Types of soft tissue sarcomas
There are many types of soft tissue sarcomas, but the ones that are most common in young people are:
- Rhabdomyosarcomas: These are sarcomas that grow in the muscles that you are able to control and move. Rhabdomyosarcomas mainly occur in the head, neck or pelvis, but can also occur in the arms or legs.
- Synovial sarcomas: These sarcomas may start near to joints, such as the knee or elbow.
- Fibrosarcomas: These are sarcomas that occur in the fibrous tissues that join together parts of your body, such as connecting the muscles to the bones.
Ewing’s sarcomas are normally a type of bone cancer, but they can also develop in the soft tissue. Soft tissue Ewing’s sarcomas are treated in a similar way to the ones that develop in the bones, so you may wish to look at our bone cancer page for more information.
Sarcomas are relatively rare in children and young people. Around two thirds are diagnosed in people aged 50 or above. However, they can occur in anyone of any age. Rhabdomyosarcomas, synovial sarcomas and fibrosarcomas are the most common types of sarcomas in children and young people.
The first noticeable symptom of a soft tissue sarcoma may be a painless lump that continues to grow or does not go away. A lump measuring more than 5cm across or increasing in size is more likely to be a sarcoma. You may experience some soreness as the lump grows and presses against nerves and muscles.
Soft tissue sarcomas are usually diagnosed at the hospital, following a biopsy. A biopsy involves a specialist taking a sample of the cells found inside your lump and examining them under a microscope to see if cancer cells are present. You may also need X-rays, scans and blood tests.
The specialist will need to determine the size of your tumour, how deep it is, whether there are lymph nodes with cancer in them, and whether the cancer has spread.
Surgery is the most common treatment for soft tissue sarcomas. This involves removing the cancer and some of the tissue surrounding it. If the sarcoma is small, and it’s possible to remove it completely, then you might not need any further treatment. The type of surgery you need will depend on the size and location of your sarcoma. For some sarcomas in your arm or leg, you may need ‘limb-sparing surgery’ (where just the cancerous area is removed, not the whole limb) or an amputation.
Chemotherapy involves targeting the cancer cells with anti-cancer drugs. You may need chemotherapy before your surgery to shrink the size of the tumour and make it easier to remove, or afterwards to destroy any remaining cancer cells.
Radiotherapy is often used for soft tissue sarcomas that affect the arms or legs. It may be used as an alternative to surgery, or be given after surgery to target any remaining cancer cells.
Proton beam therapy
For certain types of soft tissue sarcoma, your specialist may recommend you have a specialised form of radiotherapy called proton beam therapy. See our proton beam therapy section for more information.
If you are undergoing chemotherapy, you may experience tiredness, sickness, diarrhoea and temporary hair loss. You will also be at greater risk of infections.
Radiotherapy can also make you feel tired and sick. You might experience skin irritation similar to sunburn and hair loss in the area that is being treated.
Talk to your specialist or nurses about how you can manage these side effects, or see the side effects section of our website for more information.
After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse). They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.
Long-term follow up
Once your risk of relapse has reduced, the focus of ongoing follow up changes to looking out for potential long term side effects of treatment. The risk of long term side effects depends on the type of cancer you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and ongoing investigations that you require. Many people are at low risk of future health problems but some will have significant ongoing health needs. Talk to your specialist about the potential long-term side effects of your treatment.
Updated March 2018, next review due 2021.