World Sarcoma Awareness Month: Advocating for early detection and timely treatment

World Sarcoma Awareness Month is a global initiative aimed at raising awareness about sarcoma, a rare form of cancer that originates in the connective tissues of the body. Observed every July since 2008, this month-long global event commemorates sarcoma awareness.¹

Sarcomas can occur in any part of the body, including bones, muscles, tendons, and blood vessels. Recognizing the importance of early detection and timely treatment, World Sarcoma Awareness Month serves as a platform to educate the general public, healthcare professionals, and policymakers about the challenges associated with sarcoma and the potential strategies to overcome them.

Importance of World Sarcoma Awareness Month

According to the Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute, it is estimated that in 2023, there will be ~13,400 new cases of soft tissue sarcoma and approximately 3,970 new cases of bone and joint cancer in the United States alone. Additionally, the projected number of deaths for soft tissue and bone sarcomas is expected to be 5,140 and 2,140 individuals, respectively. The five-year survival rates for soft tissue sarcomas and bone and joint sarcomas are reported to be 65.8 percent and 68.9 percent, respectively.²

Raising awareness about this “unconventional cancer” is of utmost importance since it is less familiar compared to more well-known cancers like liver, breast, or lung.¹

Sarcomas are characterized by their complexity, making early detection and accurate diagnosis challenging.³ The significance of World Sarcoma Awareness Month lies in its ability to shed light on this often overlooked and misunderstood disease. Here are some reasons why World Sarcoma Awareness Month is important:

• Early Detection and Diagnosis: Sarcoma accounts for less than 1% of solid malignant cancers in adults.⁴ It can occur at any age, including in children and adolescents. However, it often presents with vague symptoms or is mistaken for other conditions. Due to its rarity, healthcare professionals and patients alike have limited knowledge about sarcoma. Lack of awareness about sarcoma can lead to delays in diagnosis, which can negatively impact treatment options and prognosis. World Sarcoma Awareness Month serves as a crucial reminder to acknowledge the significance of early detection, promptly identifying signs and symptoms, as well as advocating for precise and timely diagnosis.
• Support for Patients and Families: It provides a platform to acknowledge and support individuals and families affected by sarcoma. It serves as a reminder that they are not alone in their journey and that there is a community of patients, survivors, caregivers, and healthcare professionals who understand and are ready to provide assistance. The month also helps in connecting patients and families with support groups, educational resources, and research initiatives aimed at improving outcomes and quality of life.
• Advocacy and Research: World Sarcoma Awareness Month encourages advocacy efforts to increase funding and support for sarcoma research.⁵ Increased awareness and advocacy can drive more resources towards understanding the underlying causes, developing effective treatments, and improving overall care for sarcoma patients.

Unlike more common cancers, sarcomas encompass a wide range of subtypes, each with distinct biological behaviors and treatment approaches. Additionally, sarcomas often present with nonspecific symptoms, leading to delays in diagnosis. The rarity of the disease further complicates matters, as healthcare professionals may have limited experience in recognizing and managing sarcomas. Thus, promoting awareness and knowledge about sarcoma is crucial in enhancing early detection and reducing diagnostic delays.

The Significance of Early Detection in Improving Prognosis

Early detection of sarcoma plays a crucial role in improving the prognosis and treatment outcomes for ailing patients. Treatment is generally more effective if sarcoma is detected at an early stage, prior to metastasis. Surgical resection, the primary treatment for sarcoma, is more likely to be successful when the tumor is small and localized.⁶ Early detections may also allow for less aggressive treatment options, minimizing the need for surgery or radiation therapy. Therefore, raising awareness about the importance of early detection as well as its symptoms can lead to timely diagnosis and intervention, potentially resulting in better long-term survival rates.

Common Signs and Symptoms of Sarcoma

Sarcoma can manifest with a variety of signs and symptoms, although these can be nonspecific and easily mistaken for other conditions. Some common signs and symptoms of sarcoma include:

A palpable lump or mass: The most common symptom of sarcoma is the presence of a painless lump or swelling that gradually increases in size. The lump may be deep within the body, making it difficult to detect without medical examination.

Pain or discomfort: Sarcomas can cause pain in the affected area, especially when the tumor grows and compresses surrounding tissues or nerves.

Limited range of motion: Depending on the location of the sarcoma, it can restrict movement in joints or muscles, leading to difficulty in performing everyday activities.

Bone pain or fractures: In the case of bone sarcomas, localized pain in the affected bone or frequent fractures without significant trauma may occur.

