A Glimpse into the World of Sarcomas: Understanding Liposarcoma, Leiomyosarcoma, and Ewing’s Sarcoma

Sarcomas are a rare and diverse group of cancers that arise from the body's connective tissues, such as bones, muscles, fat, and cartilage. Unlike more common cancers, sarcomas are well-known and can present unique challenges. In India, these cancers are often diagnosed late, making treatment complex. Let’s explore three specific types of sarcomas: Liposarcoma, Leiomyosarcoma, and Ewing’s Sarcoma.

How they differ in symptoms and progression

While all sarcomas are serious, their origin and behavior differ. Liposarcoma starts in fat cells and is a common soft tissue sarcoma. It often appears as a painless, slow-growing mass, most frequently in the limbs or the back of the abdomen. It is often discovered when the tumour is already large due to its subtle symptoms,

Leiomyosarcoma originates from smooth muscle tissue, which is found in organs like the uterus, stomach, or blood vessels. Symptoms can vary greatly by location. For instance, uterine leiomyosarcoma may cause abnormal bleeding, while an abdominal tumor can lead to pain or bloating. It tends to be more aggressive than many liposarcomas.

Ewing’s Sarcoma is a highly aggressive cancer that typically affects bone but can also occur in soft tissue. It is more common in children and young adults. Symptoms often include localized bone pain, swelling, and fever. Its rapid growth makes early diagnosis critical.

Diagnosis and treatment

Diagnosing sarcomas requires doctors to use their expertise because these cancers are rare and highly varied. The initial step is usually a physical examination, followed by imaging tests like MRI, CT scans, and PET scans to determine the tumour’s size and location. The most crucial step is a biopsy, in which doctors take a tissue sample and a pathologist analyses it to confirm the type and grade of sarcoma. In India, a team of specialists manages sarcoma treatment using a multi-faceted approach. Surgeons perform the primary treatment, aiming to remove the tumor with clear margins. Doctors now commonly perform limb-sparing surgery, saving the affected limb rather than amputating it, which has become the standard of care in major Indian cancer centers. Oncologists often combine surgery with radiotherapy, using high-energy beams to kill cancer cells before or after the operation. Chemotherapy works particularly well for certain subtypes, like Ewing’s sarcoma, and doctors use it to shrink the tumor before surgery or to treat cases that have spread. For some sarcomas, specialists also use newer treatments, such as targeted therapy and immunotherapy.

Prognosis and survivorship challenges

The prognosis for sarcoma patients in India depends heavily on the specific subtype, stage, and how well the treatment is tolerated. While treatment advances have improved survival rates, survivors often face long-term challenges. Beyond the physical side effects of treatment, many face mental health issues like anxiety and depression. There are also social and financial burdens, including the fear of recurrence, which can be particularly challenging in a country where access to comprehensive survivorship care is still developing. Continued support and a focus on long-term well-being are crucial for a better quality of life.