7 Warning Signs and Symptoms of Sarcoma Cancer You Should Know

Sarcoma is a rare type of cancer that develops in the connective tissues of the body, including bones, muscles, fat, blood vessels, and cartilage. Unlike more common cancers, sarcomas can occur anywhere in the body and often go unnoticed in their early stages. Understanding the warning signs and symptoms of sarcoma is crucial for early detection and better outcomes. This comprehensive guide will help you recognize the key symptoms of sarcoma cancer and understand when to seek medical attention.

Sarcomas account for approximately 1% of all adult cancers and about 15% of childhood cancers. There are more than 70 different types of sarcoma, broadly classified into two main categories: soft tissue sarcomas and bone sarcomas (osteosarcomas). Because these tumors can develop in various parts of the body, their symptoms can vary significantly depending on the location and size of the tumor.

1. Painless Lump or Swelling

The most common and often the first noticeable symptom of sarcoma is a lump or swelling that appears somewhere on the body. This lump typically develops gradually and may go unnoticed for weeks or months.

Key characteristics of sarcoma lumps include:

• Usually painless in the early stages, which can delay diagnosis
• May feel firm or soft to the touch
• Can appear anywhere on the body, but most commonly in the arms, legs, chest, or abdomen
• Often grows slowly but steadily over time
• May be deep within the tissue, making it harder to detect
• Size can range from very small to several inches in diameter

Many people dismiss these lumps as harmless cysts or lipomas (benign fatty tumps). However, any lump that persists for more than two weeks, continues to grow, or is larger than 2 inches (5 cm) should be evaluated by a healthcare professional. Soft tissue sarcomas in the limbs may become more noticeable as they grow larger and push against surrounding structures.

2. Pain or Soreness in the Affected Area

While early-stage sarcomas are often painless, pain can develop as the tumor grows larger and begins to press on nearby nerves, muscles, or organs. This is frequently one of the symptoms that prompts people to seek medical attention.

Pain associated with sarcoma may present as:

• Dull, aching pain that persists or worsens over time
• Sharp or shooting pain if the tumor presses on nerves
• Pain that doesn’t improve with rest or over-the-counter pain relievers
• Discomfort that interferes with daily activities or sleep
• Pain that seems unrelated to any injury or physical activity

In bone sarcomas, pain is often one of the earliest symptoms and may initially be mistaken for growing pains in children or arthritis in adults. The pain may be worse at night or during physical activity. It’s important to note that persistent pain without a clear cause should always be investigated, especially if accompanied by other symptoms.

3. Limited Range of Motion or Stiffness

When a sarcoma develops near or within a joint, it can interfere with normal movement and cause stiffness. This symptom is particularly common with bone sarcomas and soft tissue sarcomas located in the extremities.

Movement-related symptoms include:

• Difficulty bending or straightening a limb fully
• Reduced flexibility in the affected joint
• Stiffness that worsens over time rather than improving
• Inability to perform certain movements that were previously easy
• Joint swelling that restricts movement
• A feeling that the joint is “locked” or unstable

These symptoms occur because the tumor occupies space within or near the joint, physically preventing normal movement. Additionally, inflammation caused by the tumor can contribute to stiffness. Athletes or active individuals might first notice this symptom as a decline in performance or difficulty with specific movements related to their sport or exercise routine.

4. Abdominal Pain and Digestive Issues

Sarcomas that develop in the abdomen or gastrointestinal tract can cause a variety of digestive symptoms. These tumors may grow quite large before being detected because the abdominal cavity provides significant space for expansion.

Abdominal and digestive symptoms may include:

• Persistent abdominal pain or cramping
• A feeling of fullness or bloating even after eating small amounts
• Nausea or vomiting
• Changes in bowel habits, including constipation or diarrhea
• Blood in the stool (which may appear black or tarry)
• Unexplained abdominal swelling or distension
• Difficulty swallowing if the tumor is near the esophagus
• Loss of appetite

Gastrointestinal stromal tumors (GISTs), a specific type of sarcoma that develops in the digestive tract, commonly present with these symptoms. Because abdominal sarcomas can grow quite large before causing noticeable symptoms, they may only be discovered during imaging tests performed for other reasons or when symptoms become severe.

5. Bone Pain and Fractures

Bone sarcomas, such as osteosarcoma, Ewing sarcoma, and chondrosarcoma, primarily affect the skeletal system and produce distinct symptoms related to bone health and integrity.

