Every year, the global community observes sarcoma and bone cancer awareness month to shed light on these rare but impactful diseases affecting children worldwide. Sarcoma is a rare cancer comprising a heterogeneous group of cancers predominantly originating from bone or soft tissue. Sarcomas that originate in bones are termed "bone cancer," whereas those originating in tissues such as muscles, fat, blood vessels, nerves, tendons, and joint linings are known as "soft tissue sarcomas."
Sarcomas constitute approximately 10 percent of all childhood cancers, split evenly between soft tissue and bone sarcomas. Early diagnosis significantly impacts treatment outcomes localised disease has a 70 percent cure rate compared to metastatic cases, which see cure rates around 30 percent.
Dr Sandeep Jain, senior consultant pediatric hematology oncology, Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), says that while they can arise anywhere in the body, 90 percent originate from these tissues. In children, the spectrum varies by age, with rhabdomyosarcoma prevalent in younger children and bone tumors more common among adolescents aged 10 to 20. Due to their aggressive nature and poor prognosis, sarcomas are among the most challenging tumors to treat. They pose significant difficulties due to their diverse symptoms and complexities in treatment.
Symptoms
If someone notices any mass in their body, whether in soft tissue or bone, particularly if it's painless and progressively growing, it's crucial to consult a doctor, says Dr Jain. They can assess whether the mass appears malignant or benign and proceed accordingly.
Additionally, young children may not easily experience fractures, but a minor injury could unexpectedly lead to one. Children can present with a variety of symptoms for instance, young children might develop masses in organs like the bladder, prostate, or other internal areas, which could indicate sarcoma.
Dr Jain adds that if you notice any unusual lumps in your hands, legs, thighs, arms, feet, or near joints such as the knee, hip, or shoulder, along with persistent pain that has developed recently and does not subside, it could be a sign of sarcoma. These lumps may also occasionally lead to pathological fractures.
Treatment modalities
Treatment typically involves a combination of chemotherapy, radiotherapy, and surgery. Chemotherapy serves as a cornerstone, complemented by localised treatments tailored to tumor size and location. Recent advancements in surgical techniques and radiotherapy have revolutionised outcomes, with limb-saving surgeries now possible in 90 percent of cases. While chemotherapy protocols have seen minimal new drug introductions in recent years, refinements in drug delivery and supportive care have improved efficacy. Similarly, radiotherapy techniques, such as proton therapy and advanced image-guided approaches, have minimised collateral damage to healthy tissue, enhancing both treatment tolerability and effectiveness.
While sarcomas and bone cancers in children present significant challenges, ongoing research and awareness initiatives offer hope for improved outcomes and quality of life. Careful selection of biopsy sites is crucial to reduce the risk of recurrence. For example, when performing a biopsy for a sarcoma near the knee on the thigh bone, it's important to avoid impacting critical muscles.
Early detection not only reduces treatment burdens but also enhances survivors' quality of life by minimising long-term complications. Education and vigilance among healthcare providers and the general public are paramount in ensuring timely diagnosis and intervention.
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