Treatment of fibrosarcoma abroad
Fibrosarcoma is a malignant neoplasm arising from the connective tissues. This usually affects women more than men, especially in the age group from 30 to 40 years of age.
The tumour can be located in any body part, but its preferred spot is the connective tissue of the upper (shoulder area) and lower (thigh area) limbs.
Causes of fibrosarcoma
At the moment, the exact reasons for this disease remains unclear. There are several factors that can increase the risk of the malignant process outlined below:
- Chromosomal abnormalities, which can arise as early as childhood, can be congenital and lead to the development of fibrosarcoma.
- Ionizing radiation impact (radiation, X-ray irradiation) leads to the damage of connective tissues genetic material with their subsequent malignant degeneration. The development of fibrosarcoma is possible in 5-10 years, after exposure to high doses of radiation.
- Injuries of different locations in the anamnesis with the subsequent formation of connective scar tissue. It is assumed that scars provoke the accelerated development of the already formed malignant neoplasm.
The impact of some viruses that build into the genome of connective tissue cells is being also researched. Viruses change the genome which leads to the malignant process.
Symptoms of fibrosarcoma
Clinical signs of fibrosarcoma depend on its size and location.
Symptoms related to the tumour location are:
- A small tumour located in the soft tissues will not show itself for a long time. It is usually detected accidentally during a study to diagnose other diseases
- In the case of fibrosarcoma location near the joint, it can grow into its structures and lead to a significant reduction in the extent of one’s daily movements (contracture)
- The location of a tumour formation directly under the skin can lead to its thinning, the appearance of cyanotic staining, as well as venous fibres
Symptoms related to the tumour size are:
- Tumour is mobile at the early stages of the disease and it feels like a round or an oval formation
- Fibrosarcoma becomes immobile as malignant process progresses and it grows into the surrounding tissues
- Advanced stages of the disease are characterised by a significant tumour growth, which leads to the deformation of the body area, as well as the development of general intoxication
If the intoxication syndrome develops, it is manifested by a lack of appetite, weakness, fever, emotional instability (rapid mood swings), and depression.
The appearance of metastases in the bones is manifested by persistent pain sensations, the severity of which practically does not decrease with the use of non-steroidal anti-inflammatory drugs. Metastases in the lungs lead to coughing, shortness of breath and hemoptysis.
Diagnostics of fibrosarcoma
Diagnostic measures are prescribed by a doctor on the basis of a clinical exam including a survey, examination of the patient, as well as palpation of tissues in the area of the tumour development and regional lymph nodes.
Objective diagnostics pursues several main goals, which include determining the histological structure of the tumour, its size and the precise location in the body. Diagnostics will also show possible metastases, their number and location.
Such diagnostic goals are reached in modern European hospitals with the use of the latest devices providing accurate results. The tests include:
- Radiography of a body part where a tumour or metastasis is suspected to be
- Ultrasound of the soft tissues
- Computer tomography or magnetic resonance imaging, which makes it possible to see even small distant metastases
- Fine needle biopsy means obtaining a part of the tumour with a thin needle in order to study its histological structure under a microscope
Additional tests including a complete blood count, urine test, blood biochemistry, and electrocardiogram are conducted. This way, specialists are able to analyse possible functional disorders of various organs and systems.
Comprehensive diagnostics enables a doctor to confirm the stage of fibrosarcoma development and to choose the most effective therapeutic measures.
Treatment of fibrosarcoma abroad
Radical or palliative treatment is prescribed based on the diagnostics results. The type and extent of the surgery is defined by the location and prevalence of the oncologic process.
Radical treatment in modern European hospital presupposes tumour removal, prevention of recurrence and formation of metastases. Chemotherapy and radiation therapy are used to reach this goal.
Palliative therapy is recommended in the late stages and it can include tumour or metastases removal to restore the tissues function around the fibrosarcoma area and ease the symptoms.
Innovative treatments of fibrosarcoma
Different kinds of radiation therapy are implemented in German hospitals. This therapy is an additive to the surgery which helps to prolong the patient’s life expectancy.
The following methods are used for the treatment of fibrosarcoma:
- IMRT (intensity modulated radiation therapy) has a direct impact on the tumour cells, while causing minimal damage to surrounding healthy tissues.
- Proton therapy can replace IMRT as it’s safer, although much more expensive and is available only in certain hospitals.
- Intra operative radiation therapy is included in the treatment scheme. The radiation dose is given only after the removal of the tumour but before the wound is closed.
- Brachytherapy presupposes the introduction of granules with radioactive material right next to the tumour. It is injected through catheters, which are left after the operation. Different approaches are used in brachytherapy. Fibrosarcoma is irradiated with large doses of radiation for several minutes, or granules with radioactive material are placed inside the body for several days, but have low radioactivity.
Prognosis for fibrosarcoma
Depending on the tissue structure there are highly-differentiated tumours distinguished with a predominance of collagen fibres over cancer cells and low-differentiated fibrosarcomas, where cancer cells predominate. Low-differentiated fibrosarcomas are characterised by more aggressive growth, early metastasis and a worse prognosis.
Five-year survival, depending on the prevalence of fibrosarcoma:
- In case of localised fibrosarcoma - 83%
- In case of regional metastases presence - 54%
- In case of distant metastases presence - 16%
A favourable outcome of the disease is possible only with early radical treatment of a highly differentiated tumour.