Unexplained weight loss or fatigue: As with many types of cancer, sarcoma can cause unexplained weight loss, fatigue, and a general feeling of malaise.

Diagnostic Tests and Imaging Techniques for Early Detection

Early detection of sarcoma involves a combination of clinical examination, imaging tests, and biopsy. Diagnostic methods that are commonly used for detecting and evaluating sarcoma include:

• Imaging tests: X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans can help visualize the tumor and determine its location, size, and potential spread to nearby tissues or organs.
• Biopsy: A biopsy is the definitive diagnostic procedure for sarcoma. Different types of biopsies, such as needle biopsy or surgical biopsy, may be performed depending on the location and characteristics of the tumor.⁷
• Pathology and histology: Pathological examination of the biopsy sample can determine the type and grade of the sarcoma. This information is crucial for guiding treatment decisions.

These diagnostic tests and procedures are essential for accurate diagnosis, staging, and treatment planning. Early detection through these methods can lead to timely intervention and potentially improve the overall prognosis for individuals with sarcoma.

Challenges in Early Sarcoma Detection

Although their efficacy varies, diagnostic methods play a crucial role in the early detection of sarcoma. While imaging techniques like MRI and CT scans can provide useful information about the presence and location of tumors, they may not always detect lesions that are smaller or less obvious.

The potential heterogeneity of biopsied samples, which can result in false negatives, is one significant obstacle to sarcoma diagnosis.¹² The organization of sarcomas can contrast with various locales of the growth. It is possible to obtain a false negative result when a biopsy sample is taken from an area that does not accurately represent the entire tumor.

To address this test, doctors might perform extra demonstrative strategies, like recurrent biopsies, sub-atomic testing, or examining various examples from various areas of the growth. By gaining a comprehensive understanding of the characteristics and genetic profile of the tumor, these methods aim to improve diagnosis accuracy.

Proceeded with examination and headways in demonstrative techniques are fundamental for improving early discovery exactness and limiting the challenge of misleading negatives in sarcoma determination.

Timely Treatment of Sarcoma

Sarcoma treatment often involves a multidisciplinary approach, with a team of healthcare specialists, with diverse perspectives and knowledge, collaborating to develop an individualized treatment plan for each patient. This team may include surgical oncologists, radiation oncologists, medical oncologists, pathologists, radiologists, and other healthcare providers.

The multidisciplinary approach ensures that different aspects of sarcoma treatment, including surgery, radiation therapy, chemotherapy, and supportive care, are carefully coordinated and tailored to the specific characteristics of the cancer to optimize patient outcomes.⁸

The choice of treatment for sarcoma depends on various factors, including the type and stage of the sarcoma, its location, and the patient’s overall health. The main treatment modalities for sarcoma include:

Surgery: Surgical resection is the primary treatment for sarcoma whenever feasible. The goal is to remove the tumor along with a margin of healthy tissue to minimize the risk of recurrence. In some cases, limb-sparing surgeries may be performed to preserve function while effectively removing the tumor.

Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells or shrink tumors. It can be administered before surgery (neoadjuvant)⁸ to reduce tumor size or after surgery (adjuvant) to eliminate any remaining cancer cells. Radiation therapy may also be used as the primary treatment for inoperable tumors or to relieve symptoms in advanced cases.

Chemotherapy: Systemic chemotherapy involves the use of drugs that circulate throughout the body to kill cancer cells. It is often used in cases where there is a high risk of metastasis or when surgery or radiation therapy alone is insufficient. Similar to radiation therapy, chemotherapy can be given before or after surgery to shrink tumors or destroy any remaining cancer cells.⁹

Targeted therapies: Targeted therapies are medications that specifically target the underlying genetic or molecular abnormalities in cancer cells. They work by disrupting specific pathways or proteins involved in tumor growth and progression.¹⁰ Targeted therapies are increasingly being used in certain types of sarcoma, particularly those with specific genetic alterations.

Personalized medicine: In sarcoma, personalized medicine means tailoring treatment plans to each patient based on their specific characteristics, like the type of sarcoma they have, changes in their genes, and other relevant factors. Physicians are able to identify specific genetic mutations, chromosomal rearrangements, and biomarkers that are associated with particular subtypes of sarcoma through a variety of molecular tests, such as DNA sequencing and gene expression analysis. This data helps guide treatment choices, as it empowers clinicians to choose designated treatments that explicitly address the basic sub-atomic irregularities driving the cancer’s development.¹³

However, it’s important to note that personalized medicine in sarcoma is still evolving, and its widespread implementation faces certain challenges. Access to comprehensive molecular profiling and targeted therapies may not be universally available, and the interpretation of molecular test results can be complex.³ Additionally, the high cost of certain targeted therapies can pose barriers to their widespread use.

