What is cancer?
Cancer is a word that is often used but not fully understood until it affects us or someone we love. It is a disease caused by the uncontrolled growth of abnormal cells in the body. These cells can multiply and form tumors, which can invade nearby tissues and organs and spread to other parts of the body. Despite the advances in medical research and treatment, we still have a lot to learn about cancer and how it affects us. More research is needed to better understand this disease and find ways to prevent and treat it.
How cancer begins
Cells are the basic units that make up the human body. Cells grow and divide to make new cells as the body needs them. Usually, cells die when they get too old or damaged. Then, new cells take their place. Cancer begins when genetic changes interfere with this orderly process. Cells start to grow uncontrollably. These cells may form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. Some types of cancer do not form a tumor. These include leukemias, most types of lymphoma, and myeloma.
Types of cancer
Doctors divide cancer into types based on where it begins. Four main types of cancer are: Carcinomas. A carcinoma begins in the skin or the tissue that covers the surface of internal organs and glands. Carcinomas usually form solid tumors. They are the most common type of cancer. Examples of carcinomas include prostate cancer, breast cancer, lung cancer, and colorectal cancer. Sarcomas. A sarcoma begins in the tissues that support and connect the body. A sarcoma can develop in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartilage, or bone. Leukemias. Leukemia is a cancer of the blood. Leukemia begins when healthy blood cells change and grow uncontrollably. The 4 main types of leukemia are acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myeloid leukemia, and chronic myeloid leukemia. Lymphomas. Lymphoma is a cancer that begins in the lymphatic system. The lymphatic system is a network of vessels and glands that help fight infection. There are 2 main types of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphoma.
When cancer spreads
A cancer that has spread from the place where it first formed to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis. Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer. Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes. In some cases, treatment may help prolong the lives of people with metastatic cancer. In other cases, the primary goal of treatment for metastatic cancer is to control the growth of the cancer or to relieve symptoms it is causing. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.
Diagnosing cancer
Often, a diagnosis begins when a person visits a doctor about an unusual symptom. The doctor will talk with the person about his or her medical history and symptoms. Then the doctor will do various tests to find out the cause of these symptoms. But many people with cancer have no symptoms. For these people, cancer is diagnosed during a medical test for another issue or condition. Sometimes a doctor finds cancer after a screening test in an otherwise healthy person. Examples of screening tests include colonoscopy, mammography, and a Pap test. A person may need more tests to confirm or disprove the result of the screening test. For most cancers, a biopsy is the only way to make a definite diagnosis. A biopsy is the removal of a small amount of tissue for further study.
Further Reading
What are Soft Tissue Sarcomas?
Sarcomas are rare tumors that develop in tissue, like bone or muscle. There are more than 70 subtypes of sarcoma cancers. Soft tissue sarcomas develop in soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues.
Undifferentiated Pleomorphic Sarcoma
Soft tissue sarcomas can usually be accurately diagnosed as a certain type. This is based on the type of cell the sarcoma starts from. But sometimes it is not clear which cell the sarcoma starts from. This type of sarcoma is known as an undifferentiated pleomorphic sarcoma (UPS), also sometimes referred to as a soft tissue sarcoma NOS (not otherwise specified).
UPS can occur anywhere throughout the body. It can occur at any age but is one of the more common sarcomas that affects older people. UPS affects both males and females equally.
Signs & Symptoms
Symptoms of UPS can vary depending on the size and location of your tumour. One may experience all, some or none of these symptoms before being diagnosed with UPS: - A lump or swelling within the soft tissue of the body, which can occur anywhere in the body - This lump is often fast-growing and can be painful
Diagnosis
A specialist doctor will diagnose UPS through a series of tests. These may include: - Physical examination – looking at and feeling any lump - A scan – taking pictures of the inside of the body using scans such as ultrasound, x-ray, CT, MRI or PET scans - A biopsy – taking and testing a sample of the tumour. UPS is a “diagnosis of exclusion”. This means that the tumour shows no identifiable characteristics for the doctors to be able to diagnose it as a specific sarcoma type. A doctor will look to see if the biopsy looks like a specific sarcoma subtype and if it doesn’t, then it will be diagnosed as UPS
Treatment
Surgery: - The first treatment method for UPS is surgery. The surgeon will remove the tumour and will aim to take out an area of normal tissue too – this is known as “taking a margin”. This is to make sure that all of the cancer has been removed - When UPS affects the arms and legs, surgeons will do limb-sparing surgery so that the limb can continue to work well - Although very rare, if the cancer has spread throughout the limb, then the surgeons may have to perform a partial or full amputation to stop the cancer. Radiotherapy: - This treatment uses high-energy radiation to destroy cancer cells - It can be used either before or after surgery - When used before surgery, radiotherapy aims to make the tumour smaller so that it can be more easily removed - When used after surgery, radiotherapy aims to kill off any remaining cancer cells that have not been removed by surgery Chemotherapy: - This treatment uses anti-cancer drugs to destroy cancer cells. It is sometimes used in patients that have a high risk of the cancer coming back or if it has spread to other parts of the body, also known as “metastasis” Targeted and experimental therapies: In UPS, researchers have been learning more about treatments known as “targeted therapies” and “immunotherapies” Targeted therapy is a treatment that targets specific characteristics within cancer cells in order to stop them from growing and spreading. Immunotherapy is a treatment that helps the person’s own immune system to fight and kill cancer cells. Researchers have found that some targeted therapies and immunotherapies worked well in clinical trials of UPS. But, more research and trials are needed before these treatments are approved Clinical Trials: Sometimes there is the opportunity to join a clinical trial.
After treatment
After treatment, the patient will have regular follow-up appointments for several years. The follow-ups will usually include: - A chance to discuss symptoms - An examination to look for any signs of UPS returning. This may include scans such as CT or MRI scans - A chest x-ray to rule out any secondary cancers occurring in the lungs
Living with
UPS can reappear in the same area after the treatment of a previous tumour; this is called a “local recurrence”. If the cancer does reappear, it is important to get treated as quickly as possible. This could involve further surgery and/or radiotherapy; the treatment will be assessed on an individual basis. It is useful to check for recurrences oneself through self-examination: a doctor or sarcoma clinical nurse specialist can tell the patient what to look for. If the patient is worried about your cancer returning, they can contact their doctor or nurse. They may decide to bring forward the date of the follow-up appointment to investigate any concerns. What if the cancer spreads to another part of my body? A recurrence of UPS may be accompanied by cancer in other parts of the body. This is called “metastasis” or “secondary cancer”. Some people are diagnosed with sarcoma because their metastases have been discovered before their primary UPS tumour. In UPS patients, these secondary cancers may appear in the lungs, which is why a chest x-ray is taken at follow-up appointments. Secondary cancers may also appear in the lymph nodes and bones. Treatment for secondary cancer may involve surgery, radiotherapy or other therapy as appropriate; your treatment will be assessed on an individual basis.
Further Reading
