July is Sarcoma Awareness Month

Due to their rarity, not a lot is known about sarcoma cancers. As these cancers are not as regularly discussed as others, there is unfortunately a lot of scope for clinical negligence surrounding their diagnosis and treatment, which could have a potentially devastating effect on patients and their families.

What are sarcoma cancers?

Sarcomas can occur in various locations in your body, usually developing in your bones or soft connective tissue. There are up to 100 types of sarcoma but the three main categories are:

• Bone sarcoma, which start in the bones – not to be confused with bone cancer.
• Soft tissue sarcoma – these can affect any part of the body. They develop in supporting or connective tissue such as the muscle, nerves, fatty tissue and blood vessels.
• Sarcomas can also develop in the stomach, intestines and behind the abdomen (retroperitoneal sarcomas), female reproductive system (gynaecological sarcomas) and gastrointestinal (GI) tract. This sarcoma is known as GIST and is the most common type.

It is not clear what causes soft tissue sarcoma. In general, cancer occurs when cells develop mutations in their DNA, which make the cells grow and divide out of control. The accumulating abnormal cells from a tumour can grow to invade nearby structures and the abnormal cells can then spread to other parts of the body.

The type of cell that develops the genetic mutation determines which type of soft tissue sarcoma you have. For example, angiosarcoma begins in the lining of blood vessels while liposarcoma arises from fat cells.

What are the risk factors of sarcoma?

• Inherited syndromes

A risk of soft tissue sarcoma can be inherited from your parents. Genetic syndromes that increase your risk include hereditary retinoblastoma, Li-Fraumeni syndrome, familial adenomatous polyposis, neurofibromatosis, tuberous sclerosis and Werner syndrome.

• Chemical exposure

Being exposed to certain chemicals, such as herbicides, arsenic and dioxin, may increase the risk of soft sarcomas.

• Radiation exposure

Previous radiation treatment for other cancers can increase the risk of soft tissue sarcomas.

• Chronic swelling

Such as lymphoedema

• Exposure to viruses

The virus, human herpesvirus 8, can increase the risk of a type of sarcoma called Kaposi’s sarcoma in people with weakened immune systems.

How do you know if you have a sarcoma?

Sarcomas are usually found by the person themselves as they appear as a lump on their leg, trunk or arm, but they can also be found during a routine examination or operation. The earlier sarcoma is diagnosed, the better chance there is of treating it and ensuring it hasn’t spread to neighbouring areas.

Soft cell sarcomas often have no symptoms in the early stages but they can cause symptoms as they grow bigger or spread. Symptoms include:

• A swelling under the skin that may cause a large lump (larger than 5cm) that can’t easily be moved around.
• Swelling in the abdomen which could cause pain, constipation or a feeling of being full.
• Swelling near the lungs that cause breathlessness or a cough.

You should see your GP if you find a lump, particularly one that has increased in size.

Bone sarcoma symptoms can vary depending on size and location of the tumour. Symptoms include:

• Bone pain, particularly at night
• A mass or swelling
• Restricted movement in the joint

Symptoms can sometimes be confused with more common problems such as sports injury or growing pains in children and young people.

Symptoms of GIST can vary depending on the size and location of the tumour. They may include:

• Anaemia (low level red blood cells)
• Fever and sweating at night
• Discomfort or pain in your tummy
• Feeling sick and vomiting
• Blood in your faeces or vomit
• Weight loss

Symptoms of gynaecological sarcomas may include:

• Heavy periods or bleeding in between periods
• An enlarging fibroid
• Blood in vaginal discharge
• Abdominal pain and bloating
• A noticeable lump on a section of the vulva

A specialist doctor will diagnose sarcoma through a series of tests. These may include a clinical examination, a scan, a biopsy or bone scan.

Treating sarcoma

If you’ve been diagnosed with sarcoma, you should be referred to a specialist sarcoma team for diagnosis and treatment. Your case will be managed by a team of experts from a wide range of healthcare professions called a multidisciplinary team (MDT). Your MDT will support you throughout your treatment to ensure you get the right treatment as and when you need it. Treatment can include surgery, radiotherapy or chemotherapy.

Get in touch

Finding out you have any type of cancer can impact your daily life in many different ways but can be particularly difficult when the cancer is rare and not a lot is known about it. If your sarcoma has been misdiagnosed, it can make the already worrying time much worse.

At Harding Evans, we have significant experience in representing clients with clinical negligence claims against the NHS or private institutions. If you or one of your relatives has a cancer that was misdiagnosed and would like to speak to one of our legal experts, please get in touch on 01633 244233 or email hello@hevans.com for a no-obligation chat.