It may be one of the less common forms of cancer, but that does not mean you should not be aware of your risk of developing a bone or soft tissue sarcoma the next time you see or feel a lump or bump that just does not feel like it should be there and be that painful.

“Any mass larger than a golf ball in areas adjacent to the arms or legs or a mass larger than a marble in the hands or feet should be considered a sarcoma until proven otherwise,” said Dr. Kelly Homlar, an associate professor in the Department of Orthopaedic Surgery at the Medical College of Georgia at Augusta University.

When it comes to thinking about cancer types, it can help to put them into three broad categories. The first category is organ cancers or solid tumors. These include prostate, breast, lung cancer, etc. The second category is your blood cancers including leukemia, lymphoma, and myeloma. The final category is where we find sarcoma. For those who do not know what sarcoma is, it is a cancer type affecting the connective tissues in the human body.

“Soft tissue sarcomas are around eight for 100,000 people and bone sarcomas are around one per 100,000 people,” Homlar said. “And, when it comes to metastasizing or spreading to other parts of the body, sarcoma cells travel through the bloodstream where they often find their way to a person’s lungs.”

According to a recent report from the World Health Organization, there are around 70 different types of sarcomas. For Homlar, she divides the types into two broad categories. The first is bone sarcoma. The three most common types are Ewing Sarcoma, osteosarcoma, and chondrosarcoma. The usual treatment plan begins with chemotherapy, followed by surgery, with a second round of chemotherapy to follow. The second category would be soft tissue sarcoma. The treatment plan for soft tissue sarcoma involves radiation and surgery with some patients needing additional chemotherapy for their cancer subtype.

“Working with sarcoma patients, for me, is like putting puzzle pieces together to form a full picture,” Homlar said. “You get a patient’s medical history, you take both MRI and CT scans of their problem area, you get biopsies for the pathologist to review, and all those details start coming together to form the treatment and care path for each patient.”

When it comes to treating both soft tissue and bone sarcomas, Homlar works with a multidisciplinary team with expertise in sarcoma care. Members of this team include a medical oncologist, radiation oncologist, sarcoma pathologist, orthopedic surgeon, plastic surgeon, and musculoskeletal radiologist among others.

For Homlar, the power of this multidisciplinary approach provides patients with better continuity of care because each specialist knows what is happening with a patient during their entire treatment process. This approach allows the patient to flow through their care plan effortlessly because the road map is complete with different stops along the way and the specialist at that stop prepared for their role in the patient’s care plan.

Homlar works diligently with Augusta University Health and the Georgia Cancer Center’s physician outreach team to share information with primary care providers and other physicians referring patients to the Cancer Center for care. This training includes clearing up misconceptions such as Soft tissue sarcomas are painful. That is not the case, and in fact, most soft tissue sarcomas are painless. Another common misconception Homlar finds is that soft tissue sarcomas are “spiculated” or “invasive” appearing on imaging.

“In fact, most soft tissue sarcomas look well-marginated or well-encapsulated on scans,” she said. “Most are deep, intramuscular and fill the muscle compartment creating a football/fusiform shape, pushing the muscle aside without invading adjacent neurovascular structures.”

This is why it is always important to remember to be a strong advocate for your health. Do your research, ask lots of questions, and see other physicians’ opinions when necessary. Like with any form of cancer, the sooner you know what you are dealing with, the better the outcome will be. But, it all begins with being proactive about your health, knowing what is “normal” for your body, and discussing any changes you are concerned about with a primary care provider who can refer you to more specialty care if necessary.