Sarcomas are rare and complex cancers that are often difficult to diagnose and challenging to treat. They require treatment by specialists with extensive experience—that’s why it's important to go to a cancer center with a team dedicated to treating them.
Sarcoma is a rare type of cancer that forms tumors in connective tissues, such as bones, muscles, blood vessels, cartilage, fat, ligaments, lymph vessels, nerves, and tendons. Connective tissues are the structures that hold the body together while storing fat, moving nutrients, stopping disease, and supporting repairs.
Sarcomas can arise in bone or soft tissue in many locations across the body, but most often occur in the arms and legs. They may form near the skin’s surface, but are frequently hidden deep within the muscles.
Sarcomas affect people of all ages, making up 15 percent of pediatric cancers and just 1 percent of adult cancers. Each year, doctors diagnose about 15,000 sarcomas.
There are dozens of different subtypes of sarcomas. Some grow slowly, while others are more aggressive. All sarcomas can metastasize (spread), most often to the lungs. Because sarcomas are so diverse, each tumor requires an individualized plan and expert care.
- Bone sarcomas: These cancers start in bones. There are approximately 10 to 12 types of bone sarcomas, with 3,000 to 4,000 new cases a year. While most of these cancers are diagnosed in children and young adults, some types specifically affect older adults. They can occur in the arms, legs, ribs, pelvis, spine, and base of the skull. Bone sarcomas are more rare than soft tissue sarcomas but are often easier to detect because they typically cause pain.
- Soft tissue sarcomas: These connective tissue cancers are more common in adults, with 11,000 to 12,000 new cases a year. There are more than 50 types of soft tissue sarcoma. They’re found most frequently in the arms and legs and the retroperitoneum (back half of the abdomen, or belly). Other locations include the chest wall, uterus, pelvis, buttocks, spine, and head and neck. Because soft tissue sarcomas are often not painful, you might think a growing lump is not serious, however, you should get all new growths evaluated.
Sarcoma Symptoms and Warning Signs
Sarcoma symptoms may not start until the tumor grows fairly large. Symptoms are more likely to occur when cancer destroys bone than when it just forms a lump. When people do experience early symptoms of sarcoma, they may include:
Sarcomas of the Bone
- Consistent pain that gets worse over time—in the spine, pain may come from tumors pressing on nerves and may be felt in the arms and legs
- Fractures
- An enlarging lump near the bone
Sarcomas of Arm and Leg Soft Tissues
- Lumps that are generally painless—soft tissue sarcomas rarely cause pain
- A lump that doesn’t go away or grows over time
- Bumps that feel firm and can’t be easily moved by pressing on them
- Lumps that have reached golf ball size (though sarcomas can also be pea-sized)
- Lumps that sit deeper inside tissue, rather than near the skin
Sarcomas of the Retroperitoneum
- Belly or back pain that doesn’t go away
- Bloated or expanded belly
- Blood in stool
- Feeling full sooner while eating
- Loss of appetite
- Unusual bladder or bowel function that doesn’t go away
- Unintended weight loss
Sarcoma Causes and Risk Factors
Doctors and scientists don’t yet know what causes most types of sarcoma. However, there are known factors that can increase your risk of developing this form of cancer including certain bone diseases, chemical exposure, some genetic syndromes, lymphedema, and previous radiation or chemotherapy treatment.
Sarcoma Care at Penn Medicine
If you or your doctor suspect you may have sarcoma, our staff will work to get you an appointment as soon as possible.
Once your appointment is scheduled, a nurse coordinator will reach out to gather more information on the type of care you’ve already had and obtain any needed medical records. If your imaging studies are already in the Penn Medicine system or can be electronically imported, we may be able to perform a biopsy at your first appointment. If not, we will use your first appointment to conduct the necessary imaging studies.
You can expect full support through each stage of your sarcoma care:
Diagnosis: Doctors who don’t see many sarcomas may overlook or misdiagnose them. Even an accurate diagnosis may take several weeks. Our radiologists and pathologists are extremely experienced in accurately and quickly interpreting scans and tissue samples in order to return a reliable diagnosis.
