Muscle cancer in medicine is called myosarcoma, and connective - sarcoma. Similar cellular structures in the human body are almost everywhere, due to which the tumor process can start in a variety of organs. On average, among oncological pathologies in adults in our country, this option accounts for 0.7% of cases. For children, the indicators are significantly higher - up to 6.5%, which makes the disease the fifth oncological in frequency of occurrence. A distinctive feature is rapid aggressive growth and a tendency to quickly metastasize. In addition, such a cancer has an increased risk of relapse, even if a successful operation has already been performed. This is especially characteristic of juvenile patients.
What provokes?
Soft tissue cancer in children and adults can occur for a variety of reasons. So far, several risk factors have been identified, but a complete list of the phenomena initiating the disaster has not been formulated. It has been established that ionizing rays as well as ultraviolet can have a strong effect. It was found that more often the sarcoma bothers those who have previously undergone treatment with radiation or chemicals.
It is more likely to find out for yourself what cancer of the soft tissues of the legs, trunk, and other parts of the body is, if, due to work, a person is forced to regularly contact with carcinogens. Failures in the functioning of the immune system, HIV and genetic factors can lead to similar results. It has been established that in the presence of people with sarcoma among blood relatives, a person faces an increased risk of developing the disease. In addition, among patients there are people who previously had lymph nodes removed, as well as those who previously suffered from benign neoplasms.
Types and Forms
In modern medicine, a soft tissue cancer classification system has been introduced. If other types of malignant diseases are localized in a specific organ, then the sarcoma is distinguished by the unpredictability of its location. On average, approximately half of all cases occur in the limbs, up to 40% of patients suffer from cancerous processes in different parts of the body. In every tenth case, sarcoma is detected on the head, neck. Significantly less often, the pathology is localized in the stomach or intestinal tract.
Among other varieties, angiosarcomas formed by the cellular vascular structures of the lymph and circulatory system are distinguished. Embryonic cells can become the basis for the development of mesenchymoma. From fat cells, liposarcoma can begin to grow, and from striated skeleton muscles, rhabdomyosarcoma. Finally, leiomyosarcoma is initiated in smooth muscle fibers. Such a neoplasm is formed in a variety of internal organs. Among other areas of localization, the more common ones are: uterus, intestine, stomach. Fibrous tissue can be the foundation for the development of histiocytomas, starting from ligamentous tissue and tendons.
In total, modern doctors know about fifty varieties of soft tissue cancer. Among adult patients, approximately 40% of cases are histiocytoma, liposarcoma. In children, malignant processes in skeletal muscle are much more common.
Step by step
The development of the pathological process in the study is evaluated not only by the area of localization (for example, striated muscles), but also by the level of progress of the condition. The determination of the stage is possible after clarifying the dimensions of the neoplasm, identifying metastases located nearby and in remote parts of the body. Damage to the lymphatic system in the periphery is possible. In addition, it is necessary to accurately establish the level of malignancy of the process. In many ways, it follows from the stage how the disease should be treated.
Examining the case of cancer of the soft tissues of the neck, trunk, limbs, in clinical conditions, determine the dimensions of the primary focus. To do this, you need to do an ultrasound examination, x- ray, MRI, CT. To evaluate malignancy, tissue samples are taken during biopsy, which are then analyzed under a microscope. The level of damage to the lymphatic system and the presence of widespread metastasis is rather difficult to determine; one has to turn to numerous methods and methods of analyzing the condition. Specific ones are selected based on the nuances of the location of the primary focus, the patient's condition and the characteristics of the process.
WHO, UICC, AJCC: on categorization
Currently, the study and grouping of all cases of cancer of the soft tissues of the thigh, trunk, head and other areas of localization is based on the system adopted in 2011, which is recommended for use at the world level. 1A is a designation of a low level of malignancy. This category includes processes with sizes less than 5 cm, the lymphatic system is normal. 1B is also a malignant process without disturbing the lymphatic structure, but the dimensions of the focus exceed 5 cm.
