July is sarcoma awareness month. Sarcomas are rare tumour of soft tissue and bone, which account for about 1% of new cancers, and can occur at any age, and any part of the body. Although infrequent, soft tissue sarcomas present with common symptoms, and in the UK referral to a diagnostic service is recommended if a lump, is found which has any of the following features:
▪ Rapid growth
▪ Deep to the skin
▪ Recurrent lump after treatment
▪ Larger than 5cms (bigger than a golf ball)
Describing the symptoms and signs of soft tissue sarcoma, led to the development of the Sarcoma UK “On The Ball” campaign which aims to raise awareness of the symptoms of soft tissue sarcoma. This is important as more than half of people in the UK have not heard of sarcoma, and due to its rarity, physicians may not immediately identify a lump as a potential cancer. Early recognition may reduce time to treatment, and catch a sarcoma at an earlier stage.
Investigation is straightforward, with clinical history and examination, ultrasound or MRI, and a core-needle biopsy. Ideally these investigations should occur in the context of a “one-stop” clinic. Fortunately, only around 10% of patients presenting with theses clinical features will have a sarcoma, and most of the benign lumps which cause troubling symptoms can be treated with surgery. Definitive treatment of sarcoma usually requires both surgery and radiotherapy, with physiotherapy extremely important for rehabilitation. Expertise in sarcoma and soft tissue surgery is essential as part of the multidisciplinary treatment of these rare tumours.
The Lister hospital has a long history of treating patients with soft tissue disease and sarcoma, and from mid-September 2016 will offer a “One Stop” diagnostic Soft Tissue Clinic. We hope this will further develop and enhance our existing services at both 280 King’s Road and Chelsea Bridge sites.
Mr Myles Smith is a General Surgeon with a special interest in Surgical Oncology, specifically Soft Tissue Sarcoma and Melanoma. He practices in the Royal Marsden and Lister Hospitals.
Clinics will be held on Friday afternoons, with every effort made to complete all necessary investigations in “one-stop”. Our aim is to see patients within one week of referral, allowing time to triage and arrange necessary investigations ahead of time. Communications should be addressed to Mr. Myles Smith via:
▪ Anje Lanting, The Lister Hospital, tel: 020 7808 2785
▪ Anje Lanting, The Lister Hospital, email: myles.smithPA@rmh.nhs.uk
1. Pencavel TD, Strauss DC, Thomas GP, Thomas JM, Hayes AJ. Does the two-week rule pathway improve the diagnosis of soft tissue sarcoma? A retrospective review of referral patterns and outcomes over five years in a regional sarcoma centre. Ann R Coll Surg Engl. 2010 Jul;92(5):417-21.
2. Rowbotham E, Bhuva S, Gupta H, Robinson P. Assessment of referrals into the soft tissue sarcoma service: evaluation of imaging early in the pathway process. Sarcoma. 2012;2012:781723.