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Learning you have an uncommon type of cancer, such as a sarcoma, can create a lot of questions: How are sarcomas diagnosed? What are the treatment options? Will I lose my arm or leg? Our collaborative teams of experts treat rare sarcomas every day, and we’re leaders in developing new techniques—so we can help provide some answers.
Sarcomas are rare cancers that start in the body’s connective tissues. While some genetic conditions can make it more likely someone will develop a sarcoma, most happen without any known cause.
The American Cancer Society estimates more than 13,000 people will be diagnosed with soft tissue sarcomas in 2025, and about 3,700 will be diagnosed with bone sarcoma. Sarcomas make up only about 1% adult cancer diagnoses but they’re 15% of cancers in people younger than 20.
Sarcomas can be aggressive, and effective treatment relies on specialists working together with the latest technologies. Because this condition is uncommon, it’s important to seek treatment at a high-volume center such as MedStar Georgetown Cancer Institute. Working with a team of experienced experts gives patients the best chance at accurate diagnosis, effective treatment, and long-term recovery.
Two main types of sarcomas.
There are at least 80 different types of sarcomas. There are two main groups—those that that develop in the bone and those that start in soft tissues.
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Bone sarcomas: Sarcomas that begin in the bone are more common in children than adults but can happen at any age. Bone tumors most often grow in the arms and legs, especially around the knee joint. Bone sarcomas are usually diagnosed in teens who are having growth spurts during puberty. They often feel like a dull, aching pain that gets worse at night.
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Soft tissue sarcomas: The body’s soft tissues, such as muscles, tendons and ligaments, fat, blood vessels, and nerves support and connect other body parts and organs. Soft tissue sarcomas are more common in adults. They can form anywhere in the body, but most often they’re found in the arms, legs, and abdomen. They can develop just underneath the skin or deep within or around the muscles. Usually painless lumps, these sarcomas can be difficult to detect until they have grown large, especially when they occur deep.
How are sarcomas diagnosed?
Because sarcomas are uncommon and there are so many types, these cancers can be challenging to diagnose, but MedStar Health experts care for patients with sarcomas every day.
To diagnose sarcomas, an MRI can pinpoint where the mass is located, but a biopsy is necessary for definitive diagnosis. Guided by real-time images, an interventional radiologist will use a needle to precisely remove a sample of cells from the lump. In the lab, an experienced pathologist can identify whether lump is a sarcoma.
If the lump is a sarcoma, we must determine whether and how far it has spread. Staging is the process of learning these details and assigning one of four stages based on how far the cancer has advanced. The most common place for sarcomas to spread is the lungs, so we typically conduct a CT scan of the chest to look for signs that the cancer has spread there.
What are the treatment options for sarcoma?
MedStar Georgetown Cancer Institute experts work together with our patients to understand their goals for treatment and decide the best way to achieve them. To determine the specifics of each treatment plan, we consider a patient’s sarcoma type, location, and stage as well as their overall health.
Generally, sarcomas are treated with a combination of three methods:
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Chemotherapy: Medical oncologists give drugs to help eliminate cancer cells. Chemotherapy is used sparingly for soft tissue sarcomas that have not spread but is commonly used to treat bone sarcomas.
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Radiation therapy: To decrease the risk of a tumor coming back in the same location, radiation oncologists use focused beams of radiation energy to help eliminate cancer cells. Radiation can be given before or after sarcoma surgery.
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Surgery: Orthopaedic oncologists remove the tumor and some surrounding normal tissue to help reduce the risk that cancerous cells outside the main tumor are left behind.
Our team of specialists discusses each case in bi-weekly tumor boards, where we collectively provide the best treatment recommendation for each individual patient. We’ve received Accreditation with Commendation from the American College of Surgeons because of our track record of success.
When a sarcoma grows in the arm or leg, it can sometimes interfere with nerves and blood vessels. Today, advanced techniques mean we can avoid amputation and spare the entire limb in 98% of cases. Limb-sparing techniques involve collaboration with our colleagues in reconstructive and plastic surgery. We work together from the beginning to plan treatment strategies that mean our patients have as much functional use of their limb after surgery as possible.
Recovery after sarcoma treatment is different for everyone and often involves physical therapy, emotional support, and help managing treatment side effects. Patients get regular follow-up care to support their recovery and check that cancer hasn’t come back.
Research-backed treatment from an expert team.
For decades, studies have shown that patients who get sarcoma treatment at a high-volume center have better outcomes. Sarcomas are rare, so getting care from specialists with experience means patients survive longer and keep their limbs more often.
Our sarcoma specialist team works closely with other specialists and Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI). Participating in clinical trials means our patients can access the latest treatments before they’re available to the public.
Today there is more hope than ever before for patients diagnosed with sarcomas. Team-based care and research is leading to advances that will help patients lead fulfilling lives long after being diagnosed with a sarcoma.
