The generic term “soft tissue tumor” includes all benign and malignant tumors that have their place of origin in the soft tissues of the human body. Soft tissues include connective tissue – a malignant tumor arising here is called a fibrosarcoma. Fibrosarcomas occur very rarely and, if detected early, are treatable with a good prognosis.
What is fibrosarcoma?
Fibrosarcoma is a malignant growth that originates in connective tissue. Fibrosarcoma usually forms on the legs, but less commonly on the arms and back. Cancer cells reach other organs via the bloodstream and form metastases there. Fibrosarcomas occur very rarely in adults – about 2% of all cancers are soft tissue tumors. In children, the proportion is much higher and is about 10%.
Causes
The causes leading to fibrosarcoma are not clearly known. However, some correlations have been identified that influence the development of soft tissue tumors. For example, a cluster occurs in adults who have been exposed to asbestos, polyvinyl chloride, and/or dioxin. In addition, previous cancer with concomitant radiation therapy may be causative in the development of fibrosarcoma. In general, however, the same applies here: An unhealthy lifestyle – such as smoking, excessive alcohol consumption, poor, high-fat diet and lack of exercise promote the development of fibrosarcoma.
Symptoms, complaints and signs
Since fibrosarcoma is a tumor disease, in the worst case it can lead to the death of the affected person. Usually, this case occurs only when fibrosarcoma is not treated. The tumor can also spread to other regions of the body, resulting in metastasis. In this case, the affected person suffers from nodes that are located under the skin. These nodes are usually not associated with pain and can take on a brownish or reddish color. It can also lead to the formation of ulcers. The patient’s lymph nodes are also swollen due to the fibrosarcoma and the affected person suffers from severe fatigue and exhaustion. Weight loss continues to occur if the tumor continues to spread and is not treated. The affected person appears pale and no longer actively participates in everyday life. In many cases, the tumors also spread to the lungs, so that patients are dependent on various examinations in this region of the body as well. In addition to physical discomfort, fibrosarcoma is also associated with depression or with other psychological upsets, which can occur not only in patients but also in their relatives.
Diagnosis and course
Like a benign soft tissue tumor, fibrosarcoma initially causes no symptoms. Only when the location and size of the tumor are particularly striking will the affected person notice the fibrosarcoma. As a rule, however, the affected person only notices a painless swelling that does not cause any discomfort. The only sign that the swelling could be a soft tissue tumor is that the swelling does not subside and is not visible under the skin. At a later stage of the disease, the fibrosarcoma spreads. If the tumor presses on nerves and/or on the periosteum, the first symptoms appear. Pressure on the lymphs and on blood vessels also cause the swelling to increase. Other accompanying symptoms of fibrosarcoma may include severe weight loss, unnatural pallor and fatigue. If any of the described symptoms occur, a doctor should be consulted. The physician can already deduce the first signs of a malignant soft tissue tumor from the medical history. If swellings have occurred without concomitant injury and if they enlarge rapidly, further examinations are necessary for final clarification of the initial suspicion. First, the doctor will examine the tumors by ultrasound. Malignant tumors are usually very well perfused and thus distinguishable from a benign tumor. A computed tomography (CT) scan or magnetic resonance imaging (MRI) can also provide information on whether and how far the tumor has already spread. Fibrosarcomas tend to metastasize to the lungs.To clarify whether this has already occurred, an X-ray examination of the lungs will be performed. The doctor will also take a biopsy to further determine the type of tumor. To do this, he or she will remove tissue from the tumor with a needle and give it to a pathologist for clarification.
Complications
Because fibrosarcoma is a tumor, it can have a variety of complications. If it is discovered early or is benign, there are usually no particular symptoms and the cancer can be removed. However, if the diagnosis comes too late, the patient can die from the cancer in the worst case. Most often, fibrosarcoma manifests itself in the form of nodules on the skin. These do not cause pain and are red or brown in color. The tumor disease causes fatigue and severe weight loss. The patient often feels unable to perform physical activities and suffers from severe pallor. The affected areas may also show swelling and ulceration. The treatment itself is done by removing the fibrosarcoma from the body with the help of a surgical procedure. If this happens early enough, no further complications occur. As a rule, chemotherapy is still administered after the surgery. However, if the fibrosarcoma has already spread further in the body, it is not possible to remove the tumors. In this case, the patient will usually die prematurely.
When should you go to the doctor?