The choice and sequence of treatments depend on various factors and are determined by the healthcare team.

Importance of Personalized Treatment Plans and Collaboration Among Healthcare Professionals

Sarcoma is a complex disease with 70+ subtypes and variations.¹¹ Hence, it is important to have personalized treatment plans as per each patient’s diagnosis, tumor characteristics, overall health, and personal preferences.¹²

Collaborative decision-making among healthcare professionals, along with active involvement and communication with the patient, ensures that the treatment approach is tailored to meet the unique needs of each individual.

Regular interdisciplinary tumor boards or multidisciplinary meetings provide a platform for experts from different specialties to discuss complex cases, review diagnostic findings, and develop consensus on the most appropriate treatment strategy. This collaboration ensures comprehensive evaluation, optimal treatment planning, and continuous monitoring of patient progress.

Moreover, ongoing communication between the primary healthcare team and sarcoma specialists helps ensure seamless care transitions, facilitates access to supportive services, and addresses potential side effects or complications that may arise during treatment.

Final Thoughts

World Sarcoma Awareness Month serves as an opportunity to highlight the importance of research and collaboration in advancing the field of sarcoma. By fostering partnerships between clinicians, researchers, and patient advocacy groups, we can accelerate the development of novel therapies, refine diagnostic approaches, and improve the overall understanding of sarcoma biology. Furthermore, international collaboration allows for the sharing of best practices, clinical data, and treatment outcomes, leading to more standardized and evidence-based management strategies.

Similar to the Sarcoma Foundation of America, the Sarcoma Alliance, and numerous other organizations, we can make a significant impact in the fight against sarcoma and offer hope to patients and their loved ones.

References:

1. “Sarcoma Awareness Month, July 2023🎗️- Theme & Importance.” 2023. Www.pacehospital.com. June 26, 2023. https://www.pacehospital.com/sarcoma-awareness-month.
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8. ‌Bhardwaj, Prarthna V, Holly Mason, Seth A Kaufman, Paul Visintainer, and Grace Makari-Judson. 2023. “Outcomes of a Multidisciplinary Team in the Management of Patients with Early-Stage Breast Cancer Undergoing Neoadjuvant Chemotherapy at a Community Cancer Center.” 30 (5): 4861–70. https://doi.org/10.3390/curroncol30050366.
9. ‌“Goals of Chemotherapy | How Is Chemotherapy Given?” n.d. Www.cancer.org. https://www.cancer.org/cancer/managing-cancer/treatment-types/chemotherapy/how-is-chemotherapy-used-to-treat-cancer.html.
10. Tang, Fan, Yan Tie, Yu-Quan Wei, Chong-Qi Tu, and Xia-Wei Wei. 2021. “Targeted and Immuno-Based Therapies in Sarcoma: Mechanisms and Advances in Clinical Trials.” Biochimica et Biophysica Acta (BBA) – Reviews on Cancer 1876 (2): 188606. https://doi.org/10.1016/j.bbcan.2021.188606.
11. “Types of Soft Tissue Sarcoma | Memorial Sloan Kettering Cancer Center.” n.d. Www.mskcc.org. https://www.mskcc.org/cancer-care/types/soft-tissue-sarcoma/types.
12. ‌Nacev, Benjamin A., Francisco Sanchez-Vega, Shaleigh A. Smith, Cristina R. Antonescu, Evan Rosenbaum, Hongyu Shi, Cerise Tang, et al. 2022. “Clinical Sequencing of Soft Tissue and Bone Sarcomas Delineates Diverse Genomic Landscapes and Potential Therapeutic Targets.” Nature Communications13 (1): 3405. https://doi.org/10.1038/s41467-022-30453-x.
13. Colella, Gianluca, Flavio Fazioli, Michele Gallo, Annarosaria De Chiara, Gaetano Apice, Carlo Ruosi, Amelia Cimmino, and Filomena de Nigris. 2018. “Sarcoma Spheroids and Organoids—Promising Tools in the Era of Personalized Medicine.” International Journal of Molecular Sciences19 (2): 615. https://doi.org/10.3390/ijms19020615.

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Author:

Uttkarsha Bhosale
Editor, Enago Academy
Medical Writer, Enago Life Sciences
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