Bone-specific symptoms include:

• Deep, aching bone pain that may be worse at night
• Pain that is not relieved by rest or typical pain medications
• Swelling or tenderness over a bone
• Pathological fractures (bones breaking with minimal trauma or during normal activities)
• Bone pain that was initially intermittent but becomes constant
• Limping if the tumor is in a leg bone
• Visible bone deformity in advanced cases

Bone pain from sarcoma is often initially attributed to sports injuries, growing pains in children, or arthritis in older adults. However, sarcoma-related bone pain typically worsens progressively and doesn’t respond well to standard treatments. Pathological fractures occur because the tumor weakens the bone structure, making it susceptible to breaking even with minor stress. This is often a alarming symptom that prompts immediate medical evaluation.

6. Unexplained Weight Loss and Fatigue

As with many cancers, sarcoma can cause systemic symptoms that affect the entire body, even though the tumor itself may be localized to one area. These general symptoms tend to appear as the disease progresses.

Systemic symptoms of sarcoma include:

• Unintentional weight loss of 10 pounds (4.5 kg) or more
• Loss of appetite or feeling full quickly when eating
• Persistent fatigue that doesn’t improve with rest
• General feeling of being unwell (malaise)
• Low-grade fever without an obvious infection
• Night sweats
• Weakness or decreased energy levels

These symptoms occur because the cancer cells consume nutrients and energy, and the body’s immune system is working overtime to fight the disease. The metabolic demands of a growing tumor can lead to weight loss even when caloric intake remains normal. Fatigue associated with cancer is often more profound than normal tiredness and doesn’t improve significantly with sleep or rest. While these symptoms are non-specific and can be caused by many conditions, their presence along with other sarcoma symptoms warrants medical investigation.

7. Breathing Difficulties and Chest Symptoms

Sarcomas that develop in or near the chest, lungs, or heart can cause respiratory and cardiac symptoms. Additionally, soft tissue sarcomas from other parts of the body may metastasize (spread) to the lungs, causing similar symptoms.

Chest and respiratory symptoms include:

• Shortness of breath during normal activities or at rest
• Persistent cough that doesn’t resolve
• Coughing up blood (hemoptysis)
• Chest pain or discomfort
• Wheezing or noisy breathing
• Difficulty taking deep breaths
• Recurring respiratory infections
• Feeling of pressure or heaviness in the chest

These symptoms develop when a tumor physically obstructs airways, compresses lung tissue, or interferes with normal heart function. Sarcomas in the chest cavity can grow quite large before being detected because the chest provides considerable space. Some people first discover they have a chest sarcoma when a routine chest X-ray reveals an unexpected mass. Because these symptoms can also indicate serious cardiac or pulmonary conditions, they should always be evaluated promptly by a healthcare provider.

Main Causes and Risk Factors of Sarcoma

The exact causes of sarcoma are not fully understood, and in most cases, there is no identifiable cause. However, researchers have identified several risk factors that may increase the likelihood of developing this type of cancer:

Genetic Conditions: Certain inherited genetic syndromes increase sarcoma risk, including:

• Li-Fraumeni syndrome
• Neurofibromatosis type 1 (NF1)
• Familial adenomatous polyposis (FAP)
• Retinoblastoma
• Werner syndrome

Previous Radiation Therapy: People who have received radiation therapy for other cancers have an increased risk of developing sarcoma in the radiation field, typically 10 or more years after treatment. The risk is higher with higher radiation doses.

Chemical Exposure: Exposure to certain chemicals has been linked to increased sarcoma risk, including:

• Vinyl chloride (used in plastic manufacturing)
• Arsenic
• Dioxin
• Herbicides containing phenoxyacetic acid

Chronic Lymphedema: Long-standing swelling of the arms or legs due to lymphatic system damage can increase the risk of angiosarcoma, a rare type of sarcoma.

Viral Infections: Human herpesvirus 8 (HHV-8) has been associated with Kaposi sarcoma, particularly in people with weakened immune systems.

Previous Bone Diseases: Conditions such as Paget’s disease of bone may slightly increase the risk of osteosarcoma.

It’s important to note that having one or more risk factors doesn’t mean a person will definitely develop sarcoma. Many people with risk factors never develop the disease, while others with no known risk factors do. Most sarcomas occur sporadically without any identifiable cause.

