I was inspired to read and write about sarcoma, a deadly type of cancer, and carcinoma, too, due to the fact that many of our Hispanic patients have been diagnosed with these types of cancers. July is “Sarcoma Awareness Month” and September is “Childhood Cancer Awareness Month”. Since I started interpreting for the University of Michigan Hospital and Health Systems, I have worked with sarcoma patients and their families and care providers to the extent that it has given me chills. I decided to research this disease, and found out that sarcoma comes from a Greek word meaning “fleshy growth”.
It seemed that each time I interpreted for a patient diagnosed with sarcoma, it was a new and different type of sarcoma. Did you know that there are more than 50 types of sarcoma that fall into two basic categories: soft tissue sarcoma and bone and joint sarcoma? Soft tissue sarcomas are tumors that affect tissues connecting, supporting, or surrounding any of the body systems. Sarcomas also affect bone, skin, and other soft tissue including fat, muscle, blood vessels, deep skin tissues, cartilage, tendons, and ligaments. I have met and worked with patients that fall under both sarcoma categories. Sometimes there are no signs or symptoms in soft tissue sarcoma until a lump, swelling, or tumor gets big enough and presses on nearby nerves or other parts of the body. Some sarcomas are aggressive and difficult to treat.
Children and adults can develop soft tissue sarcoma. Treatments for children diagnosed with sarcoma appear to work better than treatments for adults, and they have a better chance of recovery. Soft tissue sarcoma is found in many types of soft tissue cells and based on the location it may be treated differently. We find rhabdomyosarcoma in children younger than 10 years old. Stromal tumors of the gastrointestinal tract (stomach or small intestine) are found more commonly in adults. Mesenchymal neoplasms and sarcomas in children are rare, but are slightly more common in adults. Ewing sarcoma is found in the bone, while Kaposi sarcoma is found in the skin, lymph nodes, and other organs. Uterine sarcoma occurs in the uterus and its supporting tissues. Other soft tissue sarcomas include angiosarcoma, a malignant neoplasm in the blood vessel walls, osteosarcoma, a tumor of the bone, chondrosarcoma, found in the cartilage, liposarcoma, found in fat cells, fibrosarcoma, found in the fibrous connective tissue, and hemangioma, found in the vascular neoplasm.
With a rare and complex cancer like sarcoma, it is important to seek the best possible care to improve your chance of survival. Get a second opinion from a doctor that specializes in sarcoma to determine the initial diagnostic and treatment plan.
The statistics show that about 11,000 people are diagnosed with soft tissue sarcoma in the United States each year and about 2,900 people are diagnosed with bone and joint sarcoma, with almost half of them under the age of 35. I haven’t met older patients with sarcoma, but I have read that sarcoma has been found in patients as old as 71. Sarcoma, like most cancers, do not discriminate based on age, gender, race, language, or ethnicity.
Depending on the stage and type of cancer, doctors will first perform a biopsy to confirm the diagnosis before surgery. If the tumor cannot be removed, the patient will have to undergo chemotherapy and radiation therapy to try to reduce the size of the tumor and kill any remaining cancer cells. These therapies consist of a specific number of treatments or cycles, based on the type and aggressiveness of the sarcoma, given over a set period of time. Patients also have to battle side effects and symptoms depending on the drug and the dose. To find the most effective treatments, doctors may run tests to identify the genes, proteins, and other factors in the tumor. There are people for whom treatments have not been successful, in which case the disease may be called advanced or terminal cancer. When the doctors are ready to give this diagnosis to families, this situation is stressful and difficult for everyone. Throughout this process, from diagnosis to treatment and beyond, is where health care and palliative care teams, including Medical Interpreters, have the necessary skills, experience, and knowledge to support our patients and their families in a culturally appropriate way.