July is International Sarcoma Awareness Month and for the first time in Israel, a march in its honor took place in Tel Aviv.
If you have no idea what sarcoma is, you’re probably not alone. This is one of the main reasons why Ichilov Hospital decided to hold such a march, to inform the public about the disease and the advanced treatment options for it. The march was organized by the hospital in partnership with Haim Association, a charity that assists children with cancer in Israel.
“In the US, this is already an old tradition that takes place every July, during Sarcoma Awareness Month. This morning, for the first time in Israel, it happened to us as well,” one of the organizers posted on Facebook.
“There are more than 50 known subtypes of this rare cancer, and each has a different biological behavior.”
Prof. Guy Lahat
What is a sarcoma?
“Sarcoma is a type of cancer that develops in bones, soft tissue like fat, muscle, nerves, cartilage and blood vessels. Soft tissue sarcomas can develop anywhere in the body from head to toe, while most commonly appearing in the abdomen or feet,” Prof. Guy Lahat, director of surgery at Ichilov Hospital told the crowd at the event. According to the American Cancer Society the main types of sarcoma are found in bone and soft tissue.
“There are more than 50 known subtypes of this rare cancer, and each has a different biological behavior,” Lahat added.
According to the Cleveland Clinic, approximately 16,000 cases of sarcoma are reportedly diagnosed annually in the US. Ichilov Hospital states that about 300 are diagnosed each year. Sarcoma makes up about 15% of childhood cancer diagnoses and only 1% of all adult cancer diagnoses.
The Cleveland Clinic website notes the following rates of sarcoma in the various parts of the body:
- 40% occur in the lower extremities (legs, ankles, feet).
- 15% occur in the upper extremities (shoulders, arms, wrists, hands).
- 30% occur in the trunk/chest wall/abdomen/pelvis.
- 15% occur in the head and neck.
Some noteworthy sarcomas are liposarcoma (tumors that develop from fatty tissue, usually over the age of 50), synovial sarcoma (typically occurs in the arms, legs, fingers and toes), Ewing sarcoma (commonly affects bones, such as the ribs, upper arm bone, thigh bone, and pelvic bone in young adults), osteosarcoma (usually develops in the osteoblast cells that form bone, and leiomyosarcoma (develops in the smooth muscle of abdominal and pelvic organs and blood vessels over the age of 50).
How are sarcomas dealt with?
Sarcomas are typically diagnosed with a thorough in-depth examination of one’s family history, a physical examination, scans (MRI, CT, PET-CT, bone scintigraphy, X ray, or ultrasound) and a biopsy.
“There are several proven risk factors for sarcomas like radiation, edema of the limb due to lymphatic issues, exposure to chemicals and rare genetic conditions, but most sarcoma patients don’t belong to any of the groups I mentioned,” Lahat said at the march.
So when should one suspect that something is wrong? When a new lump appears under the skin and grows over time.
Because of the diverse biological nature of these tumors, there isn’t a one-size-fits-all treatment, but rather many different protocols of treatment. Most will include some type of chemotherapy, surgery if possible, and radiation.
In most localized sarcomas, the best chance for a “cure” is to remove it by surgery, according to the American Cancer Society. But due to the complexity of early detection of sarcomas, the tumor will often develop beyond what is called “stage 1.”
In such cases the first line of defense (or attack) is chemotherapy (most commonly ifosfamide and doxorubicin), with a goal to shrink the tumor, making it easier to remove.
Due to the fact that the main course of action on these tumors is surgery, whether it is resection of the tumor itself with surrounding healthy tissue (i.e margin) or whether an amputation of an entire limb, sarcoma survivors are often left with some type of disability.
Starting off on the right foot
That brings us back to July 1, to Tel Aviv’s Weitzman Street and Ichilov Hospital, where dozens of sarcoma patients and survivors, families and friends, doctors and medical staff from the Ichilov oncology departments gathered in honor of Sarcoma Awareness Month, to march in order to raise awareness for this type of cancer and for its early diagnosis.
“Usually the hospital isn’t a place I’m especially happy to come to... I usually come once every couple of months for some tests and a check-up. But today everyone is dressed in white. There is a different feeling, you can feel it, all the people here were in the same boat, everyone was affected by sarcoma,” one survivor said.
Often cancer awareness events are held in a running/race setting, but because some sarcoma patients and survivors can no longer run like they used to, it was decided to have a march, to allow most people to participate.
After a quick half-hour walk from the hospital to Shaul Hameleh Street down Sderot Chen, the march arrived at Habima Square, where in the southern corner of the square waited for the participant’s tables with drinks, food and yellow balloons (the color of the sarcoma ribbon).
After the crowd cooled down from the hot short walk (it’s still Tel Aviv and still summer), several speakers spoke. Dr. Amir Sternheim, director of the orthopedic oncology department, and surgical treatment of metastases bone diseases, opened by acknowledging that there are a lot of patients who are still on the road to recovery, unlike most of the attendees who are recovering.
“You know there are patients who are laying in the hospital as we speak, or who are just getting their diagnosis, which... I do not know if you’ve ever thought of it, but you the survivors, you are their hope,” Sternheim said. “The fact that we are at a sarcoma march with sarcoma survivors gives a lot of hope to the patients who are currently in treatment.
“You know there are patients who are laying in the hospital as we speak, or who are just getting their diagnosis, which... I do not know if you’ve ever thought of it, but you the survivors, you are their hope”
Dr. Amir Sternheim, director of the orthopedic oncology department
“There are three main important advanced pillars that the national orthopedic oncology department stands on: 30 years of experience, a multidisciplinary team, and technological advances. There is no other department of orthopedic oncology in Israel that has these components and in addition, has the passion to pursue excellence and take it to the next level,” Sternheim said.
“Every doctor wishes that his or her job will have meaning and an impact, and you [patients and families] give us that. To the survivors, thank you for coming, to the medical staff thank you for showing up every day,” he added.
One survivor, a 17-year-old girl who recently finished treatments and is on her road to recovery, optimistically summed it up: “We can’t control what life throws at us, but we can control the way we react.”
The event concluded with a short performance by singer Shusha Onyema, a long-time sarcoma survivor, performing songs written and inspired by her personal journey with cancer and her road to recovery. ■