Strong Bones, Stronger Together: Bone Cancer Awareness

Among other celebrations, July is also recognized as Sarcoma Awareness Month. It is dedicated especially to raise awareness about sarcoma that’s relatively rare, supporting affected patients and their families and at the same time promoting research efforts in treating this disease. 

Did you know? The human body consists of 206 bones. Providing shape and support to our body, responsible for facilitating movement as well as function as the protective shields for our vital organs; our bones most certainly deserve an honorary month to celebrate and acknowledge all its glory and for being a fantastic component of us. 

What is Sarcoma?

Primary bone cancer, also known as sarcoma, is essentially a type of cancer that originates in the body’s connective tissues, including bones, muscles and other soft tissues that occur in various locations of your body. It can affect people of all ages, accounting for about 1% of all adult cancers and 15% of pediatric cancers. 

There are 2 main types of sarcoma:

(i) Soft tissue sarcoma

Soft tissue sarcomas typically originate in the soft tissues of the body (ie: the muscle, fat, nerves and tendons). They encompass specific subtypes like rhabdomyosarcoma, vascular tumors and Kaposi sarcoma. 

(ii) Bone sarcoma (osteosarcoma)

The most prevalent type of bone cancer is osteosarcoma, which can be commonly seen affecting the larger bones of the arms or legs. Since osteosarcoma typically tends to occur during periods of rapid bone growth, it is more prevalent among children and young adults, although it may happen to people of all ages. 

How is Sarcoma identified?

Symptoms of sarcoma may not always appear in the early stages of cancer. Some common signs of soft tissue sarcoma can present include: a lump or swelling, often appearing under the skin of the arms or legs. As the sarcoma grows bigger, it may begin to exert pressure on neighboring organs, nerves, or muscles that may lead to pain or difficulty breathing.

Pain is also noted as the primary symptom experienced in bone cancer, although not all bone cancers necessarily cause pain. Other symptoms may also include a lump that may feel soft and warm, limited range of motion in a joint, an unexplained fever or a bone fracture occurring without apparent cause.

How is sarcoma diagnosed?

If your doctor suspects you have sarcoma, a physical examination or imaging tests such as X-ray, ultrasound, CT or PET scan will be ordered and performed on you. They may also choose to run a biopsy and/or blood tests to confirm the diagnosis and assess the severity of the disease.

What causes sarcoma?

The exact cause of sarcoma still remains unclear but there are a few risk factors that would increase the likelihood of one getting sarcoma: 

(i) History of radiation therapy. Patients who had undergone radiation therapy for previous cancers are said to possess a higher risk of developing secondary cancers like sarcoma. It is thus important for individuals who have undergone radiation to go for their routine follow-up screenings and remain vigilant for any signs or symptoms of sarcoma and other potential complications that may come with it.

(ii) Genetic disorders. Patients with a family history of inherited disorders such as Von Recklinghausen’s disease (aka neurofibromatosis), Werner syndrome, Gardner syndrome, tuberous sclerosis, Li-Fraumeni syndrome are all thought to have a higher risk of developing sarcoma. These genetic conditions are associated with specific gene mutations that can disrupt normal cell growth and increase the likelihood of sarcoma development.

(iii) Chemical exposure. Long term exposure to vinyl chloride monomer (substance used to make plastics), dioxin or arsenic have been reported to increase the risk of sarcoma. However, most sarcomas are not directly linked with specific environmental hazards. 

(iv) Long term swelling. Besides, having lymphedema, or swelling in the arms or legs due to factors such as surgery, radiation therapy, infection or underlying conditions that impair the lymphatic system for an extended period of time could also increase the risk of developing sarcoma. 

While these are some of the common risk factors of sarcoma, it is important to note that in many instances, sarcomas usually occur without a clear or identifiable cause.

What treatment options are available for Sarcoma and how effective are they?

The treatment options for sarcoma depend on several factors such as the type, stage, location, and extent of the cancer as well as the individual’s overall health condition. A multidisciplinary/multimodal approach involving a team of medical professionals is often employed to curate a personalized treatment plan, especially for those that are high-grade and larger than 5cm. Radiation and chemotherapy may be used before surgery to shrink the tumor and ease removal. 

The best treatment for sarcoma is still surgery if it is in the early stages or if it is of low grade (unlikely to spread to other parts of the body). To date, there are patients with soft tissue sarcoma that have been successfully treated by surgery alone.

All in All

Sarcomas are relatively rare in contrast to the other types of cancer, and their diagnosis and treatment can be challenging. Depending on the specific subtype, location, and stage of the sarcoma, treatment may involve a combination of surgery, radiation therapy, chemotherapy, targeted therapy or even immunotherapy. Early Detection and timely treatment are essential to optimize treatment outcomes. If you or someone you know is concerned about sarcoma or experiencing related symptoms, they should consult a healthcare professional for a proper diagnosis and appropriate treatment options. 

This article is written by Janelle Leong, Bpharm(Hons) (DOC2US),
reviewed by Dr. Muhamad Syaqir bin Shukri, MBBS (DOC2US). 

References 

1. https://www.icrfonline.org/news/july-is-sarcoma-and-bone-cancer-awareness-month-2/#:~:text=Sarcomas%20are%20a%20rare%20group,soft%20tissues%20of%20the%20body.
2. https://provisionhealthcare.com/2020/07/09/sarcoma-awareness-month-shining-light-on-the-forgotten-cancer/ 
3. https://www.columbiaasia.com/malaysia/health-articles/what-is-sarcoma 
4. https://www.hopkinsmedicine.org/health/conditions-and-diseases/sarcoma#:~:text=Sarcoma%20Symptoms&text=Their%20growth%20may%20cause%20pain,of%20motion%20in%20a%20join 
5. https://my.clevelandclinic.org/health/diseases/17934-sarcoma

Written by

Janelle Leong, Bpharm(Hons) DOC2US