There are two main types of sarcoma:
- Soft tissue sarcomas
- Bone cancer
About sarcoma
Sarcoma develops after a change in the DNA of the cells of soft tissue or bone (DNA is the genetic material that tells cells what to do.) As these faulty cells divide and multiply, they eventually cause a cancer.
Primary bone cancer is cancer that starts in the bone. It is rare – only about 550 people a year develop it in the UK. It is different from cancer that starts in another part of the body and spreads to the bone (secondary bone cancer).
Different types of bone cancer start in different types of cells in the bone. The main types are:
Examples include:
- Osteosarcoma – the most common type, which mostly affects children and young adults under 20
- Ewing sarcoma – which most commonly affects people aged between 10 and 20
- Chondrosarcoma – which tends to affect adults aged over 40
Usually it is not known what caused someone’s bone cancer. You might be more at risk if:
- You have had radiotherapy in the past
- You have certain other conditions:
- other bone conditions such as Paget's disease of the bone – most people with this condition do not develop bone cancer
- rare genetic conditions, such as Li-Fraumeni syndrome
- You have a history of certain other conditions including retinoblastoma
Young people can develop bone cancer if tumours form during rapid growth spurts.
Soft tissue sarcomas are rare cancers affecting the tissues that connect, support and surround other body structures and organs.
Soft tissue sarcomas can affect body tissues including fat, muscle, blood vessels, deep skin tissues, tendons and ligaments.
They can develop in almost any part of the body, including the legs, arms and tummy (abdomen).
There are different types of soft tissue sarcoma – named after the part of the body where they start:
They include:
- Leiomyosarcoma – develops in muscle tissue
- Liposarcoma – develops in fat tissue
- Angiosarcoma – develops in the cells of the blood or lymph glands
- Gastrointestinal stromal tumours (GISTs) – develop in the connective tissues that support the organs of the digestive system
There are also many other types of soft tissue sarcoma in addition to the examples above.
Usually it is not known what caused someone’s soft tissue sarcoma. Some factors might mean you are more at risk:
- Age – they can happen at any age but in most cases your risk increases as you get older. Some sarcomas occur more frequently in children, teenagers and young adults
- Radiotherapy treatment in the past for another cancer
- Certain genetic conditions, such as neurofibromatosis type 1 and retinoblastoma
- Exposure to certain chemicals, including vinyl chloride, dioxins and phenoxyacetic herbicides
- Kaposi's sarcoma is a very rare sarcoma caused by a virus that can infect people with weakened immune systems (such as people with HIV or following organ transplant)
Symptoms
Symptoms of sarcoma vary depending on which part of the body is affected.
Soft tissue sarcomas often have no obvious symptoms until they get bigger or spread. Symptoms depend on where the cancer develops. They can include:
- A lump, which may be painless, that cannot easily be moved around and gets bigger over time – caused by swelling under the skin
- Tummy (abdominal) pain, feeling full all or most of the time and constipation – caused by swelling in the tummy
- A cough or breathlessness – caused by swelling near the lungs
You should see a GP if you have a lump – particularly one that's getting bigger over time. If a lump is the size of a golf ball you should see your GP. Most lumps are not cancer but it is best to get it checked.
Bone cancer is more common in long bones such as the arms or legs but can affect any bone.
Symptoms can include:
- Persistent bone pain that gets worse over time and continues into the night
- Swelling and redness (inflammation) over a bone – it might make movement difficult if it is near a joint
- A noticeable lump over a bone
- A weak bone that breaks (fractures) more easily than normal
- Problems moving around such as walking with a limp
If you or your child have bone pain that is persistent, severe or getting worse, visit your GP – it might be nothing but it is best to check.
Treatment at The Clatterbridge Cancer Centre
Treatment depends on a range of factors including the size, stage and location of your tumour, as well as the specific type of sarcoma. It may also depend on your age, general health and genetic factors (linked to the DNA changes in your cells) that tell us how your cancer developed.
Treatment options can include one or more of the following:
- Surgery – this may be before, during or after other treatments
- Drug therapies such as chemotherapy and other biological therapies. The general term for these is systemic anti-cancer therapies (SACT)
- Radiotherapy
When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider the best treatment options for you. Your doctor will discuss this with you so you can decide what is right for you.
Genomics is the study of a person’s genes (or ‘genome’) – the material in DNA that makes each person unique. Cancer is caused by changes in the DNA of a cell and tell it to multiply out of control.
Understanding where this change has occurred – for example, which gene is faulty – can help us know which treatment will give you the best chance of killing the cancer cells and stopping new ones from growing.
Your clinical team will explain this to you in more detail at your appointment.
The Clatterbridge Cancer Centre provides non-surgical treatment (such as chemotherapy, immunotherapy and radiotherapy) for sarcoma.
We work closely with surgical teams in other hospitals to plan and manage your care so you get the very best treatment.
Systemic anti-cancer therapy (SACT)
SACT is a term used to describe the different drug therapies for cancer. These include:
- Chemotherapy – which aims to kill cancer cells
- Biological and targeted therapies – which aim to target the DNA and cell changes that cause cancer
Find out more about chemotherapy and SACT at The Clatterbridge Cancer Centre.
Radiotherapy
We use different types of radiotherapy, depending on the size, location and stage of the cancer. Sometimes people have radiotherapy instead of surgery. Sometimes they have it after surgery or to help ease symptoms.
The radiotherapy treatments we offer for sarcoma include:
- Traditional external beam radiotherapy – where radiation is delivered from outside the body
- Stereotactic ablative radiotherapy (SABR) – a way of very precisely targeting radiotherapy to certain cancers
- Brachytherapy – also known as ‘contact radiotherapy’ because the radiation is placed inside the body in close contact with the tumour. This is rarely used in sarcomas in certain locations within the body.
- In some situations with certain sarcomas Proton Beam Therapy (a specialised form of intensive radiotherapy) is used in partnership with one of the UK proton beam centres
Find out more about radiotherapy at The Clatterbridge Cancer Centre.
Sometimes SACT and radiotherapy are used together. Your clinical team will discuss the most appropriate treatments with you.
Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.
You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have.
We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes.
We provide systemic anti-cancer therapies (e.g. chemotherapy and biological therapy) for sarcoma at the following sites:
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Wirral
- Outreach services to the Isle of Man
We provide radiotherapy for sarcoma in our three specialist sites:
- Clatterbridge Cancer Centre – Liverpool
- Clatterbridge Cancer Centre – Aintree
- Clatterbridge Cancer Centre – Wirral
Clinical trials for sarcoma are delivered at Clatterbridge Cancer Centre – Liverpool.
Our team
The team consists of clinical oncologists, medical oncologists, a consultant radiographer, clinical nurse specialists, radiographers, pharmacy, research practitioners, administrative support and a cancer support worker. Dietitians and speech and language therapists are also an important part of the team.
Our operational management team makes sure the service runs smoothly.
Clinical Nurse Specialists
Laura Ryder
Lucy Taylor
Clinical Support Worker
Samantha Griffiths
Research Practitioner
Pembe Yesildag
Further information
Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.
There are also local Macmillan services in other hospitals across our region.
External sites that offer extra support and information about sarcoma include:
Maggie’s Wirral (local cancer support)