Leiomyosarcoma is a tumor that often goes undetected at first. However, early diagnosis can increase the chances of cure.
What is leiomyosarcoma?
Leiomyosarcoma is a comparatively rare malignant tumor of so-called smooth (non-volitional) muscle. While leiomyosarcoma is present in approximately 1 in 100 cases of a malignant (malignant) tumor of the uterus, the tumor can form in almost any part of the body with smooth muscle. According to the malignancy of a leiomyosarcoma, different forms of tissue neoplasm (tumor) can be distinguished – for example, low-grade leiomyosarcoma is one of the comparatively less dangerous formations. In most cases, leiomyosarcoma occurs after the age of 30. The malignant tumor most frequently affects individuals during the 6th decade of life. Symptoms associated with leiomyosarcoma are usually not very specific – in the uterus, the sarcoma often leads to rapid organ enlargement and bleeding that occurs.
Causes
Regarding the specific causes of leiomyosarcoma, various uncertainties currently exist in the medical community. Contrary to what was assumed in previous medical studies, leiomyosarcoma does not arise as a degeneration of leiomyoma (a benign tumor of smooth muscle), according to current findings. Risk factors that favor the development of a so-called endometrial carcinoma (a malignant tumor of the uterus) can be largely excluded for leiomyosarcoma – corresponding factors include, for example, obesity, diabetes mellitus, hypertension (high blood pressure) and childlessness. Because leiomyosarcoma is clustered in patients who are in their 6th decade of life, bodily processes that occur increasingly within this life span probably play a role in tumor development.
Symptoms, complaints, and signs
The symptoms of leiomyosarcoma are in most cases relatively clear and therefore also directly indicate the disease. For this reason, early detection and treatment of this disease is also possible in this case. Those affected suffer from the formation of tumors, which occur mainly in the area of the abdomen. In the process, the abdomen enlarges enormously and severe abdominal pain occurs. In many cases, the leiomyosarcoma also damages the patient’s liver, resulting in severe liver pain or jaundice. Patients also suffer from kidney disease and can die from this in the worst case. Often, the legs also swell, so that there are restrictions in movement and thus in the everyday life of the affected person. The life expectancy of the patient is significantly reduced and limited by the leiomyosarcoma. If metastases form, cancer can develop in other regions of the body and weaken the body. In this case, the complaints and symptoms depend greatly on the affected region. It is not uncommon for the disease to cause psychological discomfort or upset, so many patients also suffer from depression.
Diagnosis and course
Because of its comparatively nonspecific symptoms, leiomyosarcoma is often diagnosed only by chance. It is not always possible to immediately distinguish the tissue of the malignant tumor from that of the benign leiomyoma in the laboratory. Characteristically, however, leiomyosarcoma under microscopic observation shows, for example, a high multiplicity of cells and a characteristically increased cell division rate. On average, leiomyosarcoma of the uterus shows a comparatively poor prognosis. However, the course of the disease depends on factors such as the extent of the tumor and the presence of metastases (a spread of malignant tumor cells). A leiomyosarcoma that is less than 5 centimeters in diameter usually takes a more favorable course than larger tumors. Low-grade leiomyosarcoma usually shows an equally relatively favorable course with slower disease progression.
Complications
Because leiomyosarcoma is a tumor, it is always associated with complications. In the worst case, the tumor thereby leads to the death of the affected person if it is discovered late and therefore late treatment occurs.In many cases, however, leiomyosarcoma does not show any characteristic complaints and symptoms, so that unfortunately it is often diagnosed at a late stage. Those affected suffer from an enlarged liver and pain in the abdomen. Furthermore, jaundice also occurs and patients may suffer from kidney complaints. In the worst case, kidney insufficiency develops, and the affected person is dependent on dialysis or a donor kidney to prevent death. Leiomyosarcoma can also cause the legs to become swollen and painful. During treatment, the tumor is removed. There are usually no complications during this process. However, with chemotherapy, there may be various side effects that can reduce the quality of life. In some cases, however, leiomyosarcoma will reduce the patient’s life expectancy unless the disease progresses favorably.
When should you see a doctor?
If enlargement of the abdomen or any other sign of serious disease is noticed, a physician must be consulted. The symptoms indicate that a leiomyosarcoma has formed. If kidney disease or swelling of the legs becomes apparent, the condition may already be advanced. At the latest then the family doctor or a dermatologist must be consulted, who can clarify the complaints and if necessary suggest a treatment. If metastases have already formed, treatment must be initiated immediately. The affected person must immediately go to the nearest doctor’s office and have typical complaints such as skin nodules, coughing up blood or stomach cramps clarified. If psychological problems have developed concomitantly with the tumor, a therapist must also be called in. Leiomyosarcoma is a serious disease that must always be examined and treated by a physician. People who suffer from high blood pressure or diabetes mellitus are particularly susceptible. So are people who are overweight and childless women. Anyone who belongs to these risk groups is best to confer with a doctor immediately if signs of the disease are mentioned.
