Soft tissue sarcoma diagnosis involves blood tests, imaging studies, and biopsy. Treatment may include surgery, radiation therapy, chemotherapy, targeted therapy, or immunotherapy. A multidisciplinary team approach is required to develop customized treatment plans and improve overall outcomes. The survival rate for soft tissue sarcoma depends on several factors.
What are the Soft Tissue Sarcoma Diagnosis Tests?
Multiple tests are available for soft tissue sarcoma diagnosis. The following are the commonly recommended techniques for soft tissue sarcoma diagnosis:
Physical Evaluation
The patients consulting the doctor for their symptoms undergo a comprehensive physical evaluation to determine the appropriate cause of the symptoms. The doctor may inquire about the severity of the symptoms. They may also ask about the onset and progression of the symptoms. The healthcare provider examines the affected area and assesses the pain, mobility, and any neurological symptoms.
Medical and Family History Assessment
The medical history of the patients and their family history are important considerations for soft tissue sarcoma diagnosis. Patients with a history of soft tissue sarcoma have a higher chance of developing the disease again, and the doctor should evaluate any symptoms at the same or any other place. Certain genetic syndromes also increase the risk of soft tissue sarcoma. Studies suggest that individuals with a family history of soft tissue sarcoma have a slightly higher risk for this disease. Thus, evaluating family history is important for soft tissue sarcoma diagnosis.
Blood Tests
Blood work is not primarily recommended for soft tissue sarcoma diagnosis. However, they may provide crucial information about the patient's overall health. Further, specific blood tests also inform about the metastasis of soft tissue sarcoma to specific organs. Blood tests are also helpful during chemotherapy treatment to detect the levels of blood cells. Some patients with soft tissue sarcoma have elevated levels of lactate dehydrogenase. C-reactive protein and erythrocyte sedimentation rate are linked with inflammation and should be monitored to evaluate the presence of systemic inflammation.
X-Ray
X-rays are not usually the primary imaging technique for soft tissue sarcoma diagnosis. This imaging technique is ineffective for soft tissue scans, such as connective tissues and muscles, where soft tissue sarcoma usually develops. However, the doctors may recommend an x-ray examination if bone involvement is suspected in patients with soft tissue sarcoma.
Computed Tomography
Computed tomography is an effective imaging modality for soft tissue sarcoma diagnosis. The technique provides comprehensive and clear cross-sectional images of various body soft tissues where soft tissue sarcoma is suspected. A CT scan provides important information about the location, size, and other characteristics of the soft tissue sarcoma. The technique also assists oncologists in detecting any bone involvement or bone damage caused by the tumor. CT scans also effectively evaluate the vascular system near the soft tissue sarcoma and examine the vascular invasion. Oncologists recommend computed tomography to stage the disease, which assists in treatment planning and monitoring responses to treatment. However, it is important to consider ionizing radiation in the CT scan, especially when repeated imaging is required.
Magnetic Resonance Imaging
MRI is also an important imaging modality for soft tissue sarcoma diagnosis. Soft tissue MRI provides detailed, high-resolution images of the soft tissues and effectively demarcates the extent of the tumor. It is highly effective for detailed visualization of the soft tissues, including ligaments, muscles, tendons, and other soft tissues. Like CT scans, MRI also assists oncologists in determining the location, size, and cellular characteristics of the tumor. This information is used to determine the type and aggressiveness of the cancer. The scan also helps provide information about the involvement of nearby structures, such as nerves and blood vessels. The images provided by the MRI are obtained from multiple angles, helping to detect the tumor precisely. MRI helps in staging the cancer and assists the oncologists in planning the treatment. Once the treatment is started, the oncologists may use MRI to monitor the treatment response.
PET Scan
A PET scan is also an important imaging technique used in soft tissue sarcoma diagnosis as it provides valuable information regarding the metabolic activity of the abnormal tissues. PET scans measure the uptake of a radioactive glucose analog to determine metabolic activity. A PET scan is a complete body scan; this helps specialists determine the site of the primary tumor and possible metastases. Staging the disease is done through the results provided by the PET scan, as it assesses the spread of the tumor to nearby structures, lymph nodes, and distant organs. PET scans can help differentiate between scar tissue and active tumors, offering important information for clinical decision-making. Doctors may also recommend PET scans to monitor the treatment response and evaluate recurrence, especially in high-risk patients.
Ultrasound
Ultrasound is not a preferred imaging technique for soft tissue sarcoma diagnosis. However, doctors may recommend this imaging technique to evaluate the superficial mass or during a biopsy (ultrasound-guided biopsy). It provides a real-time image of the abnormal site, helping visualize the tumor mass and surrounding structures. Ultrasound may also examine blood flow within the tumor and surrounding tissues. Increased vascularity may suggest certain types of soft tissue sarcomas. Ultrasound may be preferred over other imaging techniques that involve ionizing radiation in pediatric patients or pregnant women.
Biopsy
A biopsy is recommended as a confirmatory test for a soft tissue sarcoma diagnosis. It involves obtaining a tissue sample from the suspicious area for pathological examination. While imaging tests, such as CT scans and MRIs, provide valuable information about the characteristics, location, and extent of the tissue mass, a biopsy confirms the presence of soft tissue sarcoma. Several techniques are implemented in the biopsy. These include a needle biopsy, an incisional biopsy, and an excisional biopsy. A biopsy is also performed under the guidance of various imaging techniques, including ultrasound, MRI, and CT scans.
