Diagnosing Soft Tissue Sarcoma: What Doctors Look For
Here’s how doctors confirm a soft tissue sarcoma cancer diagnosis.
Soft tissue sarcoma—a type of cancer that forms from soft tissues (muscles, tendons, nerves, and blood vessels)—is rare, and in most cases the cause is unknown. (However, there are certain factors that may increase your risk of developing soft tissue sarcoma.)
Soft tissue sarcoma often presents as a mass (it can be as large as golf ball-sized; approximately 5 cm), and more often than not, is painless. “It’s not that pain alerts them to that part of the body. If [they] notice something either in the mirror or the shower, and they follow that over time and notice that it’s [getting] slightly bigger, that usually prompts a doctor’s visit,” says says Richard Bakst, MD, a radiation oncologist at Mount Sinai Hospital.
How Doctors Diagnose Soft Tissue Sarcoma
If a person has symptoms of soft tissue sarcoma, like a new or growing lump or abdominal pain, a doctor may refer them to a surgical specialist depending where the cancer is in the body. “For instance, if they notice [it] in the head/neck region, we’ll likely send them to an ear, nose and throat (ENT) surgeon or physician. If they noticed it in their thigh, [we] may send them to an orthopedic specialist,” says Dr. Bakst.
Next, patients would undergo a form of biopsy—a procedure that removes a sample of tissue from a tumor to see if it is cancer—to either confirm a sarcoma diagnosis, or to confirm a benign diagnosis.
Several types of biopsies are used to diagnose sarcomas. A doctor will choose one based on the size and location of the tumor. Most choose to start with a fine needle aspiration or a core needle biopsy, both using needles of different sizes to withdraw a sample of the tumor. If a doctor needs a larger sample, a surgical biopsy may be needed.
Once the biopsy is done, it’s sent to a pathologist who will examine it under a microscope. “That process usually takes about a week or so, at which point that patient would return to that physician’s office, and go over the results of the biopsy,” says Dr. Bakst.
Next Steps: Imaging and Staging
After the diagnosis of the soft tissue sarcoma is made, the next step is to [conduct] imaging tests—like a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan—of the tumor’s site and of the rest of the body to understand where there is and isn’t disease, says Bakst.
After a Soft Tissue Sarcoma Diagnosis: Treatment
Getting a soft tissue sarcoma diagnosis in undoubtedly frightening—but first off, know that you can fight it. “We take the diagnosis very seriously,” says Dr. Bakst.
After being diagnosed, it’s important that patients know their soft tissue sarcoma treatment options, so they can work with their doctor to find the best treatment course for their disease.
The outcome of any cancer depends on the stage, on the patient’s ability to receive treatment, and whether or not it can be taken out surgically, says Dr. Bakst.
“When I’m treating patients with soft tissue sarcoma, I tell them this is a curable cancer, and to focus on the treatment that you have to do at the moment—whether that’s get through surgery and recover, or get through radiation. And our hope is that you’ll have a great outcome long term,” says Dr. Bakst.
Dr. Bakst is a board-certified radiation oncologist and assistant professor at The Icahn School of Medicine at The Mount Sinai Hospital.
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In general,
these are painless lumps in the body.
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They could occur from head to toe,
so it really depends where.
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However, oftentimes people
will notice a slow-growing
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mass on an extremity like your thigh.
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And they will present to their primary
care doctor just noticing this.
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If the primary care doctor has suspicion,
they would then refer them to most likely
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a surgical specialists depending
on the side of the body.
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For instance,
if they notices this in head region,
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they'l likely send them to
an ENT surgeon or physician.
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If they notice it in your thigh, they may
send them to an orthopedic specialist.
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To diagnose any cancer you
typically need a biopsy.
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So before the diagnosis is established
they would undergo a form of biopsy to
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either confirm a sarcoma diagnosis or
to confirm a benign diagnosis.
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The biopsy's have evolved for
soft tissue sarcoma,
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in the past it may have been
a more invasive procedure.
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Currently most people are doing what we
call a core needle biopsy where they take
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a piece of a tissue out,
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which is typically done in the office and
not done in the operating room.
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With that said,
depending on where the mass is,
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it may require a more invasive biopsy,
but that's a generalization.
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Once the biopsy's done,
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it's sent off to a pathologist who
will look at it under the microscope.
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That process typically takes about a week
or so, at which point the patient will
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return to that physician's office and
go over the results of the biopsy.
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After the diagnosis of a soft
tissue sarcoma is made,
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the next step is to permit imaging
both of the tumor site and
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of the rest of the body, to understand
where there is or isn't disease.
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We take the diagnosis very seriously.
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And any cancer prognosis
depends on the stage,
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on the patient's ability to
receive treatment and whether or
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not it's resectable or not,
meaning it could come out surgically.
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And so in general when I'm treating
a patient with soft tissue sarcoma I tell
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them, this is a curable cancer, and
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to focus on the treatment that
you have to do at the moment.
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And whether that's get through surgery and
recover or get through radiation.
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And our hope is that you'll
have a great outcome long term.
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How Are Soft Tissue Sarcomas Diagnosed? The American Cancer Society, 2014. (Accessed on February 21, 2018 at https://www.cancer.org/cancer/soft-tissue-sarcoma/detection-diagnosis-staging/how-diagnosed.html)