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Sarcoma / Melanoma

What Is Sarcoma?

Sarcoma is the name given to a variety of cancers that arise from the bones and soft tissues (including fat, muscle, blood vessel, nerve, etc). Bone sarcomas typically occur in children and adolescents, whereas soft tissue sarcomas are more common in adults. Sarcomas are very rare in comparison to carcinomas, which develop in the glands and organs of the body such as lung, breast, and prostate. It is estimated that 10,000 new sarcomas occur annually in the U.S. out of a total of over 1 million new cancer cases per year.

There are over 50-70 types of soft tissue sarcoma. Some of the more common types are:

  • Liposarcoma - which arises from fat
  • Leiomyosarcoma – smooth muscle
  • Rhabdomyosarcoma – skeletal muscle
  • Angiosarcoma – blood vessel
  • Malignant peripheral nerve sheath tumor – covering around nerves
  • Synovial sarcoma – unknown tissue of origin
  • Undifferentiated pleomorphic sarcoma – unknown tissue origin
  • Desmoid tumor – unknown tissue origin
  • Dermatofibrosarcoma protuberans – unknown tissue origin

All of the different types of sarcoma are considered cancer. However, some types of sarcoma are very slow growing and are almost benign; whereas other types of sarcoma grow rapidly and are very aggressive.

Sarcoma x-ray - diagnosis and treatment, Los Angeles, CaliforniaHow and where does sarcoma appear?

Symptoms of sarcoma can be, but are not limited to, a new lump and pain. Sometimes sarcomas do not cause any symptoms are detected incidentally for other unrelated reasons.

Sarcoma can arise from anywhere in the body. The most common location is in the limbs (legs, arms = extremity). About 20% of sarcomas appear in the back of the abdomen, which is also known as the retroperitoneum. Sarcomas in this location can frequently grow to very large size before detection.

How can I diagnose if I have sarcoma?

If a soft tissue sarcoma is suspected, x-rays such as CT or MRI are usually done, followed by a biopsy. The type of biopsy that is done will be based on the size and location of the tumor. There are two types of biopsy that may be used:

  • Core biopsy: The removal of tissue using a wide needle. This can be done as a minor procedure in the clinic or by a radiologist (sometimes guided by ultrasound or CT/MRI).
  • Incisional biopsy: The removal of part of a lump or a sample of tissue through a minor surgery.

A pathologist views the biopsy tissue under a microscope to look for cancer cells to make the diagnosis (including the specific type of sarcoma) and determine the grade of the tumor. The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the cells are dividing. High-grade tumors usually grow and spread more quickly than low-grade tumors. Because sarcoma can be hard to diagnose, patients should ask to have their biopsy reviewed by a trained sarcoma pathologist. The correct diagnosis is critical to determine the appropriate treatment.

How do I treat sarcoma?

For sarcomas that have not spread, surgery is the main treatment.  Surgery may be challenging and in some cases, chemotherapy and/or radiation therapy may be given either before or after the operation. For patients with sarcomas that have already spread or that cannot be removed by surgery, chemotherapy is given. In the last few years there are newer drugs available for sarcoma including better “targeted” therapies.

Because it is so rare, the treatment of sarcoma should be done at a specialized center with physicians that have experience and expertise in this specific disease. The treatment plan can be complicated and the best approach is through a multidisciplinary team discussion that involves sarcoma experts from surgery, medical oncology and radiation oncology. Surgery for sarcoma is also best performed by a surgical oncologist (cancer surgeon) trained to manage this frequently challenging disease. This avoids inappropriate treatment such as incomplete or overly-aggressive surgery.

What Is Melanoma?

Melanoma is the most serious type of skin cancer.

Melanoma begins in skin cells called melanocytes. Though melanoma is predominantly found on the skin, it can occur in other parts of the body such as the sole of the foot, palm of the hand, anus/rectum and eye (uvea).

Melanocytes are the cells that make melanin, which gives skin its color. Melanin also protects the deeper layers of the skin from the sun's harmful ultraviolet (UV) rays. When people spend time in the sunlight, the melanocytes make more melanin and cause the skin to tan. This also happens when skin is exposed to other forms of ultraviolet light (such as in a tanning booth). If the skin receives too much ultraviolet light, the melanocytes may begin to grow abnormally and become cancerous. This condition is called melanoma.

How and where does melanoma appear?

The first sign of melanoma is often a change in the size, shape, or color of a mole. But melanoma can also appear on the body as a new mole. In men, melanoma most often shows up on the upper body, between the shoulders and hips and on the head and neck. In women, melanoma often develops on the lower legs. In dark-skinned people, melanoma often appears: under the fingernails or toenails or on the feet and hands. Although these are the most common places on the body for melanomas to appear, they can appear anywhere on the skin. It is important to always examine your skin to check for new moles or changes in moles and to see a dermatologist regularly especially if you have a lot of moles.

Detecting the ABCDEs of Melanoma

With early diagnosis and treatment, the chances of recovery are very good.

The chance of getting melanoma increases as you get older, but people of any age can get melanoma. In fact, melanoma is one of the most common cancers in young adults (ages 25 to 29). Each year, more than 50,000 people in the U.S. are diagnosed with melanoma.

Melanoma is a serious and sometimes life-threatening cancer. If melanoma is found and treated in its early stages, the chances of recovery are very good. If it is not found early, melanoma can grow deeper into the skin and spread to other parts of the body. Melanoma typically first spreads to the nearby lymph nodes. With more advanced disease, melanoma can also spread to organs such as the lungs, liver, and brain. This spread is called metastasis. Once melanoma has spread to organs, it is more difficult to treat.

Sarcoma / Melanoma Surgeons at USC

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