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Where Can Sarcoma Spread To?

Physician speaking to patient before a CT scan

There are many different types of sarcoma that affect different connective tissues, such as the bones, cartilage and blood vessels. This type of cancer can develop anywhere in the body, but it most often occurs in the head, neck, arms, legs or abdomen. In its early stages, soft tissue sarcoma that is localized to one area of the body may not have noticeable symptoms, or may present as only a small, painless lump. However, as with other cancers, sarcoma that advances to a late stage can spread through the bloodstream or lymph system to distant areas of the body.

Physicians use a system of stages from 1 to 4 to describe how large a malignant tumor is and whether cancer cells have spread to other parts of the body. Stage 4 sarcoma is cancer that has metastasized, or spread, to other bones or soft tissues, the liver, skin or lymph nodes. However, the most common place where it spreads is the lungs. This does not mean that a patient with sarcoma has developed lung cancer, as the cancer cells did not originate in the lungs. Instead, the cancer cells in the lung are identical to the original sarcoma, so it is still considered sarcoma that has metastasized to the lungs.

How fast does sarcoma grow?

There are more than 70 sarcoma subtypes, and the growth rate of sarcoma tumors can vary widely according to which subtype the patient has and other factors. Generally, soft tissue sarcomas—which are more common than bone sarcomas—are slow-growing cancers. They often take years to become large enough to be detected by touch. In some cases, sarcoma tumors may grow slowly or even remain the same size for years and then suddenly start to grow. Sarcoma tumors that reach stage 2 or stage 3 are more likely to grow and spread quickly.

When sarcoma is diagnosed, cancer specialists will not only determine what stage it’s in but also assign it a grade based on how different the cancer cells are from normal cells. A high-grade malignancy is more likely to spread quickly—possibly within weeks or months. Some bone sarcoma tumors, including Ewing’s sarcoma, are always considered to be high grade and likely to grow and spread quickly.

What happens when sarcoma spreads to the lungs?

Cancer that has spread to the lungs is often detected through imaging, such as X-rays or CT scans. However, a person whose sarcoma has spread to the lungs may also experience symptoms such as:

  • Chronic coughing that may bring up blood
  • Chest pain
  • Shortness of breath
  • Decreased appetite
  • Weight loss

If sarcoma has spread only to the lungs and no other parts of the body, surgery may be a treatment option. Other treatments may include chemotherapy and radiation therapy.

What is the life expectancy of patients with metastatic sarcoma?

Life expectancy statistics for cancer are generally expressed in terms of five-year survival rates, meaning the percentage of people with a particular type of cancer who survive at least five years after the malignancy is discovered. The overall five-year survival rate for sarcoma is 65%. For those with locally advanced sarcoma (meaning the malignancy hasn’t spread beyond the area where it developed), the five-year survival rate is 56%. For people with metastatic sarcoma, the five-year survival rate is 16%.

In any discussion of life expectancy, it’s important to remember that statistics are based on averages—they don’t consider specific information such as a patient’s age, overall health, tumor size and location and response to therapy. They also won’t include data from any treatment options that weren’t in use at the time the statistics were compiled. Therefore, metastatic sarcoma survival rates are subject to change—and improvement—as effective treatments are discovered and put into practice.

Metastatic Ewing’s sarcoma is a good example. The overall five-year survival rate for localized Ewing’s sarcoma is 82%, while the five-year survival rate for patients whose tumor has metastasized is 39%. The survival rates are somewhat higher for children younger than 10, possibly because children with Ewing’s sarcoma tend to respond better than adults to chemotherapy.

It's also worth noting that survival rates for patients with Ewing’s sarcoma have increased substantially with advancements in treatment over the years. Studies show that patients who receive treatment at an NCI-designated cancer center, such as Moffitt, can improve their long-term survival rates by up to 25%.

What should I do if I have sarcoma?

Whether you’ve been diagnosed with early-stage or metastatic sarcoma, or you have symptoms that may be related to this malignancy, you can find the diagnostic and treatment services you require at Moffitt Cancer Center. Our Sarcoma Program is made up of a multispecialty team that is dedicated to treating all types of sarcoma. We take an individualized approach to developing treatment plans, and our cancer experts meet regularly in tumor board meetings to ensure each patient’s case receives the attention it deserves.

Moffitt is the only Florida-based Comprehensive Cancer Center designated by the National Cancer Institute (NCI). This designation means we receive NCI support for our cancer research, including for conducting our own clinical trials and participating in clinical trials with other cancer centers. As a result, our eligible patients may benefit from participating in one of our clinical trials, which can give them access to the latest and most advanced sarcoma treatments before they are available elsewhere.

At Moffitt, we’re committed to providing every new patient with access to a cancer expert within a day of reaching out to us, and you don’t need a referral to schedule an appointment with us. Simply fill out a new patient registration form online or call 1-888-663-3488.

References

National Institutes of Health – Size Matters for Sarcomas
National Organization for Rare Disorders – Soft Tissue Sarcoma
World Journal of Surgical Oncology – Highly Malignant Soft Tissue Sarcoma of the Extremity With a Delayed Diagnosis
American Cancer Society – Ewing Tumor Stages
American Society of Clinical Oncology – Ewing Sarcoma, Childhood and Adolescence: Statistics
Journal of the National Cancer Institute – Long-Term Survivors of Childhood Ewing Sarcoma