Learn more about getting a sarcoma diagnosis
Treatment: If your diagnosis confirms that you have sarcoma, we will create a personalized sarcoma treatment plan that gives you the best chance of a successful outcome while focusing on your quality of life and mobility. Most patients need surgery for sarcoma to remove the tumor. Our team will discuss your case in our weekly multidisciplinary case conference to decide if you would benefit from radiation or chemotherapy as well. We offer the latest treatment options and also offer promising clinical trials for sarcoma if further options are needed.
Learn more about sarcoma treatment
Follow-up: Your care doesn’t stop when treatment ends. We monitor you for five or more years to look for a tumor that has returned or spread to another site such as the lungs. If it does, we work quickly to get you the follow-up treatment you need. We also provide access to the Abramson Cancer Center’s long-term Survivorship Program, which can address any ongoing physical or mental health needs you or your family may have following treatment.
Why Choose Penn Medicine for Sarcoma Cancer Care?
By choosing Penn Medicine for your sarcoma care, you’ll have access to:
Experience and expertise: While other cancer centers may see one or two sarcoma cases a year, we treat 200 to 250 sarcoma patients annually. Our team has decades of combined experience, treating even the rarest and most complex tumors. Our doctors publish influential papers, serve in national leadership positions, and give talks around the country.
Top cancer care: Penn Medicine’s renowned Abramson Cancer Center is one of the largest and highest ranked cancer centers in the nation. Our patients have access to the newest and most innovative cancer treatments available, with a variety of clinical trials offered.
Multidisciplinary care: Our dedicated sarcoma clinicians include surgeons, oncologists, musculoskeletal radiologists and pathologists, and researchers who work closely together to provide specialized sarcoma care. As part of a larger health system, our patients have access to other specialists when needed as well. For younger patients, we also partner with the Sarcoma Program at the Children’s Hospital of Philadelphia (CHOP).
Flexible care: We offer same-day appointments to patients who have their imaging available. We also aim to have you see all of the providers that you need to on the same day in the same location. While most appointments take place in person at our clinics, you may be able to do some follow-ups virtually if you live in Pennsylvania. We’re also happy to work with your local doctors if you need chemotherapy closer to home.
Penn Medicine Sarcoma Tumor Board
In addition to communicating daily, our sarcoma team holds a weekly tumor board meeting that brings together more than a dozen dedicated Penn Medicine sarcoma specialists across a number of departments to discuss patient cases.
This allows for more expert input on complex cases and helps guide care at crucial points. The team might work to confirm a diagnosis, establish the best course of treatment—including clinical trial eligibility when applicable—or assess treatment progress.
The sarcoma specialists involved in this conference include:
- Musculoskeletal radiologists
- Medical oncologists
- Neurosurgeons
- Orthopaedic oncologists
- Musculoskeletal pathologists
- Radiation oncologists
- Surgical oncologists
- Additional surgeons as needed from plastic surgery, urology, gynecologic oncology, colorectal surgery, and head and neck surgery
Some sarcoma cases may also go before additional Penn Medicine tumor boards, such as Gynecologic Oncology or Neuro-oncology, depending on the location of the sarcoma in the body.
Research and Innovation to Improve Sarcoma Care
The Abramson Cancer Center was one of the first cancer centers in the U.S. to join the Sarcoma Alliance for Research through Collaboration (SARC). Scientists at Penn Medicine work closely with doctors across the Sarcoma Program to drive innovation. Our researchers also partner with experts at CHOP and the University of Pennsylvania School of Veterinary Medicine to study why sarcomas spread and develop new therapies like immunotherapy and vaccines.
In addition to receiving funding from the National Institutes of Health, much of our work is supported by philanthropy programs like Steps to Cure Sarcoma, an organization raising awareness and funds for further sarcoma research.
Learn more about our current sarcoma clinical trials
Make an Appointment
Please call 800-789-7366 or make an appointment.
The Penn Sarcoma Program offers same-day appointments to patients who have their imaging available. To learn more, call 215-349-8200.