Prevention Strategies

While there is no guaranteed way to prevent sarcoma, especially since most cases occur without identifiable causes, certain strategies may help reduce your risk:

Minimize Unnecessary Radiation Exposure: While radiation therapy is sometimes necessary for cancer treatment, discuss with your healthcare provider about minimizing radiation doses when possible and exploring alternative treatments when appropriate. Avoid unnecessary medical imaging procedures that involve radiation.

Workplace Safety: If you work with chemicals known to increase cancer risk, follow all safety protocols, use proper protective equipment, and ensure adequate ventilation. Employers should provide appropriate training and safety measures.

Genetic Counseling: If you have a family history of sarcoma or inherited genetic syndromes associated with increased cancer risk, consider genetic counseling. Understanding your risk can help you and your healthcare team develop an appropriate monitoring plan.

Regular Medical Check-ups: Attend routine health screenings and promptly report any unusual symptoms to your doctor, especially persistent lumps, unexplained pain, or other concerning changes in your body.

Healthy Lifestyle: While not specifically proven to prevent sarcoma, maintaining overall health through balanced nutrition, regular exercise, avoiding tobacco, and limiting alcohol consumption supports your immune system and general wellbeing.

Monitor Chronic Conditions: If you have chronic lymphedema or other conditions that increase sarcoma risk, work with your healthcare provider to manage these conditions effectively and watch for any unusual changes.

Early detection is crucial for better treatment outcomes. Being aware of your body and seeking medical attention for persistent or unusual symptoms is one of the most important steps you can take.

Frequently Asked Questions

What is the difference between sarcoma and carcinoma?

Sarcomas develop in connective tissues such as bones, muscles, fat, and blood vessels, while carcinomas arise from epithelial cells that line organs and glands. Sarcomas are much rarer, accounting for only about 1% of adult cancers, whereas carcinomas make up the majority of cancer cases.

How quickly do sarcomas grow?

The growth rate of sarcomas varies considerably depending on the type and grade. Some sarcomas grow slowly over months or years, while high-grade sarcomas can grow quite rapidly over weeks to months. This variability is one reason why early evaluation of any persistent lump is important.

Are all lumps under the skin sarcomas?

No, the vast majority of lumps under the skin are benign (non-cancerous) conditions such as lipomas (fatty tumors), cysts, or enlarged lymph nodes. However, any lump that is larger than 2 inches (5 cm), growing, painful, or persisting for more than two weeks should be evaluated by a healthcare professional to rule out sarcoma.

Can children get sarcoma?

Yes, sarcomas are more common in children than many other types of cancer, accounting for about 15% of childhood cancers. The most common types in children include rhabdomyosarcoma, Ewing sarcoma, and osteosarcoma. Parents should have any persistent lumps, bone pain, or swelling in children evaluated by a pediatrician.

Is sarcoma hereditary?

Most sarcomas are not hereditary and occur sporadically. However, certain genetic syndromes such as Li-Fraumeni syndrome and neurofibromatosis type 1 can increase the risk of developing sarcoma. If you have a family history of sarcoma or these genetic conditions, discuss genetic counseling with your doctor.

What should I do if I notice sarcoma symptoms?

If you notice a persistent lump, unexplained pain, swelling, or any other concerning symptoms, schedule an appointment with your primary care physician. They can perform an initial evaluation and, if necessary, refer you to a specialist. Early detection and diagnosis are crucial for the best possible outcomes. Don’t wait for symptoms to worsen before seeking medical attention.

Can sarcoma spread to other parts of the body?

Yes, like other cancers, sarcomas can metastasize (spread) to other parts of the body, most commonly to the lungs. High-grade sarcomas have a higher risk of spreading than low-grade sarcomas. This is why early detection and appropriate medical care are so important.

How is sarcoma diagnosed?

Sarcoma diagnosis typically involves a combination of physical examination, imaging tests (such as X-rays, CT scans, or MRI), and biopsy. A biopsy, where a small tissue sample is removed and examined under a microscope, is essential for confirming the diagnosis and determining the specific type of sarcoma.

References:

• American Cancer Society – Sarcoma
• Mayo Clinic – Soft Tissue Sarcoma
• National Cancer Institute – Soft Tissue Sarcoma
• NHS – Soft Tissue Sarcoma
• Johns Hopkins Medicine – Sarcoma