Soft Tissue Sarcomas (Sarcomas of the soft tissues)

Soft-tissue sarcomas or sarcomas of the soft tissues are defined as a condition in which cancer arises from the tissue of connect, support, or surround other structures and organs of the body, including includes tendons, ligaments, fascia, skin, fibrous tissues, fat, muscles, nerves blood vessels, etc.

Causes and risk factors
1. Certain chemical exposure
Exposure to chlorophenols and phenoxy herbicides might increase the risk of soft-tissue sarcomas.

2. Exposure to radiation
Researchers found that high doses of radiation caused increase the risk of soft-tissue sarcomas in some patients.

3. Herpesvirus
Researchers believe that herpesvirus is associated the increased risk of sarcomas of the soft tissues.

4. Heredity
Researchers found that certain inherited diseases and gene mutation are associated with an increased risk of developing soft-tissue sarcomas.

5. Age
A distinct group of sarcomas occurs in children in the first few years of their life. A second group develop in adulthood onward.

6. HIV/AIDs
Children with weakened immune system due to HIV or AIDS have an increased risk of development of leiomyosarcomas.

7. Smoking
American study showed that smokers have a increased risk of dying from soft tissue sarcoma than non-smokers, but other study showed no increased risk.

8 . Etc.

Main types of soft tissue sarcomas
Depending to where the cancer began soft tissue sarcomas can be classified
1. Fibrosarcomas (fibrous tissue)
2. Leiomyosarcomas and rhabdomyosarcomas (white and red muscle accordingly)
3. Liposarcomas (fatty tissue)
4. Angiosarcomas (in the walls of blood or lymphatic vessels)
5. Rofibrosarcoma (fibrous covering of nerve)
6. MFH (primitive mesoderm cell of some types)
7. Etc.

Symptoms1. Early stage
Soft tissue sarcomas cause no symptom in the early stage.
pain or soreness, as it presses against nearby nerves and muscles. If in the abdomen it can cause abdominal pains commonly mistaken for menstrual cramps, indigestion, or cause constipation.
2. Lumps
Due to abnormal cell growth.
3. Pain
Pain is a result of the enlarged tumor has pressed against nearby nerves.
4. Bleeding
If cancer is located in the abdomen or digestive tract.
4. Unintentional weight loss
Any unintentional weight loss over 10% is a concern
5. Loss of appetite
It occurs to most patients with cancer.
6. Etc.


Diagnosis and tests
1. Biopsy
In soft tissue sarcomas biopsy, samples are taken by a thin, tube-like instrument to examine under microscopy to review the stage of the cancer.

2. Incision biopsy or surgical biopsy
In most cases, if the tumor is small, surgical biopsy will be used to remove a sample or part of the tumor, if possible, the entire tumor and surrounding area through the incision of the skin. The operation is performed under local or general anesthesia, depending to location and size of the tumor.

3. CT scan
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. Unfortunately, CT scan can only review the existence of cancer, but can not tell it is a primary or secondary cancer.

4. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the affected and surrounded areas.

5. Chest X ray
If cancer arises from the chest soft-tissue or cancer has spread to the chest.

6. Bone scan
It is a nuclear scanning test, beside mostly used in identifying new areas of bone growth and damage to the bones breakdown, it can also evaluates the metastasis (spread) of cancer in the bone, if you doctor suspected that the cancer has spread.

7. Etc.

Grades
The Grades of Soft Tissue Sarcomas are depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages
Sarcomas of The Soft Tissues is classified as 5 stages
1. Stage 0
If the cancerous cell have not penetrated in deeper tissue but in the surface of the soft tissue.

2. Stage I
In stage I, the cancerous cells are no longer in the surface but have invaded into deep the soft lining, but still completely inside the soft tissue.

a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:
The invasion area is ≥ 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2:
The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.
b. Stage IB:
The cancer in this stage have invaded the connective tissue but less than 5cm (2 inch)
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:
Cancer is ≥ 4 cm (1 3/4 inches) but less than 5cm (2 inch)

3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the soft tissue.

4. Stage III
In this stage, cancerous cells has spread to the tissues immediately surrounding the soft tissue.

5. Stage IV
In this stage, cancerous cells has spread to the tissues immediately outside of the affected soft tissue into other distant parts of the body.

Prevention
A. What to avoid
There is no known way to prevent soft tissue sarcomas, but
1. Certain chemical exposure
Prevent exposure your self to certain chemical. In case of unavoidable, please use all proper protective equipment.

2. Avoid HIV infection
Since HIV infections are acquired through unprotected sexual intercours, practiczing safe sex will help.

3. Etc.

B. Diet
For over 100 healthy foods classifcation, click here
1. Cruciferous vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants, but also phytonutrients that have been shown to help prevent the onset and halt the progression of certain cancers.

