the main treatment for sarcoma, but often in combination with chemotherapy or surgery to help improve outcome. It can complement surgery for tumors, which have a high likelihood of recurrence. Radiation can help destroy remaining cancer cells (Emory).
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