Stage of soft tissue cancer 2A - a condition in which the level of malignancy is average, dimensions do not exceed 5 cm, the lymphatic system is normal, distant metastases cannot be detected. Similar process parameters, but a high level of malignancy, allow sarcoma to be assigned to group 3A. 3B - a class that is characterized by a high level of malignancy, but the lymphatic system is normal, the process has not spread to distant parts of the organ, while the neoplasm is more than 5 cm in size.
Finally, stage 4 of soft tissue cancer is an oncological disease complicated by damage to the lymphatic system. Studies can determine distant metastases. One of these symptoms is possible or both at once. The dimensions of the tumor and the level of its malignancy do not play a role in determining whether a case belongs to the fourth stage.
How is everything going?
The identification of signs of soft tissue cancer is due to information about the processes that occur as the pathology progresses. It was established that the influence of aggressive factors leads to cell mutation and uncontrolled reproduction of structures. The focus gradually increases, embracing nearby tissues and initiating destructive processes in them. From the studies it is clear that in many cases a pseudocapsule is formed. It is not a restriction on the spread of the tumor, typical cells go beyond that area. There may be several foci of growth. This, in particular, is inherent in rhabdomyosarcoma.
Soft tissue cancer spreads with the bloodstream, metastases mainly move hematogenously. Most often, the area of localization is the respiratory system. In approximately 1-2 patients, out of every ten patients, lesions of nearby lymph nodes are detected.
Features of the disease
Doctors, examining sarcomas, identifying their features, formulating what it is (uterine leiomyomas, rhabdomyoma, lipo, angiosarcomas and other types), found that in an impressive percentage of cases, successful surgery does not mean complete recovery of the person: the process is prone to re-start.
Symptomatology
The first symptom of soft tissue cancer is the formation of a tumor. At first, the disease does not bother the pain, but gradually the neoplasm becomes larger. In many cases, studies reveal a pseudocapsule. Often, trauma and a tumor process may be associated. In some cases, pain is worried. It depends on the area of localization of the neoplasm and its dimensions. As observations have shown, different patients form a variety of malignant formations. In some they are round, in others they resemble a spindle. Infiltrative growth gives blurred boundaries.
Feeling the affected area allows you to feel the density and elasticity of the area. If the process has progressed significantly, softening of the structures is possible, indicating tissue decomposition. If the lesion is large, ulceration zones may appear on the skin above the tumor. In the predominant percentage of cases, the site is motionless or has low mobility, a connection with the bone system occurs. Perhaps a violation of the functionality of the limbs (depending on localization).
Note
Sometimes the symptoms make it possible to understand that a pathology of the internal organs is developing - for example, uterine leiomyoma. What is it, the doctor will tell after making an accurate diagnosis. Malignant processes localized in the connective tissues of various organs, the space behind the peritoneum, can provoke non-standard symptoms of the process. Much is determined by the location and dimensions of the pathology, the ability of atypical structures to spread to nearby healthy ones.
Uterine leiomyosarcoma, in particular, often initiates bleeding. Women suffering from cancer note soreness and the duration of the menstrual cycle. If the intestinal tract is affected, the first manifestation of the pathology may be obstruction of the organ - at first partial, gradually progressing to absolute.
According to statistics, up to 87% of patients go to the clinic when the process has gone far. The best predictions, of course, are for those who started treatment for soft tissue cancer in a timely manner. To minimize the risk, with suspicious symptoms, you must immediately undergo a full examination, excluding or able to confirm oncological processes.
Special case: Ewing's sarcoma
What this disease can tell any oncologist: the term refers to oncological processes that occur in the skeleton. The most common area of localization is limbs. Possible malignant foci in the clavicle, spine, pelvic skeletal area. The disease was first identified in 1921 by the scientist Ewing, in whose honor the pathology is now called. Currently, among all malignant processes, it is she who is considered one of the most aggressive.