2. Tomato
Many studies showed that antioxidant lycopene in tomato inhibits cancer cell growth and exhibit apoptosis, causing cell death.

3. Garlic
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

4. Carrot
Carrot contains high amount of beta carotene which has shown to induce appotosis of cancer cells. In study of Cell Cycle Regulation and Induction of Apoptosis by β-carotene, researchers found that in vivo study warrants further confirmation that β-carotene acts as apoptosis agent in cancer cells particularly leukemia cells but not normal cells.

5. Green tea
In some clinical studies researchers suggested that the polyphenols in green tea, may play an important role in the prevention of cancer by killing cancerous cells and stopping their progression.

6. Etc.

C. Nutritional supplements
1. Antioxidant
Antioxidants such as free radical scavengers vitamin A, C, E enhance the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth. For more information of how antioxidants help to treat cancer, click here

2. Flavonoids
In a study of flavonoids intake in human, The researchers found that flavonoids’ anticancer property has been proposed to exist via prevention of the formation of cancer-causing metabolites, inhibition of tumor cell proliferation, and stimulation of programmed tumor cell self-destruction (apoptosis).

3. Phytochemicals
Phytochemicals are under active research for possible benefits immune system, and as anti-cancer agents. Flavonoids found abundant in berry, inhibit caner cell in vitro study.

4. Indole-3-carbinol
Cabbage, a curciferous vegetables contains high amount of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells.

5. Garlic
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

6. Etc.

Treatment
A. In conventional medicine
Treatments are depended on the to the age of patients as children sarcomas are curative and fundamental difference from those of adult, grade, size and stage of the tumor. In children, Chemotherapy used after surgery with or without radiotherapy offers higher chance of curing.
1. Surgery
Surgery is considered as a primary treatment of soft tissue sarcoma. The aims of the surgery is to provide cure by completely remove the cancer if possible. If not then radiotherapy and chemotherapy will be used to kill remain cancer either locally or in the body
b. Risks and side effects
Surgical and anesthesia risks

2. Radiotherapy
a. Radiation may be used for stages II, III, and IV to kill any cancer cells remaining in the body locally. By using high-energy x-rays or other types of radiation, radiation therapy kills the cancer cells and keep them from growing or regrowing.
b. Side effects
b.1. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of cancer combined with radio therapy, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells. In sarcoma soft tissue, chemo is recommended to shrink the tumor if surgery is not possible in the place
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

B. Herbal medicine
1. Absinthe
Absinthe is also known as Wormwood, a distilled, highly alcoholic beverage flowers extracted from leaves of the herb Artemisia absinthium. In a study, researcher at the University of Washington found that wormwood can be used as a promising potential treatment for cancer.

2. Fenugreek
Fenugreek is used both as a herb (the leaves) and as a spice (the seed), genus Trigonella, belonging to family Fabaceae. Vitro studies have shown that fenugreek exhibits chemopreventive properties against certain cancers.

3. Aloe
In some studies, researchers suggest that some chemical compounds of aloe, such as acemannan, aloeride, and di(2-ethylhexyl)phthalate (DEHP) may have immunomodulating and anticancer effects.

4. Asparagus Cochinchinensis
In vitro studies researchers found that curcumin acts as a weak phytoestrogen, exhibits neuroprotective, antiproliferative and preventative effects against cancer.

5. Etc.

C. Traditional Chinese medicine
1. Qing hao
Qing hao is also known as wormwood. The bitter and cold herb has been used in TCM totrea lupus, schistosomiasis, chronic bronchitis (essential oil) to elevate the calcium ions of leukemia white cells, etc. In a study, researcher at the University of Washington researcher found that wormwood can be used as a promising potential treatment for cancer among the ancient arts of Chinese folk medicine.

2. Wu Ling Zhi
Wu Ling Zhi is also known as Trogopterus Dung. A report from China Journal of Chinese Materia Medica 2006-07 showed that Radix ex Rhizoma Ginseng and Trogopterus Dung inhibit the proliferation and induce the apoptosis of tumor cell.

3. Jie geng
Jie geng is also known as Platycodon Root. The Researchers found that Saponins in Jie Geng have been shown to very significantly augment the cytotoxicity of immunotoxins and other targeted toxins directed against human cancer cells.

4. Bai Hua She She Cao
The Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine, National University of Singapore researcher results showed that the ethanol extract from Bai Hua She She Cao effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

5. Ban Zhi Lian
Ban Zhi Lian is also known as scutellaria. In a recent study results suggest that ginger, tea, and a Chinese herb called Scutellaria barbata or Ban Zhi Lian could all help to prevent cancer.

6. Etc.

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