Sarcomas - This Battle Which I Must Fight: Cancer in Canada's Children and Teenagers

SARCOMAS

Sarcomas are malignant tumours that arise from muscles, bones, nerves, fat, blood vessels or connective tissue. Each year in Canada, approximately 140 young people are diagnosed with a tumour of soft tissue or bone (Table 1). These tumours account for 12 percent of malignancies in the young, and they occur 25 to 30 percent more often among boys than girls. Slightly more than half arise in soft tissue, the remainder in bone.

Few risk factors for sarcoma have been identified. Radiation therapy for another childhood cancer may induce sarcoma;(111) however, this is less likely now than it was in the past when radiation doses were higher. Heredity may be a predisposing factor. (59,65,76,106)

Treatment of children and teenagers with sarcoma varies with the type, location and extent of spread of the tumour. It usually involves surgery and chemotherapy with or without radiation therapy. In the past, amputation of a large portion of a limb was the only way to achieve complete removal of a sarcoma in the arm or leg. Now there are surgical options that allow many children and teenagers to retain more or all of the affected limb.(52,72,81)

The five-year survival rate for sarcoma depends largely upon where the tumour arose, the extent of the disease at diagnosis and whether the tumour can be removed completely.

Soft Tissue Sarcoma
A soft tissue sarcoma can arise in the soft tissues anywhere in the body. Rhabdomyosarcoma accounts for half, and fibrosarcoma for slightly less than 20 percent, of soft tissue tumours in childhood and adolescence. In Canada, almost 70 percent of children and teenagers diagnosed with a soft tissue tumour between 1985 and 1988 were alive five years after diagnosis (Table 7).

Bone Sarcoma
Osteosarcoma and Ewings sarcoma respectively account for 54 and 36 percent of malignant tumours that originate in bone in this age group. The first symptom of a bone tumour is usually pain or a lump. Sometimes pain in a limb from overuse or injury calls attention to the tumour. Occasionally the first sign is a fracture of a bone weakened by the tumour. Pressure by the tumour on adjacent structures in the body or spread to other regions of the body can cause other symptoms. In Canada, over 60 percent of children and teenagers diagnosed with a bone tumour between 1985 and 1988 were alive five years after diagnosis (Table 7).

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