The presence of metastases can be detected in almost half of patients whose treatment at the clinic allowed them to detect Ewing's sarcoma. What kind of disease is this, more often children by five years of age recognize themselves. Very rarely, pathology occurs in people older than 30 years. The greatest risks are in the age group of 10-15 years. More often the disease occurs in boys. White children are at great risk among all races.
Diagnosis
If you suspect a sarcoma, you need to get an appointment to a specialized clinic as soon as possible. When revealing the tumor process of the patient, they are sent for analyzes, allowing to clarify the dimensions and the area of the focus. To do this, you need to do an ultrasound, CT, MRI, x-ray. The maximum of useful information is believed to be obtained during an MRI. In some cases, angiography is shown to clarify the features of the blood supply to the area, as well as the relationship with the vascular system.
In the diagnosis can not do without a biopsy of the site. This helps to identify atypical cellular features of the area and the level of malignancy of the process. Assessing the results of a biopsy, the case is considered at a certain stage, and a therapeutic course is being developed. The most useful biopsy will be if the doctors have enough material for research. As a rule, a technique for electron microscopy is needed.
How to treat?
If possible, the patient is prescribed a radical surgical intervention, during which both the tumor focus and the tissue structures are removed from the body. A resection is possible during which the tumor is removed. After surgical measures, a course of exposure is indicated. Perhaps the appointment of a comprehensive program that includes chemicals. Sometimes radiation is done before surgery.
It is noted that wide resections aimed at preserving the organ, combined with chemotherapy before and / or after the intervention, give good results for the future, even if the level of malignancy is high. Local expressed control gives such an approach in the case when cancer processes are localized in the neck, head, and trunk. The most difficult to treat pathologies in the retroperitoneal space. As a rule, it is impossible or very difficult to remove the focus here, serious restrictions are imposed on the irradiation course, since it is not always possible to use doses that are effective against atypical cells.
The nuances of therapy
In certain cases, it is shown before the operation to take a course of application of chemical pharmaceutical products, radiation. Events are aimed at reducing the size of the outbreak, increasing the possibility of events with the maximum preservation of the body. After surgery continue irradiation.
In the fourth stage of cancer, they resort to surgery if it is possible to remove metastases formed in the lungs from the body. The initial focus is not always operable. Removal of metastases, even if it is not possible to carry out an operation in the root cause, can increase the survival period. Cases of complete cure are known, although their frequency is quite small. More often this is possible when the metastases in the lungs are isolated, localized in such a way that surgical removal is not particularly difficult. The best opportunities in patients who do not have the spread of the oncological process to the mediastinal lymph nodes, there is no pleural effusion. In addition, it is important that there are no contraindications for the operation in the sternum.
Treatment: choosing a course is not easy
Choosing the possible means for chemical drug treatment, the doctor focuses on the features, type of oncological pathology, level of malignancy, area of localization. The general condition of the patient plays a role. Correctly, a well-chosen course, even with the running process, can significantly increase the patient's survival period, improve the quality of everyday life.
Chemotherapy of cancer processes localized in soft tissues has been actively changing in recent decades. Today, different approaches to the formation of drug combinations are practiced. It became known a lot about the nuances of the structure and effectiveness of the therapeutic course in certain varieties. Good prospects are associated with developments for targeted treatment.
Targeted medications specifically target molecular targets. The interaction takes place directly in typical cells, while healthy structures remain intact. Active work is underway to assess the effectiveness and safety of using such a group of medicines. The possibilities of prescribing many recently appeared drugs are expanding: both for using drugs on their own, and for including them in a combined course.
What to count on?
The prognosis is determined by a complex of factors: age-related features, dimensions of the neoplasm, its level of malignancy. An important stage at which treatment of the disease began. Worst forecasts are characteristic of the case when a person is over 60 years old. Great risks are associated with the presence of a tumor more than five centimeters in diameter and an increased level of malignancy.
Five-year survival in the first stage is estimated at more than 50%. With the prevalence of the oncological process, indicators decrease to 10%, and in some cases even less.