Bone and Soft Tissue Cancer (including Sarcoma)

According to the American Cancer Society, bone cancer is a cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

Bone cancer is a malignant (cancerous) tumor of the bone that destroys normal bone tissue (1). Not all bone tumors are malignant. In fact, benign (noncancerous) bone tumors are more common than malignant ones. Both malignant and benign bone tumors may grow and compress healthy bone tissue, but benign tumors do not spread, do not destroy bone tissue, and are rarely a threat to life.

Malignant tumors that begin in bone tissue are called primary bone cancer. Cancer that metastasizes (spreads) to the bones from other parts of the body, such as the breast, lung, or prostate, is called metastatic cancer, and is named for the organ or tissue in which it began. Primary bone cancer is far less common than cancer that spreads to the bones


Staging of Bone Cancer:

The most common system used to stage cancer is the TNM system of the American Joint Committee on Cancer (AJCC):
T refers to the size of the Tumor;
N describes whether the cancer has spread to lymph Nodes. (Lymph nodes are bean-sized collections of immune system cells found throughout the body); and
M, for Metastasis, means that the cancer has spread to distant organs.

In some bone cancers, the letter G is used to describe another factor, called Grade. The grade is based on how the cancer cells look under the microscope. A high grade means the cancer is more likely to grow fast and spread.

All of this information is then combined to get the stage. The stage is given as a Roman numeral from I through IV (1-4). The smaller the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced disease. Most stages are also further sub-divided into A and B.

Even though the AJCC staging system is widely used for most cancers, bone cancer experts tend to simplify the stages into localized and metastatic. Localized includes stages I, II, and III, while metastatic is the same as stage IV.

Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you better understand your treatment choices.

Treatment of Bone Cancer:

Treatment options depend on the type, size, location, and stage of the cancer, as well as the person’s age and general health. Treatment options for bone cancer include surgery, chemotherapy, radiation therapy, and cryosurgery. Clinical trials, a research study of new treatment methods, are also an available treatment option.

Search for clinical trials in Georgia.

Reference on this section: American Cancer Society at: http://www.cancer.org/cancer/bonecancer/detailedguide/bone-cancer-what-is-bone-cancer  (Accessed June 2016)

Soft Tissue Sarcoma

Adult soft tissue sarcoma is a disease in which malignant (cancer) cells form in the soft tissues of the body. It is cancer that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body.

The soft tissues of the body include the muscles, tendons (bands of fiber that connect muscles to bones), fat, blood vessels, lymph vessels, nerves, and tissues around joints. Adult soft tissue sarcomas can form almost anywhere in the body, but are most common in the legs, abdomen, arms, and trunk. There are many types of soft tissue sarcoma. One type that forms in the wall of the stomach, intestines, or rectum is called a gastrointestinal stromal tumor (GIST). The cells of each type of sarcoma look different under a microscope, based on the type of soft tissue in which the cancer began.

Staging of Adult Soft Tissue Sarcoma:

Stage I: In stage I, the tumor is any size, low-grade (likely to grow and spread slowly), and may be either superficial (close to the skin's surface) or deep.

Stage II: In stage II, the tumor is high-grade (likely to grow and spread quickly) and either:

  • 5 centimeters or smaller and can be superficial (close to the skin's surface) or deep; or
  • larger than 5 centimeters and superficial.

Stage III: In stage III, the tumor is high-grade, larger than 5 centimeters, and deep.

Stage IV: In stage IV, the tumor is any size, any grade, and has spread to nearby lymph nodes or to other parts of the body.

Treatment of Adult Soft Tissue Sarcoma:

Three types of standard treatment are used:

  • Surgery
  • Radiation therapy
  • Chemotherapy

 

 

New types of treatment are being tested in clinical trials.

  • High-dose chemotherapy with stem cell transplant
  • Targeted therapy

 

Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. To search for clinical trials available in Georgia, please visit www.georgiacancerinfo.org/clinicaltrials.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/types/colorectal. (Accessed June 2016)