Dr Deepti Rajkumar dreaded doing rounds that day, in particular she was apprehensive of seeing the young girl at the far end of the hospital ward and even put off seeing her until the last possible second, knowing that she would have to look at the bright young girl -- who was just around her own age-- and break the news of her diagnosis to her. “She actually came in with very vague symptoms, and was quite active, hardly 20 years old she was. Her major complaint was a swelling in her leg, which had been slowly increasing in size,” Dr Deepti tells TNM, adding “Most of her reports were coming back skewed, but we didn’t know exactly what was wrong at that moment.”
A few blood tests and a biopsy later, the team of oncologists diagnosed the girl with osteosarcoma, a type of malignancy which affects the bones. “Sarcomas are cancers which affect the body’s connective tissue - the cells which connect and support other tissues of the body,” says Dr Deepti.
July is recognised as ‘Sarcoma Awareness Month’. Considering its relatively low prevalence rates, there are certain challenges in research efforts geared towards sarcoma, which result from a lack of awareness.
Sarcoma is more commonly seen in children and adolescents than in adults. Sarcomas make up over 20% of cancers seen in the paediatric age group and account for 1% of malignancies seen in adults.
“Most sarcomas are soft tissue sarcomas, while around 8% to 10% of them originate from the bone,” says Dr Keerthi M, a pathologist from Chennai. “In the larger scheme of things, it’s still considered a relatively ‘rare’ cancer.” Her patient happened to be among the ones diagnosed with osteosarcoma - a sarcoma arising from the bone.
The American Cancer Society states that lifestyle factors do not play a role in the development of sarcomas, however certain genetic factors do predispose some individuals to develop the same, though no etiological (causative) factor has been strictly pinpointed.
Symptoms of sarcomas tend to be vague, with most people appearing with a lump in the arm, leg or in some cases in the abdominal region. It may be painless or painful. In a majority of cases, people present themselves to doctors after the swelling has progressively increased. “They can be hard to spot, since connective tissue is present everywhere in the body, sarcomas can literally develop anywhere,” Dr Keerthi states. “The initial work-up consists of a few blood tests and sometimes an ultrasound or MRI scan might be done, but ultimately a biopsy of the swelling is what ends up giving us a conclusive diagnosis,” she adds.
Depending on the type and extent of spread, doctors will determine whether to go for surgical intervention, radiation or chemotherapy to treat the sarcoma.