Description

In Québec, around 300 people are diagnosed with soft tissue or bone cancer (musculoskeletal sarcomas) each year. Musculoskeletal sarcomas account for about 1% of all newly diagnosed cancers in adults and about 15% of malignant tumours in children.

Soft tissue or bone sarcomas are rare malignant (cancerous) tumours. They can be found, in particular, in muscle, bone, fat (adipose tissue) and nerves. Each cancer is named according to the tissue where the tumour forms.

Soft tissue cancer

Most soft tissue sarcomas are located in the lower or upper extremities (60% of cases). They can also be found in the abdominal, thoracic and retroperitoneal cavities, and, more uncommonly, in the head and neck region.

There are more than 50 subtypes of soft tissue sarcomas. The most common are pleomorphic sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumor.

Bone cancer

Bone sarcomas originate in the cells within the bones or cartilage. Bone cancer (also called primary bone cancer), is very rare in adults older than 40 years of age. It is seen more often in children, adolescents and young adults.

The most commonly diagnosed bone sarcomas in young people are osteosarcoma and Ewing sarcoma. In adults, these are chondrosarcoma, undifferentiated pleomorphic sarcoma of bone, and osteosarcoma. Other types of bone sarcomas exist, but they are far more uncommon.

Other types of cancer may spread to the bones. In such case, the cancer begins in another part of the body and spreads to the bones or forms metastases. Lung, breast, prostate, kidney and thyroid cancers may behave more frequently in this way. This is not the same disease as primary bone cancer. Metastases are in such case  much more common.

Symptoms

The most common symptom of soft tissue sarcoma is the appearance of a lump (mass) or swelling. It may be associated with local sensitivity and sometimes pain as the lump grows.

In the case of bone sarcoma, the most common symptom is pain, often sharper at night.

See a doctor

If you have been experiencing one of the symptoms described above for some time, you should see a doctor. However, these symptoms are not necessarily caused by cancer. They could also be related to other health problems.

Detecting cancer at an early stage improves the chances of successful treatment.

Treatment

A biopsy is crucial for treatment planning. It determines the histological type of the sarcoma. Following the histological analysis and radiologic assessment, the stage of the disease is determined, that is, the extent of the disease. Several diagnostic tests are performed, according to the type of sarcoma. These include, in particular, magnetic resonance imaging (MRI); computed tomography (CT) scan of the chest; computed tomography (CT) scan of the abdomen and pelvis; bone scan (bone scintigraphy); or sometimes positron emission tomography (PET) scan.

When a person is diagnosed with soft tissue cancer or bone cancer, a specialized multidisciplinary team draws up a personalized treatment plan with them. This treatment plan can vary according to several aspects, such as cancer type, cancer stage and the person’s health status. The treatment plan also takes into account the wishes and concerns of the affected person and those of their family.

The main treatments offered to people with soft tissue cancer or bone cancer are:

  • surgery;
  • chemotherapy;
  • radiation therapy.

In some cases, only one of these treatments is necessary. In other cases, the physician may recommend a combination of two of these treatments or all three.

Risk factors

Soft tissue cancer

Soft tissue cancer can strike at any age, but it is more common in people over the age of 50 years.

Bone cancer

Primary bone cancer is seen most often in children, adolescents and young adults, very rarely in adults older than 40 years of age.

The causes of sarcoma are not fully known. Most people who develop sarcoma have no risk factors. However, we do know that some situations may increase the risk of developing a sarcoma:

  • a diagnosis of Paget’s disease of bone or neurofibromatosis;
  • exposure to large doses of radiation;
  • prolonged exposure to chemical products such as arsenic;
  • having certain rare inherited genetic syndromes.

Musculoskeletal sarcoma cancer network

A musculoskeletal sarcoma cancer network now exists in Québec. It provides better care for people with this type of cancer. These people can benefit from co-ordinated follow-up care and have access to  leading-edge expertise. Knowledge sharing leads to the faster detection of this disease and contributes to saving lives as a result of early diagnosis.

This network was created by three designated reference centres, that is, Hôpital Maisonneuve-Rosemont, the McGill University Health Centre (MUHC) and the CHU de Québec –  Université Laval. These centres are committed to ensuring that all Quebecers have rapid access to quality services related to sarcoma.