The Sarcoma Unit at IOB treats patients diagnosed with tumours that affect the connective tissue, which includes the bones and so-called soft tissues of the body such as muscles, cartilage, fat or blood vessel and the nervous system tissues. Patients who come to the unit may have been previously diagnosed in another medical centre, or they may be people who have suspected sarcoma and require a first diagnosis. Likewise, like other IOB units, the Sarcoma Unit offers a second opinion service to patients who are treated by oncologists from other centres.
Patients treated at the Sarcoma Unit are treated by a multidisciplinary team consisting of oncologists, surgeons, radiotherapists, anatomic pathologists, image diagnosis specialists and specialised cancer nursing staff. This multidisciplinary team makes it easier for patients to undergo all the tests and receive all the treatments they need in a coordinated way in the same place and in as little time as possible, without the need to travel and visit different specialists separately. The unit comprises oncologists Dr. Xavier García del Muro and Dr. Ricardo Cubedo.
The earlier the detection of a sarcoma, the higher the likelihood of being able to treat it successfully and of the treatment causing the minimum possible sequelae for the patient.
The appearance of a mass with a diameter of more than five centimetres in the extremities or in the trunk is the most characteristic symptom that can make us suspect a soft tissue sarcoma and, although it does not cause discomfort, it requires consulting a specialist in this type of tumour. The fact that most of these masses are painless wrongly leads a high percentage of patients to ignore them and delay the diagnosis.
If a person detects a mass with a diameter of less than five centimetres, it also requires consulting a specialist if it has grown within a few months or if it is in a deep area, for example a leg. This recommendation is justified because it is in deep areas where most soft tissue sarcomas are located and where it is more difficult to establish its diameter accurately.
In bone sarcomas, which are less frequent, the first sign of alarm that requires consulting a specialist is usually bone pain of unknown origin.
The diagnosis is based on an MRI to evaluate the size, shape and location of the possible sarcoma, and a biopsy to obtain cells to allow specifying the diagnosis. The analysis of the cells in the pathological anatomy laboratory will give us the type of sarcoma in question, and together with the size of the tumour at the time of diagnosis, will enable to make a prognosis on whether it is a more or less aggressive cancer and to decide on the most appropriate treatment. In some patients, diagnostic tests are supplemented with a chest CT scan to check whether the cancer has spread or not to the lungs.
The rapid diagnosis circuit at IOB has made it possible to reduce the average time between the first consultation of a patient due to a suspected sarcoma and the start of treatment to a period of less than one week.
The treatment for sarcoma is based on the surgical removal of the tumour. The surgery should remove the tumour in its entirety, in addition to a thin layer of cells around the tumour. Given that this type of surgery can be mutilating, especially in large sarcomas, it is essential to wait for the results of all the diagnostic tests before performing the surgery.
This way, we can establish accurately the cells that must be removed and those that must be preserved.
The surgery is sometimes combined with a radiotherapy treatment lasting six to eight weeks that allows reducing the size of the tumour and performing a less aggressive surgical intervention.
Chemotherapy is given in cases where the sarcoma has already spread to the lungs at the time of diagnosis. A five-month chemotherapy treatment is also administered in sarcomas that, despite being located, are considered high risk, to reduce the risk of spreading to other organs.
In addition, IOB pioneered introducing personalised genetic analyses to identify patients who may benefit from the new generation medicine that selectively attack tumours or others depending on their molecular characteristics.
Once the treatment is finished, and during the first two years, the follow-up consists in physical examinations and blood tests every three months to verify that the sarcoma does not reappear, as well as chest x-rays, also every three months, to verify that it has not spread to the lungs, and an annual magnetic resonance of the affected area. From the third year, when the risk of recurrence is already lower, controls are spaced every six months. Since, in rare cases, some sarcomas reappear in the long term, revisions must be maintained for ten years.