Soft Tissue Sarcoma

Soft Tissue Sarcoma

Soft tissue sarcomas are malignant (cancerous) tumors that start in the soft tissues. These tumors can grow in soft tissue in any part of the body , but generally appear in the stomach, arms and legs.

Soft tissue is tissue that supports and connects structures around the body. Tissues that are included in soft tissue include fat, muscle, blood vessels, nerves, tendons, bones, and joints.

Soft tissue sarcoma can affect all ages, but is more common in middle age and the elderly. A person's risk of developing soft tissue sarcoma also increases with age.

Types of Soft Tissue Sarcomas

Based on the location of the appearance of cancer cells, soft tissue sarcomas are divided into the following types:

  • Angiosarcoma , which can form in lymph vessels or in blood vessels
  • Chondrosarcoma, which forms in cartilage tissue
  • Gastrointestinal stromal tumor , which forms in the digestive tract
  • Leiomyosarcoma , which forms in smooth muscle tissue
  • Liposarcoma , which forms in fatty tissue
  • Neurofibrosarcoma , which forms in the peripheral nerve sheaths
  • Rhabdomyosarcoma , which forms in skeletal muscle tissue
  • Askin's tumor , which forms from the soft tissue in the chest cavity

Causes of Soft Tissue Sarcoma

Cancer occurs when the DNA in cells undergoes mutations or changes, so that cells grow abnormally and uncontrollably. These abnormal cells then form tumors that can spread and invade other parts of the body.

It is not yet known what causes these cells to mutate. However, there are several factors that can increase a person's risk of developing soft tissue sarcoma, namely:

  • Have a genetic disorder passed down from your parents, such as neurofibromatosis, hereditary retinoblastoma , Li-Fraumeni syndrome, Gardner syndrome, tuberous sclerosis , or familial adenomatous polyposis
  • Exposure to radiation for a long time, for example from treating cancer with radiotherapy or working in an environment with high radiation
  • Exposure to chemicals for a long time, such as arsenic , dioxins, and herbicides
  • Aged

Symptoms of Soft Tissue Sarcoma

In its early stages, soft tissue sarcoma generally doesn't cause any signs or symptoms. However, when the tumor gets bigger, symptoms can appear with different characteristics, depending on where the tumor grows.

The following are examples of symptoms that can occur:

  • Abdominal pain and constipation, if the tumor grows in the soft tissue of the intestine
  • Cough and shortness of breath, if the tumor grows in the soft tissue around the lung
  • A solid, firm (hard to move) lump that is painless but can visibly enlarge over time, if the tumor grows in soft tissue near the surface of the skin

When to see a doctor

Although not all lumps are cancer, you still need to consult a doctor if you notice a lump anywhere on your body. Immediately do an examination to the doctor if a lump appears that is getting bigger, is located a little deeper, causes pain, or reappears after being removed.

Diagnosis of Soft Tissue Sarcoma

The doctor will ask about the patient's symptoms, followed by a physical examination of the lump. After that, the doctor will carry out supporting examinations to confirm the diagnosis, such as:

  • Scanning with X-rays, CT scans , MRI, or PET scans on parts of the body that are suspected of having a tumor
  • Biopsy or taking samples of tumor tissue using a needle ( core needle biopsy ) or through open surgery, to determine whether the tumor is malignant and to determine the type of tumor

From the results of the examination above, the doctor can determine the severity (stage) or spread of soft tissue sarcoma. This will help the doctor in choosing the right method of treatment.

The severity or stage of soft tissue sarcoma can be divided into:

  • Stage 1A
    At this stage, the tumor measures ≤ 5 cm, with a slow growth rate and has not spread to the lymph nodes or other organs.
  • Stage 1B
    Stage 1B indicates that the tumor can be up to > 15 cm in size, but the tumor is still growing slowly and has not spread to the lymph nodes or other organs.
  • Stage 2
    In stage 2, the tumor is ≤ 5 cm in size, appears to be growing and spreading very quickly, but has not spread to the lymph nodes or other organs.
  • Stage 3A
    In stage 3A, the tumor is 6–10 cm in size, appears to be growing rapidly, but has not spread to the lymph nodes or other organs.
  • Stage 3B
    Stage 3B indicates that the tumor is > 5 cm in size, looks like it can grow and spread very quickly, but has not spread to the lymph nodes or other organs.
  • Stage 4
    At this stage, the tumor can be of any size and has spread to the nearest lymph tissue or has spread to distant organs, such as the lungs.

Soft Tissue Sarcoma Treatment

Treatment of soft tissue sarcoma depends on the type, location, and size of the tumor. Some of the treatment methods that can be done are:

Surgical procedure

Soft tissue sarcomas can be treated by surgical removal of the tumor. The tissue around the tumor will also be partially removed to ensure that no cancerous tissue is left behind.

However, in some cases, soft tissue sarcomas can be very large and located on the feet or hands. Surgical procedures to remove these tumors can require amputation or cause disability. In cases like this, the doctor may choose another treatment method first.


Chemotherapy is the administration of drugs to kill cancer cells, especially in cases of soft tissue sarcoma that has spread. Some types of soft tissue sarcoma also respond better to chemotherapy, for example rhabdomyosarcoma .

Chemotherapy drugs can be given in pill form or through an IV. Types of chemotherapy drugs used include:

  • Docetaxel
  • Ifosfamide
  • Gemcitabine

Chemotherapy can also be done before surgery to reduce the size of the cancer to make it easier to remove, or after surgery, to make sure all the cancer cells are gone. However, if the sarcoma cannot be removed surgically, the doctor will combine chemotherapy with radiotherapy to treat it.


Radiotherapy is a therapy to destroy cancer cells using high-energy rays, such as X-rays or gamma rays . Radiotherapy can be done in three options, namely:

  • Before surgery, to shrink the tumor so that it can be easily removed
  • During surgery ( intraoperative radiation ), to minimize radiation damage to healthy tissue around the cancer
  • After surgery, to kill any remaining cancer cells

Radiotherapy can also be used to slow the development of sarcomas when surgery is not possible.

Target therapy

Targeted therapy specifically attacks certain genes or proteins that play a role in the development of cancer cells. This therapy aims to prevent cancer cells from growing while reducing damage to healthy cells.

Some types of drugs used in targeted therapy are:

  • Imatinib
  • Pexidartinib
  • Tazemetostat

Complications of Soft Tissue Sarcoma

Complications that arise from soft tissue sarcoma depend on the size and location of the cancer. Considering that soft tissue sarcomas can occur in any part of the body, large tumors can cause various disorders, for example:

  • The tumor is pressing on the nerves and causing intense pain
  • The tumor presses on blood vessels and blocks blood flow to healthy tissues or organs
  • The tumor presses on the intestine and causes an obstruction in the intestine

Tumors can also spread and damage nearby or even distant tissues. In addition, soft tissue sarcomas from any part of the body can form new tumors in vital organs, such as the brain, bones, lungs, and liver, and cause organ damage that can be life threatening to the sufferer.

The patient's chance to recover will be more difficult if the sarcoma has spread. However, treatment can be given to relieve symptoms and slow the spread of the cancer.

Soft Tissue Sarcoma Prevention

While soft tissue sarcoma cannot be completely prevented, you can lower your risk of developing this disease by doing the following:

  • Avoid radiation exposure
  • Avoid exposure to chemicals
  • Check with your doctor if you have a genetic disorder

It is important to remember, sarcomas detected at an early stage have a greater chance of recovery. Conversely, the larger the size of the sarcoma and the higher the stage, the greater the possibility of the sarcoma spreading to other organs or recurring after being treated.

Back to blog