What Is Soft Tissue Cancer (Sarcoma)? Symptoms and Treatment

Soft tissue cancer, known in medical literature as sarcoma, is a rare type of cancer that develops from the body’s supportive tissues such as muscles, fat, nerves, blood vessels, and connective tissue. Sarcomas may progress slowly or rapidly; however, some subtypes behave aggressively and can spread to surrounding tissues and distant organs in a short period of time. Although sarcoma can occur at any age, certain types are more common in children, while others are more frequently seen in older adults. Because it often does not cause symptoms in the early stages and may present with varied clinical features, diagnosis can sometimes be delayed. For this reason, understanding the causes, symptoms, risk factors, and treatment options of sarcoma is crucial for early diagnosis and effective treatment.

What Is Sarcoma (Soft Tissue Cancer)?

Sarcoma is a rare type of cancer that can develop in connective tissue, muscles, fat tissue, nerves, blood vessels, or other soft tissues of the body. Soft tissue sarcomas can occur almost anywhere in the body but are most commonly found in the arms, legs, and abdominal region. Sarcomas account for approximately 1% of all cancers and can affect both children and adults. These tumors often do not cause noticeable symptoms in the early stages, which makes early diagnosis challenging.

What Are the Symptoms of Soft Tissue Cancer?

Symptoms of soft tissue cancer vary depending on the tumor’s location, size, and its effect on surrounding structures. In the early stage, it typically presents as a painless mass. As the tumor grows, pain, functional impairment, or pressure-related symptoms may develop.

Common symptoms of soft tissue cancer include:

• A painless lump under the skin that gradually increases in size

• Tenderness or pain in the tumor area

• Restricted movement when the tumor is near a joint

• Numbness, tingling, or weakness due to nerve compression

• Digestive problems or abdominal bloating when the tumor is located in the abdomen

• Fatigue, weight loss, and general weakness in advanced stages

What Causes Sarcoma?

Although the exact cause of sarcoma is not fully known, a combination of genetic predisposition and environmental factors plays a role. DNA damage leading to uncontrolled cell growth triggers tumor formation.

The most common causes associated with sarcoma include:

• Genetic mutations: Especially mutations in tumor suppressor genes such as TP53 and RB1

• Inherited syndromes: Li-Fraumeni syndrome, neurofibromatosis type 1

• Radiation exposure: Increased risk in individuals who previously received radiotherapy

• Chemical exposure: Carcinogens such as vinyl chloride and arsenic

• Weakened immune system: Following organ transplantation or long-term use of immunosuppressive medications

What Are the Risk Factors for Soft Tissue Cancer?

• Age over 50

• Male gender

• Long-term exposure to ultraviolet or ionizing radiation

• Occupational exposure to certain chemicals (pesticides, industrial solvents)

• Family history of sarcoma

• Previous soft tissue injuries (not a direct cause, but monitored closely)

Types of Soft Tissue Cancer (Sarcoma)

Sarcomas are classified into many subtypes based on their histological characteristics. Each type differs in growth rate, metastatic potential, and response to treatment.

Common types of soft tissue sarcoma include:

• Liposarcoma: Develops from fat tissue; commonly seen in the legs and abdomen

• Leiomyosarcoma: Arises from smooth muscle tissue; frequently affects the uterus and gastrointestinal tract

• Rhabdomyosarcoma: Originates from skeletal muscle tissue; more common in children

• Angiosarcoma: Develops from blood or lymphatic vessels; may occur in the skin or liver

• Fibrosarcoma: Arises from fibroblasts in connective tissue

• Synovial sarcoma: Typically occurs near joints

How Is Soft Tissue Cancer Diagnosed?

Early and accurate diagnosis is essential in sarcoma management. Evaluation begins with a detailed medical history and physical examination, followed by imaging and biopsy.

Diagnostic methods include:

• Magnetic Resonance Imaging (MRI): Determines tumor size and spread to surrounding tissues

• Computed Tomography (CT): Used to screen for metastases in the chest and abdomen

• Ultrasound: May be the first step for evaluating superficial masses

• Positron Emission Tomography (PET-CT): Assesses the presence of metastases

• Biopsy: The gold standard for diagnosis; tru-cut or open surgical biopsy is performed

How Is Soft Tissue Cancer Treated?

The goals of sarcoma treatment are to completely remove the tumor, prevent spread, and preserve the patient’s quality of life. Treatment planning depends on the tumor type, stage, location, and the patient’s overall health. In early-stage disease, surgery is the most effective treatment, and the tumor is removed with clear margins of healthy tissue.

Treatment options include:

• Radiotherapy: Used before surgery (neoadjuvant) to shrink the tumor or after surgery (adjuvant) to reduce recurrence risk

• Chemotherapy: Particularly used for high-grade or metastatic sarcomas; drugs such as doxorubicin and ifosfamide are commonly used

• Targeted therapies: Applied in certain sarcomas with specific genetic mutations

• Immunotherapy: A modern treatment approach that activates the immune system against cancer cells

Can Sarcoma Be Cured?

Sarcoma can be completely cured if diagnosed early and treated appropriately. However, treatment is more challenging in high-grade, large, or metastatic sarcomas. Regular follow-up is essential to prevent recurrence after treatment.

What Are the Stages of Sarcoma?

Sarcoma staging is based on tumor size, grade, lymph node involvement, and presence of metastasis:

• Stage 1: Small, low-grade tumor with no lymph node or distant metastasis

• Stage 2: Medium-sized or high-grade tumor without metastasis

• Stage 3: Large, high-grade tumor; may involve regional lymph nodes

• Stage 4: Presence of distant metastases (lungs, liver, etc.)

What Is the Difference Between Carcinoma and Sarcoma?

Carcinoma originates from epithelial tissues (skin and the lining of internal organs) and is much more common. Sarcoma develops from connective tissue, muscle, fat, blood vessels, or nerves and is rare. Carcinomas are more frequently seen in older adults, whereas some sarcoma types occur in children. The two diseases differ in treatment protocols, patterns of spread, and prognosis.

Can Sarcoma Recur?

Yes, sarcoma may recur after treatment. The risk of recurrence depends on the tumor type, grade, stage, and treatment approach. High-grade and large tumors carry a higher risk. Local recurrence may occur if surgical margins are insufficient. Regular follow-up with physical examinations and imaging during the first 2–3 years after treatment is especially important.

Although rare, soft tissue sarcoma is a serious cancer that can lead to significant health problems. Early diagnosis and appropriate treatment play a critical role in controlling the disease and extending survival. Regular follow-up after treatment is one of the most effective ways to reduce recurrence risk. With a multidisciplinary approach combining surgery, radiotherapy, chemotherapy, and modern treatment methods, long-term survival can be achieved in many patients. Increasing public awareness of this disease will help improve early diagnosis rates and treatment success.