Treatment and therapy
Successful treatment of leiomyosarcoma usually requires surgical removal of the tumor. This necessity is due to the fact that, in the most common cases, the malignant tissue neoplasm does not respond to conservative (nonsurgical) treatment methods such as radiation therapy or chemotherapy to the desired degree. However, since leiomyosarcoma is a relatively rare form of tumor that can also take many different forms, the necessary therapeutic steps are usually based on the individual case. If a leiomyosarcoma has already formed metastases in neighboring tissue, these also require surgical removal if medically possible. Metastases of a leiomyosarcoma of the uterus often affect the ovaries of a woman. If this is the case, doctors often recommend complete removal of the ovaries, depending on the individual clinical picture. With the help of such an operation, the risk of metastases remaining in the ovaries can be reduced. If lymph nodes are affected by metastasis in the presence of leiomyosarcoma, lymph node removal (as opposed to removal of affected ovaries) has not usually contributed to successful healing – therefore, such surgery is usually not performed.
Outlook and prognosis
The prognosis for leiomyosarcoma depends on the stage of diagnosis, the start of therapy, and the general health of the affected person. If left untreated, the cancer cells will spread in the organism and the tumor will grow. Ultimately, the affected person is threatened with premature death. The more advanced the disease, the worse the prognosis. If metastases have already formed in the body, the prospect of recovery is significantly reduced. Cancer therapy is required, which is associated with numerous side effects and risks. Due to the multitude of complaints, the impairment of the quality of life and the course of the disease, secondary diseases often develop. The emotional burden is unmanageable for many and therefore the risks for mental illness are increased. If the tumor can be completely removed during a surgical intervention, the further prospects improve.In a subsequent chemotherapy, the new formation of the cancer cells should be prevented. If no further complications occur, recovery is possible. Despite an achieved cure, a new formation of the tumor can take place in the course of life. In most patients for the recurrence of symptoms to a worsening of the prognosis. Often, the body’s immune system is so weakened due to the previous experience that a new healing is difficult.
Prevention
Because the exact causes of the development of leiomyosarcoma are currently largely unknown, it is almost impossible to prevent the disease. However, regular medical checkups can help diagnose leiomyosarcoma early. Early visits to the doctor in the event of unusual symptoms, such as uterine bleeding that is independent of the menstrual cycle or bleeding that occurs despite the fact that menopause has already been completed (the absence of menstruation due to age or development), also serve to detect a possible leiomyosarcoma in good time – in this way, further tumor growth can be prevented with the help of appropriate treatment steps.
Follow-up
In most cases, the options for follow-up care of leiomyosarcoma are significantly limited. First and foremost, early detection of the disease is important to prevent further complications and discomfort. Self-healing is also usually not possible with leiomyosarcoma, so the affected person should see a doctor at the first symptoms and signs of the disease. In the worst case, the tumor spreads throughout the body and eventually leads to the death of the affected person. Most of the affected persons are dependent on a surgical intervention, in which the tumor is removed. In any case, the patient should rest and take it easy after the operation. Physical exertion or other stressful activities should be avoided in order not to expose the body to unnecessary strain. Furthermore, even after successful removal of the leiomyosarcoma, regular checks and examinations by a doctor are necessary so that other tumors can be detected and removed at an early stage. Due to the disease, many affected persons are dependent on the support of their own family in their daily lives. It is also possible that leiomyosarcoma reduces the life expectancy of the affected person, although the further course is highly dependent on the time of diagnosis.
What you can do yourself
The possibilities for self-help are very limited in the case of leiomyosarcoma. The main focus here is on early detection and treatment of the tumor, as this can prevent metastasis. In case of chemotherapy, patients need a lot of support in their daily life. The support should not only take place on a physical level, but also on a psychological level. Here, conversations with familiar or close people can have a positive effect on possible psychological complaints or depression. Children should always be fully informed about the disease in order to avoid psychological disorders. Furthermore, those affected must always be supported in their everyday lives in order to avoid unnecessary stress on the body. Above all, help from friends or relatives always has a positive effect on the patient’s state of health. In addition to chemotherapy, some patients also rely on radiation or surgical procedures to remove the tumor. This does not always result in a complete cure. Frequently, contact with other affected patients can also have a good effect on the course of the disease and on the patient’s quality of life.
