When we talk about cancer, breast, lung, and colon usually dominate the conversation. But lurking quietly in the background is a lesser-known, often overlooked type: sarcomas. These rare cancers, which take root in connective tissues, don’t always get the attention they deserve. Yet, they deserve it and how.Not Just One, But Many TypesSarcomas are a group of cancers which arise from body tissues. It can be from bone, fat, muscle, tendons, nerves, blood and lymph vessels are the predominant ones.Unlike most other cancers that generally strike older adults, sarcomas don’t discriminate by age. “These cancers can occur in relatively younger age groups,” Dr. Karthik K S, Consultant, Surgical Oncology at KMC Hospital, Mangalore, says. Sometimes, these are also triggered by certain genetic mutations, making them all the more complex.The Trouble with TumoursThese tumours can quietly grow in any part of the body, which means the symptoms are often subtle and deceptive. Dr. Karthik says, “Presentations may be much simpler than the consequences. Unplanned treatment may lead to rather grievous consequences.”Because of the wide-ranging locations where sarcomas can appear, they often call for specialists across disciplines. “The treatment of these types of cancers will need specialised doctors, often oncologist surgeons, medical and radiation oncologists,” he explains. In short, a generalist approach just won’t do.Diagnosis: More Than Just a ScanBefore treatment even begins, the real detective work starts. “The patient will need a full evaluation,” says Dr. Karthik. That begins with imaging, but even this depends on where the sarcoma has taken hold. Once imaging has painted a picture, a biopsy is essential. “These diseases need a biopsy to prove the diagnosis and often subclassify the disease based on IHC (immunohistochemistry),” he says.If there’s a suspicion of hereditary involvement, genetic studies may also be required. Only once everything is on the table—stage, type, and location—can doctors chalk out a treatment plan.Surgery Takes the LeadAccording to Dr. Karthik, “treatment includes surgery as a main modality of treatment.” But it’s rarely a one-man show. “Treatment may also include chemotherapy and radiotherapy,” he adds, making it a team effort from start to finish.Kids Are Not SparedDr. Sachin Sekhar Biswal, Medical Oncology Consultant at Manipal Hospital, Bhubaneshwar, draws attention to another critical aspect: age is no protection. “Connective tissue is an important constituent of the human body. The cancer that arises from the connective tissue mostly constitutes sarcoma. It can be seen in all age groups, starting from infancy to geriatric populations.”In fact, in children, sarcomas are surprisingly common. “Rhabdomyosarcoma is the most common type of cancer in the children,” Dr. Biswal states. “Apart from that, osteosarcoma and Ewing's sarcoma are also common types of sarcomas in children.”SymptomsSince sarcomas can develop anywhere in the body, the symptoms can be vague or misleading. Dr. Biswal points out, “It can present as a progressively increasing swelling or a lump, bone overgrowth with pain, swelling or limitation in the range of motion, or simply a vague lump based on its location.”Which is why early detection is tough and treatment becomes even more time-sensitive.Teamwork Makes the Treatment WorkDr. Biswal explains that sarcoma treatment is not a one-specialist show. “Sarcoma treatment is always a multimodality effort involving medical and surgical oncologists, orthopaedic oncologists, radiation oncologists, interventional radiologists, onco-pathologists and the rehabilitation team.”He shares that the most common treatment plan includes “surgical excision followed by radiation or chemotherapy”. When it comes to bone or limb sarcomas, gone are the days when amputation was the only solution. “Limb salvage therapy rather than amputation is the new way. It can be achieved by high-quality implants or autografts,” he adds.Speed Is EverythingTime really is of the essence. Dr. Biswal stresses, “Though rare, the tendency to metastasise is high, such that diseases like Ewing’s sarcoma are considered systemic from the very time of diagnosis.” In other words, even at diagnosis, it’s already a whole-body concern.But with timely diagnosis and swift treatment, outcomes can be significantly improved. “A timely diagnosis and a prompt treatment can save a life and avoid much morbidity,” Dr. Biswal reminds us.
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