Sarcoma: The Cancer Most People Don't Know Exists Until They're Diagnosed

When most people think of cancer, they immediately think of breast, lung or colon cancer. Sarcoma, however, remains one of the least understood cancers despite affecting thousands of people worldwide, including in India. Often called the "forgotten cancer," sarcoma develops in the body's connective tissues - including bones, muscles, fat, blood vessels, nerves and tendons - and is frequently diagnosed only after it has progressed. According to Dr. Nishith Praveenchandra Gupta, Consultant – Musculoskeletal Oncology, Narayana RN Tagore Hospital, increasing awareness about sarcoma is crucial because early diagnosis can significantly improve treatment outcomes. “Sarcoma isn't one disease; it's an umbrella term covering more than 70 distinct subtypes,

which is part of why it's so hard to pin down,” he said.Also read: Diljit Dosanjh's Nightly Belly Button Ritual Goes Viral: Does Neem and Mustard Oil Really Work?

What is sarcoma?

According to Dr. Gupta, sarcoma can be broadly classified into:

• Soft tissue sarcoma, accounting for nearly 80% of cases, affecting muscles, fat, nerves and connective tissue.
• Bone sarcoma, which includes cancers such as osteosarcoma and Ewing sarcoma.

In India, Ewing sarcoma, synovial sarcoma and osteosarcoma are among the more commonly reported subtypes. While sarcoma is considered a rare cancer, experts estimate that soft tissue and bone sarcomas affect approximately 1 to 2 people per 100,000 population. Among children aged 0-14 years, sarcomas account for around 3-4 per cent of all cancers, making awareness particularly important in younger age groups.

Why is sarcoma often missed?

One of the biggest challenges with sarcoma is that its symptoms can easily be mistaken for common, non-cancerous conditions. Unlike many cancers that develop within organs, sarcoma can occur almost anywhere in the body - from the arms and legs to the abdomen or chest wall. “It can develop almost anywhere- an arm, a leg, the abdomen- and it rarely announces itself the way other cancers do. What a patient notices is usually a painless lump, some swelling that's stuck around longer than it should, or a bone ache that doesn't seem tied to any injury,” said Dr. Gupta. Because these symptoms resemble muscle injuries, cysts or benign growths, many patients delay seeking medical attention. Some may even consult multiple doctors before sarcoma is suspected, leading to months of delay in diagnosis.

Why biopsy before surgery matters?

Experts stress that a properly planned biopsy should always be performed before removing a suspicious lump. “The biopsy helps determine the exact subtype of sarcoma and guides treatment decisions. Removing a lump without prior biopsy can complicate future treatment, sometimes requiring additional surgery to completely remove cancerous tissue,” said Dr. Gupta. Early referral to a specialist musculoskeletal oncology centre can improve both diagnosis and long-term outcomes.

Treatment has improved significantly

Advances in cancer care have transformed sarcoma treatment over the past decade. Today, management often involves a multidisciplinary team including orthopedic oncologists, surgical oncologists, medical oncologists, radiation specialists, radiologists and pathologists. Treatment may include surgery, chemotherapy, radiation therapy and targeted therapies for selected subtypes. One of the most significant advances has been limb-salvage surgery, which allows many patients to avoid amputation while still achieving effective cancer control.

When should you see a doctor?

Doctors recommend prompt evaluation if you notice:

• A lump larger than a golf ball
• A lump that continues to increase in size
• A swelling that persists for several weeks
• Deep-seated or painful masses
• Unexplained bone pain that does not improve

Although most lumps are not cancerous, delaying evaluation can allow sarcoma to spread, making treatment more complicated.

Raising awareness saves lives

Unlike breast or cervical cancer, sarcoma receives relatively little public attention in India. This lack of awareness contributes to delayed diagnosis and treatment. During Sarcoma Awareness Month, experts encourage people not to ignore persistent lumps or unexplained swelling. Recognising the warning signs early, obtaining a timely biopsy and consulting a cancer specialist can make a significant difference. While sarcoma is rare, early detection remains the strongest tool for improving survival, preserving limbs and ensuring better quality of life.