Education - Sarcoma


Sarcomas are rare cancers that develop from connective tissues (stroma) of the body such as fat, muscles, nerve tissue, fibrous tissues or blood vessels. There are many different types of sarcoma, based on the type of tissue in which they originate. Some sarcomas may even come from stem cells, or cells that have not formed into a specific type of tissue yet.

Unlike carcinomas that are very common and arise from epithelial cells (cells that make up tissue in organs such as the colon and lung), sarcomas account for just 1% of cancers in adults.

Some of the most common types of sarcoma and its tissue of origin include:

TYPE ORIGIN
Liposarcoma   Fat tissue
Leiomyosarcoma   Smooth muscle (causes contraction of intestines, blood vessels, etc.)
Angiosarcoma   Blood vessel
Fibrosarcoma   Fibrous tissue (tendons or ligaments)
Gastro-Intestinal Stromal Tumor(GIST)   Specialized neuro-muscular cells of the digestive tract
Myxofibrosarcoma   Connective tissue
Peripheral Nerve Sheath Tumors   Cells that wrap around nerve endings
Rhabdomyosarcoma   Skeletal muscle
Undifferentiated pleomorphic sarcoma   Unknown; May be tumor of stem cells
   

Risk Factors include:

The cause of sarcomas is unknown. You may have a higher risk for developing sarcoma, however, if you have

  • A certain genetic predisposition
  • Exposure to chemotherapy or radiation
  • A compromised immune system
  • Come in contact with chemical carcinogens
  • Chronic irritation

Grade/Staging

Sarcomas vary greatly in their aggressiveness, and their ability to spread or metastasize to other parts of the body. The best predictor of the behavior of a sarcoma is its “grade.” Low grade sarcomas are slow growing tumors, and generally tend to stay in the part of the body where they originated. High grade sarcomas are more aggressive, and are more likely to grow into surrounding structures; they can also metastasize, or spread, to other parts of the body. Intermediate grade sarcomas can be variable, but are less likely to metastasize than high grade sarcomas.

Staging for sarcoma can be complicated, and usually depends on the size and grade of the tumor, and whether or not it has spread to other parts of the body. Generally, high grade and larger tumors are staged higher than low grade, smaller tumors.

Symptoms and Tests

A soft tissue sarcoma usually produces no signs and symptoms in its early stages. Determining whether a mass or tumor is benign (non-cancerous) or malignant (a sarcoma) can be challenging, and often requires a biopsy for confirmation. The size and location of a soft tissue mass will help determine whether or not a biopsy is needed or not. Fortunately, soft tissue masses are usually benign.

We recommend evaluation for any lump that is:

  • Greater than 5 cm in diameter (the size of a golf ball)
  • Increasing in size
  • Causing pain or other sysmptoms
  • Growing in a scar where another tumor was removed or surgery performed
  • In a muscle or deeper (rather than just below the skin)
  • Has concerning appearance on an x-ray

The tests used for sarcoma vary greatly from case to case. Some may require a CT scan or MRI, while others may require a PET scan. These are used to determine the size and extent of the sarcoma, and to see if it has spread to other areas of the body. Your physician may also want to perform a biopsy, or examine a piece of the tumor under the microscope, prior to surgery. Biopsies are often used not only to obtain a diagnosis, but also for surgical planning and to determine whether radiation may be useful. In some cases, biopsy is not required prior to surgery. Biopsies may be performed in the office or by radiologists, depending on the circumstances.

Treatment


The treatment of a sarcoma depends on the type, the location, the size and the extent to which it involves adjacent or vital structures. Surgical resection, or complete removal of the sarcoma by a surgical oncologist, is an essential part of any curative treatment. Radiation may be used prior to surgery, particularly for larger sarcomas of the extremity, or following surgery. This is used to decrease the size of the tumor prior to operating, or to allow preservation of important structures near the tumor, such as bone or nerves. Chemotherapy is used less frequently in the treatment of sarcomas, and generally limited to treatment of sarcomas that have metastasized. It is also sometimes used in conjunction with radiation.

Individualized treatment for each patient is determined after discussion at our bi-weekly, multidisciplinary conference, and tailored by the team of specialists to maximize cure rates, and minimize permanent dysfunction. Because sarcomas are so rare, they are best treated by a multidisciplinary team comprised of surgical oncologists, medical oncologists and radiation oncologists who specialize in this type of cancer.

 

Resources

Education - Merkel Cell Carcinoma


Merkel cell carcinoma (MCC) is a cancer of the Merkel cells of the skin and, like melanoma, is considered a very aggressive skin cancer. MCC is rare, generally occurs in older adults, and can be associated with a fair complexion, history of sun exposure, and a compromised immune system. Whereas melanoma staging is largely based on tumor thickness and lymph node status, the staging of a MCC is based on tumor size and lymph node status.

Merkel cell carcinomas are treated very much like melanoma with a Wide Local Excision and Sentinel Lymph Node Biopsy (see “Melanoma Education”). Because Merkel cell carcinomas have a higher risk of recurring in their original location, radiation therapy is often used after surgery to the operated area. The management of MCC is part of the armamentarium of our surgical oncologists at Melanoma & Sarcoma Specialists of Georgia.

 

Resources





How to Make an Appointment


Please call Melanoma & Sarcoma Specialists of Georgia front office – (404) 851-6000.
This line provides a direct access to our office staff and our surgical oncologists, Dr. Lee and Dr. Davidson.

Please click on the link below, print out and complete the New Patient Medical Questionnaire; fax to our office prior to your first appointment. Providing our office with your completed questionnaire prior to your appointment will expedite your care.

Our fax number is (404) 252-2736
If you do not have access to fax or a scanner, please bring your completed forms to your appointment with you.

In addition to the New Patient Medical Questionnaire, please bring the following items to your first appointment:
  • Insurance card
  • Photo ID
  • Physician referral form (if applicable)
  • Any recent lab work results or tests
       (including any chest x-rays or EKG’s that have been performed in the last year)
  • Medication list, or actual medication bottles
  • Co-pay (if applicable)

Thank you for choosing Melanoma & Sarcoma Specialist of Georgia. We are committed to providing you with quality healthcare. If you have any questions, please contact our office at 404-851-6000. Our phones are answered Monday through Friday, 8 a.m. to 4:30pm.



Office Location

Melanoma & Sarcoma Specialists
of Georgia
980 Johnson Ferry Road, Suite 940
Atlanta, Georgia 30342
Phone: (404) 851-6000
Fax: (404) 252-2736

Office Location

Melanoma & Sarcoma Specialists
of Georgia
980 Johnson Ferry Road, Suite 940
Atlanta, Georgia 30342
Phone: (404) 851-6000
Fax: (404) 252-2736

Frequently Asked Questions

Please print out and complete the New Patient Medical Questionnaire by clicking on the link below. Please fax the completed copy to our office prior to your appointment and bring them with you to your first appointment. Having this form completed in advance will expedite your visit to our office.

Our fax number is (404) 252-2736.

In addition to the New Patient Medical Questionnaire, please bring the following items to your first appointment:

  • Insurance card
  • Photo ID
  • Physician referral form
  • Any recent lab work results or tests
       (including any chest x-rays or EKG’s that have been performed in the last year)
  • Medication list, or actual medication bottles
  • Co-pay (if applicable)
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