Once the samples reach the laboratory, the pathologists examine them under the microscope. Pathologists provide detailed information about the types of cells present, the grade of the tumor, and other characteristics that help diagnose and classify soft tissue sarcoma. Oncologists develop appropriate treatment strategies based on the results of the biopsy.
What are Effective Soft Tissue Sarcoma Treatments?
Once the diagnosis is confirmed and the staging is confirmed, specialists begin devising a customized treatment plan based on the type of soft tissue sarcoma, its stage, its grade, the patient’s overall health, etc. The following are the different options available for soft tissue sarcoma treatment:
Surgery
Surgery is often the primary line of soft tissue sarcoma treatment. The surgery aims to remove the tumor while preserving function and lowering the risk of recurrence. The extent and type of surgery depend on various factors, such as the size, location, grade, and stage of the sarcoma. Some soft tissue sarcoma surgery techniques include wide local excision, limb-sparing surgery, sentinel lymph node biopsy, amputation, and reconstruction. Surgery is usually the only treatment required in patients with localized soft tissue sarcoma. However, in patients with advanced disease, surgery usually accompanies other soft tissue sarcoma treatments, such as radiation therapy and chemotherapy.
Chemotherapy
Soft tissue sarcoma chemotherapy is a systemic treatment that uses drugs to kill or delay the growth of cancer cells throughout the body. Chemotherapy as a soft tissue sarcoma treatment is used along with surgery or in the treatment strategy for patients with metastatic soft tissue sarcoma. Drugs under chemotherapy are used in combination to improve the outcomes. Chemotherapy for soft tissue sarcoma includes adjuvant chemotherapy, neoadjuvant chemotherapy, and palliative chemotherapy.
Radiation Therapy
Soft tissue sarcoma radiation therapy is a common treatment modality. Radiation therapy for soft tissue sarcoma treatment is used at different stages of the disease to target and kill cancer cells. The technique may be adjuvant radiation therapy, neoadjuvant radiation therapy, brachytherapy, external beam radiation therapy, and intensity-modulated radiation therapy. In case the surgery is not feasible, radiation therapy may be considered as the definitive therapy for soft tissue sarcoma treatment. In addition, radiation therapy may also be recommended as a part of palliative care to improve the symptoms of advanced and metastatic soft tissue sarcoma.
Targeted Therapy
Targeted therapy for soft tissue sarcoma involves administering the drugs specifically targeting molecules or pathways vital for cancer cells' growth and survival. Unlike traditional chemotherapy, which affects rapidly dividing cells throughout the body, targeted therapies interfere specifically with the cancer cell function. The targeted therapy's side effects are relatively fewer than traditional chemotherapy. Different classes of drugs used in targeted therapy for soft tissue sarcoma treatment include tyrosine kinase inhibitors, mTOR Inhibitors, PD-1/PD-L1 Inhibitors, KIT Inhibitors, fibroblast growth factor receptor inhibitors, and hormone receptor inhibitors.
Immunotherapy
Immunotherapy improves the body's immune system to recognize and attack cancer cells. It is an effective soft tissue sarcoma treatment. Cancer cells evade the damaging effects of the immune system through certain cellular processes. Immunotherapy interferes with these processes and makes the cancer cells sensitive to the immune system. Some of the drugs used include immune checkpoint inhibitors and PD-1 inhibitors.
Palliative Care
Palliative care is provided to patients with advanced and metastatic soft tissue sarcoma. Palliative care aims to manage the symptoms, provide emotional and psychological support, and improve the quality of life of the patients. Surgery, radiotherapy, and chemotherapy are usually the components of a palliative care strategy. Patients with advanced-stage soft tissue sarcoma that is untreatable and progressive may have the option to register themselves for soft tissue sarcoma clinical trials.
Why Choose HCG for Treatment and Diagnosis of Soft Tissue Sarcoma?
The choice of a hospital for soft tissue sarcoma diagnosis and treatment depends on various factors, including the hospital's expertise in sarcoma care, the range of treatment options offered, the availability of modern facilities and soft tissue sarcoma specialists, and the overall quality of medical care provided. HCG offers comprehensive medical care to patients suffering from soft tissue sarcoma. The hospital also has the latest imaging techniques to diagnose and stage the disease accurately.
Conclusion
Soft tissue sarcoma diagnosis methods include physical examination, blood tests, imaging techniques, and biopsy. Some effective soft tissue sarcoma treatment options include surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapy. Palliative care is provided to patients with advanced soft tissue sarcoma.
Frequently Asked Questions
Soft tissue sarcoma usually does not present symptoms in the early stages. The symptoms, if present, include a painful or painless lump, abdominal pain, and nausea and vomiting.
Some of the most common sites for developing soft tissue sarcoma are extremities (arms and legs), chest and abdominal wall, and head and neck region.
Soft tissue sarcoma has no specific symptoms, and almost all the symptoms overlap with other conditions, making the diagnosis difficult, especially in the early stages.
Due to non-specific presentation, soft tissue sarcoma can be misdiagnosed. Misdiagnosis occurs commonly in soft tissue tumors < 5 cm, are painless, and are superficial to the fascia.
The treatment length depends on the stage at the time of diagnosis, the tumor's location, and the type of treatment required.
The length of chemotherapy depends on the location, stage, and other tumor characteristics. However, chemotherapy is usually done every three weeks and requires six cycles.
