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Sarcomas are a special and relatively unknown category of cancers. Although rare, they are of great importance because they often occur in young people and can dramatically affect their quality of life. The aim of this article is to explain in a simple and understandable way what sarcomas are, how rare they are, how they are classified, what their prognosis is, and why their treatment should be carried out exclusively in specialized centers with the collaboration of many specialists.

What is sarcoma?

The word “sarcoma” comes from the ancient Greek word “σαρξ” and is used to describe malignant tumors that originate from the connective tissues of the body. These include bones, muscles, fat, tendons, blood vessels and connective tissues that hold organs together and give shape to our bodies.

Unlike other cancers that are much more common, such as breast, lung or colon, sarcomas fortunately occur in a relatively small number of patients, which makes them more difficult to diagnose and requires special experience to treat them.

How rare are they?

Sarcomas are fortunately extremely rare. It is estimated that they represent about 1% of all cancers in adults and about 15% of cancers in children and adolescents. This means that a general practitioner or even a non-specialized orthopaedic surgeon may see few or no cases of sarcoma in their entire career.

This rarity explains why patients with sarcoma should be referred to specialized centers: where there is a team with experience and knowledge in their diagnosis and treatment.

Sarcoma Categories: Bone and Soft Tissue

Sarcomas are divided into two main categories:

Bone sarcomas (bone tumors):

They arise from the bones and occur most often in children, adolescents, and young adults. The most common are osteosarcoma, Ewing sarcoma, and chondrosarcoma. They can occur in any bone, but are most commonly seen in long bones, such as the femur (thigh bone) or tibia.

Soft tissue sarcomas:

They occur in muscle, fat, nerves, blood vessels, or connective tissue. They can occur almost anywhere in the body: in the limbs, the trunk, and even in the abdomen or chest.

In total, over 70 different histological types of sarcomas have been described, each with its own behavior, biology, prognosis and therapeutic strategy.

What is the prognosis when treated correctly?

Despite their seriousness, sarcomas can be cured if diagnosed early and treated correctly.

In bone sarcomas, the survival of patients with osteosarcoma or Ewing sarcoma can exceed 60-70%, when there is proper combination treatment with surgery, chemotherapy and, if necessary, radiotherapy.

In soft tissue sarcomas, the prognosis depends on the size, location and type of tumor, but with appropriate surgical removal and often radiotherapy, the chances of long-term cure are also significant.

Importantly, in many cases we can now preserve the limb with specialized reconstruction techniques using oncological endoprostheses and complex vascular surgery and plastic surgeries, instead of amputation, which was previously considered inevitable.

What happens when they are not treated correctly?

If sarcomas are not diagnosed in time or are treated by a non-specialized doctor, the consequences can be very serious:

Local recurrence: If the tumor is not removed within healthy limits, there is a high risk of it reappearing in the same place.

Metastasis: Sarcomas tend to spread, most often to the lungs. If this happens, the prognosis becomes more unfavorable.

Unnecessary or incorrect operations: A surgical procedure without the application of correct oncological rules can make definitive treatment impossible or lead to amputation that could have been avoided.

For this reason, we often say that every step from the initial diagnosis with the biopsy to the end of the treatment and monitoring, must be done carefully and by applying strict rules. If everything is done correctly from the beginning, the chances of a definitive cure increase significantly.

Why is it important to treat them only in specialized centers?

The treatment of sarcomas requires:

specialized surgical experience,

access to advanced imaging tests,

pathologists who are well-versed in these rare forms of cancer,

possibility of combining with chemotherapy and radiotherapy.

All of this is available only in a few specialized centers. There the patient is not treated by a single doctor, but by a team of specialists.

The role of the Multidisciplinary Team (MDT)

The Multidisciplinary Team (MDT) is the “heart” of proper treatment. It includes:

• Orthopedic surgeons with expertise in sarcomas
• Pathologists-oncologists
• Radiation therapists
• Pathologists
• Radiologists
• Rehabilitation specialists
• Psychologists and nurses with experience in oncology

This team meets regularly, discusses each patient individually and decides on the best possible treatment strategy. This ensures that the patient will receive comprehensive, individualized and scientifically documented care.

Conclusion

Sarcomas are rare but very serious cancers of the bones and soft tissues. They represent a small minority of all cancers, but they require specialized knowledge to be diagnosed and treated correctly.

Early diagnosis, proper surgical removal and the collaboration of many specialists through an Interdisciplinary Team in specialized centers are the “keys” to their successful treatment.

The message to patients and their families is clear:

Do not ignore a suspicious lump or persistent pain. Seek immediate medical advice and ensure that the diagnosis and treatment are carried out by sarcoma specialists.

With proper care, the chances of recovery are high and the quality of life can remain excellent.