Swelling or changes in tissue structure should always be clarified by a doctor. If the formation of lumps, dents or growths occurs, this is considered unusual. A visit to the doctor is advisable as soon as possible. If the changes in skin appearance increase in size, extent and intensity, a doctor must be consulted. If neoplasms develop in other areas of the body, it is necessary to discuss them with a medical professional. If there is pain, a general feeling of illness, malaise or weakness, a physician should be consulted. If the affected person has a diffuse suspicion that something might be wrong with him or her, a doctor should also be consulted. If there are functional limitations, a reduced performance limit or disturbances in concentration, a visit to the doctor is necessary. In case of fever, an inner restlessness, sleep disturbances or a feeling of tightness inside the body, a doctor should be consulted. An untraceable increase or decrease in weight, emotional changes or behavioral abnormalities, should be discussed with a doctor as soon as they persist for several weeks. Discoloration or unusual pallor of the skin should be presented to a physician. Before using cosmetics to reduce the symptoms, the skin abnormalities should be examined by a physician. If the affected person suffers from lassitude, listlessness or reduction in general well-being over a prolonged period, a visit to the doctor is necessary.
Treatment and therapy
If fibrosarcoma is detected early and further therapy succeeds in completely removing the cancer from the body, the prognosis is good. Removal is attempted by surgery followed by radiation. This is usually followed by chemotherapy to kill any remaining tumor cells. If a tumor cannot be operated on initially because of its size, an attempt is made to shrink the tumor with radiation or chemotherapy. If this is successful, the tumor is usually operable. If a fibrosarcoma has already spread, curative therapy is usually not possible.
Outlook and prognosis
Patients with fibrosarcoma experience a steady decline in health without medical care. Performance decreases and general condition changes for the worse. Complaints gradually increase until, in the final stage, the patient dies. The sooner a diagnosis is made, the better the prognosis if medical treatment is sought. In the initial phase of the disease, fibrosarcoma is benign. Since there are often no symptoms at this stage, a diagnosis is usually an incidental finding. Mutation to a malignant course takes place when the disease progresses. At this stage, health impairments are already present. In a surgical treatment all conspicuous tissue changes are removed.Subsequent cancer therapy enables the patient to recover. The further the fibrosarcoma has spread in the connective tissue, the less favorable the prospects for cure. In these cases, it is not possible for physicians to remove all tissue abnormalities without leaving residues. If metastases have also formed or if organs of the patient have already been attacked by cancer cells, it is often no longer possible to reverse the progress of the disease despite comprehensive treatment. At this stage, treatment is aimed at life-prolonging measures. At the same time, the focus is on reducing existing pain.
Prevention
Measures to prevent fibrosarcoma are not yet known. A healthy lifestyle and avoiding contact with asbestos, dioxin, and polyvinyl chloride are helpful in preventing disease. In addition, swellings should be monitored and, if initially suspected, be sure to be examined by a physician.
Follow-up
It is recommended that follow-up care be taken seriously. This is because fibrosarcoma recurs in many cases, which means that the symptoms do not resolve conclusively. Scheduled follow-up is advisable to allow rapid intervention. In most cases, an internal oncologist is the right contact person. If necessary, he or she will work together with other specialists. Quarterly examinations have proven to be a good rhythm in the first and second year after recovery. Subsequently, follow-up treatments can be limited to semi-annual and then annual appointments. Depending on the severity of the fibrosarcoma, physicians use imaging techniques in addition to a medical history. Sonography, computed tomography and X-rays allow unambiguous findings about the course of the disease inside the body. In addition, blood tests are performed at least once a year. The purpose of follow-up is to continue chemotherapy at the first signs of the disease. The patient must also be active away from medical supervision. It is scientifically recognized that a healthy and balanced diet is beneficial for healing. Stress in private life and at work should be avoided. Many patients also benefit from contact with other patients. Especially in large cities, self-help groups can be found where patients share their experiences around fibrosarcoma.
What you can do yourself
For cancer patients, there is a whole range of self-help groups and patient associations that can pass on experiences in dealing with the disease. Joint ventures distract from the disease and keep the sufferer from isolation. On the physical level, a healthy lifestyle, as well as a balanced diet, plenty of exercise in the fresh air, stress management and a positive attitude, can strengthen the immune system and contribute to a better quality of life. The immune status provides information about how efficient one’s own defenses are and where a build-up is necessary. Supporting oneself also means obtaining information, researching what treatment alternatives are available, and then working with the attending physician to determine which is the most promising treatment for the individual. In addition, social workers, psychotherapists, relatives and also friends can be involved, who can make it easier to deal with the disease. Be it only with a conversation. In addition, meditations allow a little time out from everyday life and can have a positive effect on the basic condition. Self-hypnosis and the use of affirmations have the same effect. Both convey more calmness and composure in dealing with the disease.
