Oncology is a real scourge of modern society. Every year it claims millions of lives, sparing neither children nor adults. Cancer is a huge variety of malignant diseases of various human organs and systems.
So, for example, there is such a dangerous disease as soft tissue sarcoma. Compared to other types of cancer, this disease is rare. The number of patients with it is no more than 1% of the total number of cancer patients.
Sarcoma is characterized by rapid progression, a high rate of spread of metastases and a poor prognosis in most cases. As with any other cancer, the earlier the tumor is diagnosed, the higher the survival rate. Therefore, everyone needs to know about sarcoma in order to be able to notice the signs of the disease in time and seek help.
Illness concept
So what is soft tissue sarcoma? This is an oncological disease in which the growth of malignant cells in different types of connective tissue is observed. At the same time, it is replaced by fibrous. The vast majority of patients are inaged 30 to 50 years. The disease affects men more often than women. However, in both, it proceeds with the same aggressiveness and equal severity of symptoms of soft tissue sarcoma. The survival rate for both sexes is the same.
Types of sarcomas
In fact, sarcoma is a common name for a number of cancers. They all differ from each other in the type of cells from which they originated.
Angiosarcoma. It develops from the cells of blood vessels of the circulatory and lymphatic systems. Extremely aggressive and rapidly metastasizing
Kaposi's sarcoma, named after the scientist who first described it, belongs to this species. It manifests itself in the form of multiple lesions of the skin or mucous membranes. The patient is covered with spots of red, brown or purple flowers. They have an uneven contour, may rise slightly above the surface of the skin, or may be flat.
- Another type of sarcoma is mesenchymoma. It is very rare, located deep in the muscles of the arms and legs.
- Fibrosarcoma. Originates from connective tissue cells and develops for a long time without causing any symptoms.
- Extraskeletal osteosarcoma. Arises from bone tissue, while quite aggressive.
- Rhabdomyosarcoma. Formed from striated muscles. Often affects young children. A photo of a symptom of soft tissue sarcoma of this type is presented below.
- Schwannoma (neurinoma). Arises from a particulartype of nerve sheath cells.
- Synovial sarcoma refers to a fairly rare type of sarcoma that arises from the synovial membrane of the joint. This disease is characterized by extremely rapid metastasis.
In addition, sarcomas can be divided according to their degree of malignancy.
- Low level. When studying the structure of the tumor, a small number of foci of necrosis are noted.
- Medium level. The primary neoplasm consists of about half of malignant cells.
- High level. The tumor is mainly represented by a large number of foci of necrosis.
Of course, the lower the grade, the better the prognosis.
There is a soft tissue sarcoma of the head and face, as well as the hand, trunk, and so on. Therefore, we can say that sarcoma can be divided into several types depending on the part of the human body where it was formed.
Separately, I would like to single out such a type of oncology as soft tissue sarcoma of the thigh (ICD-10 code - C49).
The fact is that the lower extremities are most often affected. Approximately 50-60% of patients with sarcoma are affected precisely on the legs and mainly on the thigh area.
First of all, with this pathology, a glandular formation appears, which can grow rapidly. In addition, the affected limb becomes pale and cold to the touch. A patient with soft tissue sarcoma of the thigh may complain of general weakness, a constant increase in body temperature to subfebrile values. resultslaboratory blood tests may indicate a significant increase in ESR, platelet levels and a decrease in hemoglobin. Diagnosis and treatment are no different from sarcomas in the rest of the body.
Causes of sarcoma
There are several factors that trigger the development of sarcoma. For example:
- Any damage to the integrity of the skin and soft tissues - burns, scars, scars, fractures, and so on. Most often, the tumor occurs within the first three years after injury.
- Exposure to the body of a number of chemicals that have a carcinogenic effect. For example, toluene, benzene, arsenic, lead and others. These substances can cause DNA mutation in he althy cells and start a malignant process.
- Exposure to radiation. Exposure to gamma rays causes the DNA of he althy cells to mutate and grow. In oncological practice, there are cases when a patient was irradiated to destroy one tumor, and after that he was diagnosed with the occurrence of soft tissue sarcoma. Also at risk are people who work with X-ray machines or eliminate accidents in radiation zones.
- Among other things, some viruses also have mutagenic properties. For example, human immunodeficiency virus (HIV) and herpes type 8 tend to cause Kaposi's sarcoma.
- One of the leading factors is hereditary predisposition. The fact is that in cancer patients, the gene responsible for the prevention of malignant processes is damaged. And thisinherited.
- Among patients with some types of sarcoma, you can meet teenagers, and more often males. The fact is that the rapid hormonal growth that occurs during puberty can serve as an impetus for the development of oncology. Due to the rapid development of the body, immature cells may appear. This is especially true for hip sarcoma in adolescent boys.
Metastasis of sarcoma
Everyone knows that any malignant tumor tends to spread its cells in the patient's body.
So, most sarcomas are prone to a rapid process of metastasis. Metastases are secondary malignant foci formed from the cells of the main tumor and spread throughout the body. There are two ways to move them - through the blood and through the lymphatic vessels. This disease is characterized by spread through the bloodstream.
In fact, the tumor spreads its malignant cells from the very beginning. However, as long as the body's immune system is strong, it is able to prevent the spread of cancer. But, as you know, cancer also affects the immune system, so it gradually fades away and can no longer be able to resist the tumor. And then the green light turns on for metastases, they are carried with the bloodstream to all organs and systems.
Thus, metastases of hip soft tissue sarcoma mainly affect the nearest bone tissue. In addition, the lungs, liver, and bones are most commonly affected by sarcoma.
