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MULTI-DISCIPLINARY EXCELLENCE

Our approach to cancer care is best defined by our unique Cancer Management Teams (CMTs). We believe that cancer is a complex enemy; conquering it demands the coming together of the finest experts in specific cancer groups.

Each CMT, at the Apollo Proton Cancer Centre, is made up of specialists who straddle diverse disciplines like Surgery, Radiation & Medical Oncology, Pathology, Rehabilitation and several others. A CMT is further fortified by world-class support staff like nurses, dieticians, therapists and clinical trial coordinators. These experts play a pivotal role in drawing up the treatment blueprint based on vast experience, the unique needs of the patients and the collective expertise of the team.

Sarcoma CMT

TACKLING THE THREAT OF COMPLEX SARCOMAS

A sarcoma is a type of cancer that develops from certain tissues, like bone or muscle. Bone and soft tissue sarcomas are the main types of sarcoma. Soft tissue sarcomas can develop from soft tissues like fat, muscle, nerves, fibrous tissues, blood vessels, or deep skin tissues.

Sarcoma is rare – about one out of 100 cases of adult cancer is sarcoma. There are more than 50 kinds of sarcoma and grouped into two main categories: soft-tissue sarcoma and bone sarcoma.

 

Sarcoma Risk Factors

The following factors can increase your risk of sarcoma:​

 

Bone Cancer Facts

Bone cancer is a sarcoma that starts in the bone. To understand bone cancer it is important to have an idea of how bones are structured. Bones support the body and they usually are hollow. The main parts of the bones are:

Matrix is the outer part of bones. It is made of fiber-like tissue and is covered with a layer of tissue called the periosteum.

Bone marrow is the soft tissue in the space in hollow bones called the medullary cavity. Cells inside bone marrow include fat cells, red blood cells, white blood cells and platelets, connective tissue and Plasma (in which blood cells are suspended).

Cartilage is at the end of most bones. It is softer than bone, but it is firmer than soft tissue. Cartilage and other tissues, including ligaments, make up joints, which connect some bones.

 

Bone Cancer Types

There are several types of bone tumours. They are named according to the area of bone or tissue where they start and the type of cells they contain. The most commonly found types of primary bone cancer are:

Osteosarcoma or osteogenic sarcoma is the main type of bone cancer. It occurs most often in children and adolescents, and it accounts for about one-fourth of bone cancer in adults. More males than females get this cancer. It begins in bone cells, usually in the pelvis, arms or legs, especially the area around the knee.

Chondrosarcoma is cancer of cartilage cells. More than 40% of adult bone cancer is chondrosarcoma, making it the most prevalent bone cancer in adults. The average age of diagnosis is 51, and 70% of cases are in patients over 40. Chondrosarcoma tends to be diagnosed at an early stage and often is low grade. Many chondrosarcoma tumours are benign (not cancer). Tumours can develop anywhere in the body where there is cartilage, especially the pelvis, leg or arm.

Ewing's sarcoma is the second most prevalent type of bone cancer in children and adolescents, and the third most often found in adults. It accounts for about 8% of bone cancers in adults. Ewing's sarcoma can start in bones, tissues or organs, especially the pelvis, chest wall, legs or arms.

Secondary (or metastatic) bone cancer is cancer that spreads to the bone from another part of the body. This type of bone cancer is more prevalent than primary bone cancer.

 

Soft Tissue Sarcoma Facts

Sarcomas can start anywhere in the body. Typically, they develop in the soft tissues that surround, connect or support the body’s structure and organs. This includes muscles, joints, tendons, fat, blood vessels, nerves and tissues. They also can begin in the body’s organs.

Types

Some soft-tissue sarcomas are benign (not cancer), and others are malignant (cancer). There are more than 30 types of sarcoma, making each extremely rare. Sarcomas are classified into groups that have similar types of cancer cells and symptoms. They usually are named for the type of tissue where they start. Sarcomas within a classification often are treated the same way.

Sarcomas of uncertain tissue type: In this type of sarcoma, doctors are not able to determine the exact type of tissue where the cancer began.

 

Soft Tissue Sarcoma Risk Factors

Anything that increases your chance of getting cancer is a risk factor. For sarcoma, risk factors include:

Bone cancer Symptoms

In most cases, sarcoma does not have symptoms in the early stages. If symptoms are present, they may include:

 

Soft Tissue Sarcoma Symptoms

Signs of sarcoma vary from person to person. Many times sarcoma does not have symptoms in the early stages. Only about half of soft-tissue sarcomas are found in the early stages before they spread.

The location of the sarcoma makes a difference in the symptoms. For instance if they start:

If you have any of the following problems, talk to your doctor:

These symptoms do not always mean you have sarcoma. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.

Accurate diagnosis is the essential first step for the successful treatment of bone cancer. A biopsy is critical to determine the presence of bone cancer and also to know sure if it is benign or malignant.


Imaging

This may include:


APCC is one of the most active sarcoma treatment centres in the world. APCC’s Bone and Soft Tissue CMT surgeons see only sarcoma patients.

This acute specialisation results in a high level of expertise and experience that translates to a higher chance for successful treatment.

The treatment modalities recommended for sarcoma are customized to the particular needs of the patient. One or more of the following therapies may be recommended to treat bone cancer or help relieve symptoms.

 

Surgery

Surgery is the main treatment for most sarcomas. The goal of surgery is to remove as much of the cancer as possible. If any cancer cells remain, they may grow and spread. To get as much of the cancer as possible, the surgeon performs a wide-excision surgery. This involves removing the cancer, as well as a margin of healthy tissue around it.

If the tumour is in an arm or leg, the surgeon almost always is able to perform limb-sparing surgery, which removes the cancer cells but allows you to keep full use of your leg or arm. To replace the bone that is removed during surgery, a bone graft may be done or an internal device called an endoprosthesis may be implanted.

If this is not possible, an amputation, or removal of the limb, may be performed. Reconstructive surgery and/or prosthesis will be needed. Rehabilitation is necessary after either procedure.

 

Radiation Therapy

New radiation therapy techniques and remarkable skill allow APCC doctors to target tumours more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

 

Proton Therapy

Proton therapy delivers high radiation doses directly into the tumour, sparing nearby healthy tissue and vital organs. Potentially higher doses of radiation and a low incidence of side effects are what make proton therapy an option worth considering for bone tumours, like osteosarcoma and Ewing sarcoma. In cases where complete removal of a bone tumour is not possible, proton therapy may be used to treat tumours without exposing surrounding tissues to high doses of radiation. It is particularly suitable for paediatric bone cancers where even low doses of radiation may result in significant late complications.

 

Targeted Therapy

These newer agents are used to help fight some types of sarcomas. Targeted therapies attack cancer cells by using small molecules to block pathways that cells use to survive and multiply.


Chemotherapy

Chemotherapy may be recommended to treat osteosarcoma or Ewing’s sarcoma. In osteosarcoma, it is often given before surgery to shrink the tumour and make it easier to remove and after surgery to destroy remaining cancer cells. Chemotherapy is also used for bone cancer that has metastasized (spread) to the lungs or other organs.

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