Soft tissue sarcoma. Symptoms
Survival rate for sarcoma is low. For a long time, a person looks and feels absolutely he althy. The fact is that at first soft tissue sarcoma proceeds without any symptoms. A person does not even suspect that a malignant process is taking place inside his body.
In the initial stages of soft tissue sarcoma development, as with any other type of cancer, there are no specific symptoms, but some manifestations of general malaise are possible:
- lack of appetite;
- weight loss;
- feeling constantly weak and tired;
- fever without any signs of a cold;
- decreased immunity, which is expressed in the too frequent occurrence of various viral and bacterial infections.
However, in practice, there are patients who felt good, had an appetite and good blood test results, and so on.
Often the first and main sign is the appearance of a thickening or swelling under the skin in any part of the body. The formation can occur in any limb or on any part of the body where there is soft tissue (muscles, tendons, synovial tissue). The "favorite" place of sarcoma is the hips. However, there are cases of damage to the head and neck.
Below is a photo of what soft tissue sarcoma looks like at an early stage.
The size of education can be very different - from 2 to 30 centimeters. However, this symptomdepends on the location of the tumor. If it is deep in the body, then it may not be visible. This is the insidiousness of the disease - it does not make itself felt for a long time.
Specific symptoms depend on the location of the lesion. For example, if the joints are affected, it will be very noticeable for the patient. He will not be able to move quietly, as he will feel pain when moving. Also, due to this location of the tumor, a person may lose the ability to freely move an arm or leg.
Signs of the disease in the last stages
As the tumor grows, the symptoms become more pronounced. In the last stages, a dark reddish color appears on the skin in the place where there is a neoplasm. A bleeding wound occurs, which is prone to frequent infection.
It should be noted that the symptoms can be caused not only by the primary tumor, but also by secondary malignant foci. At the same time, as the secondary foci grow, pain sensations arise, which gradually increase. Pain can be so intense that specialists are forced to resort to narcotic drugs to stop them.
If the lungs are affected, the patient may experience shortness of breath, a persistent cough, a feeling of pressure in the chest.
If the liver is affected, there may be pressure in the right hypochondrium, pain. Lab results will indicate elevated levels of liver enzymes (such as ALT, AST).
If symptoms were detected early onsoft tissue sarcomas, the survival rate in this case is maximum.
Medical diagnostics
The diagnosis of sarcoma is represented by a range of medical examinations and is no different from the diagnosis of other cancers.
- X-ray. The image can detect the shadow of the tumor, as well as possible deformation in the bone structures.
- Ultrasound examination in the area of the tumor. With the help of ultrasound, you can determine the exact size of the neoplasm, its boundaries, as well as the degree of damage to nearby tissues.
- CT (computed tomography) of the primary tumor. Gives a clearer idea of the structure of education, the degree of its malignancy.
- MRI (magnetic resonance imaging). Gives the most complete answer to all questions about the primary tumor.
- Puncture biopsy. It is the most important diagnostic method, without which it is impossible to make a final diagnosis. Only a biopsy can determine the nature of the cells, their malignancy.
Forecast
As mentioned above, doctors often give patients with sarcoma a disappointing prognosis. The main factor determining survival in soft tissue sarcoma is the stage at which the cancer was detected. When a tumor is detected at stage 1-2, the prognosis is quite positive - about 80% of patients survive and live for the next five years. At the 3-4th stage, mortality is much higher. About 90% of patients die within five years. There is also a sarcoma, which is characterized by a very aggressive course. Almost all patients with this type of diseasedie in the next two or three years.
Thus, almost zero survival in inoperable people. Symptoms of soft tissue sarcoma in such patients most likely appeared only at the height of the disease, and they sought medical help too late. After all, the main tumor remains in the body, and it will continue to spread metastases with the bloodstream.
Treatment
Treatment of a patient suffering from sarcoma should include several methods. Only in this way will the patient have a chance of success. The main treatment for soft tissue sarcoma is surgery to remove the tumor. However, sarcoma is characterized by the rapid occurrence of relapses. Most of the operated people showed a re-growth of the tumor after a few months. In addition, it is preferable to carry out irradiation before the operation. This increases the chances of success.
Chemotherapy for sarcoma is used only as an adjuvant therapy and most often in the last stages of cancer, when the tumor is inoperable. The most commonly used drugs are Decarbazine, Doxorubicin, Epirubicin. The dosage regimen, frequency of administration, duration of the course and their number are determined by the attending oncologist and are set individually for each patient.
Typically, doctors give radiation therapy for five weeks first. At the decision of the oncologist, therapy with chemical drugs that haveanticancer activity. Then the tumor is resected. This is the standard treatment regimen for soft tissue sarcoma. Reviews of doctors say that this combination of methods is the most effective and gives the greatest possible favorable outcome.
Before the operation, the size of the tumor is necessarily studied and a biopsy is performed to assess the malignancy. In the case of a small tumor (up to 5 cm), there is no need for radiation. If the tumor is more than 5 cm, then it should be exposed to gamma rays in order to reduce and prevent further growth.
Conclusion
A person may have no symptoms of soft tissue sarcoma for a long time. Survival is low and is associated with a person's late appeal for help. In addition, this disease is quite aggressive, prone to frequent relapses and rapid metastasis. Therefore, everyone should know what soft tissue sarcoma is, be able to notice alarming symptoms in themselves or loved ones in time. All this will help in case of suspected cancer, immediately seek help from a doctor. It can literally save a life.
