Sarcoma is one of the rarest kinds of cancer but also one of the most severe ones. Sarcomas are different from other various types of cancer as it develops in the most different type of tissue. it occurs in the connective tissue of the body. Connective tissue is a type of group of cells that contributes towards connecting and supporting different kinds of tissues in your body. Common connective tissues in our body include blood vessels, fat, muscles, deep skin tissue, nerves, bones, fat and cartilage.

Sarcomas are not only present in the bones, muscles, tendons and other connective tissue, they can develop in other parts of the body as well. it is just a general term used for connective tissue and bone tumour. There are more than 50 different types of sarcoma but they are mainly divided into two common groups based on the location of their occurrence.

There are several treatment options available to cure bone cancer at Oncoplus Hospital, Delhi.

Types

it is differentiated into two main kinds: Soft tissue (Connective tissue) Sarcoma and Osteosarcoma (Bone Sarcoma). Sarcoma is very rare in adults but it does develop in both adults and children. Here is one of the most common types of sarcoma of soft tissue and Osteosarcoma:

• Leiomyosarcoma: Affects smooth muscle in organ walls, often in the abdomen.
• Gastrointestinal stromal tumour: Affects specialized gut neuromuscular cells
• Synovial sarcoma: Stem cells tumour where cancerous tissue develops around the joints
• Liposarcoma: Affects the fat cells in soft tissue. It occurs inside the thigh or in the retroperitoneum.
• Neurofibrosarcoma: Affects the protective lining of the nerves.
• Angiosarcoma: Affects the blood or lymph vessels.
• Rhabdomyosarcoma: Occur in skeletal muscle.
• Vascular sarcoma: Affects blood vessels.
• Fibrosarcomas: Affect fibroblast which is the most common cells of connective tissue
• Myxofibrosarcoma: Affects the connective tissue. Develops around the arms and legs of older adults.
• Mesenchymal: Extremely rare. Affects any part of the body.
• Schwannoma: Affects the tissues that cover the nerves.
• Kaposi’s sarcoma: Affects the skin mostly but can develop elsewhere.
• Osteosarcoma (Sarcoma of the bone)
• Chondrosarcoma: Affects the cartilage.
• Fibrosarcoma: Affects fibrogenic tissue.
• Ewing sarcoma: Affects the bone or soft tissue.

Symptoms

Sarcoma is differentiated into two groups and each shows different symptoms of their development. However, the soft tissue sarcomas are hard to identify as they can develop in any region of the body. However, some helpful signs are still there in its development. Here are some of the most common ones:

• Uncomfortable while breathing
• Presence of noticeable lump which is usually not painful in the beginning.
• Increase in the size of swelling or lump that affects the nerves or muscle
• Symptoms of Bone Sarcoma

Compared to tissue sarcoma, osteosarcoma is pretty visible and it develops quite early. Here are some of the most common symptoms of bone sarcoma:

• Pain in the body around the affected bone
• Excessive soreness and aching in bones especially at night
• Noticeable and painful swelling
• Develop a limit if it occurs in your leg

Osteosarcoma is quite prevalent in youngsters and children than adults. Hence if you experience such symptoms, don’t always mistake them for casual pain or swelling from sports or games. It’s usually bigger than that and if you experience the pain majorly at night then ask for immediate help and support from your doctors.

Book an appointment with the best oncologists for cancer treatment as well as diagnosis at best cancer Hospital in Delhi.

Risk Factor of Sarcoma

The cause of the Sarcoma is still unclear to researchers and scientists working on its development. However, some suggestive risk factors can contribute towards its leading cause.

Here are some noteworthy risk factors that increase the rate of sarcoma occurrence in the human body:

• Inherited Syndromes: Inheritance of any cancerous disease plays a consequential part on the progeny or the next generation. If there are syndromes like familial retinoblastoma and neurofibromatosis type 1 in your family then, unfortunately, you have a higher chance of developing sarcoma.
• Chemical Inhalation or Use: Harmful chemicals also contribute to sarcoma growth. Hence if you live under the exposure of Industrial chemicals then there's a higher risk of developing sarcoma that mainly affects the liver.
• Radiation therapy for cancer: If you’ve undergone radiation treatment for cancer then there’s a risk of developing sarcoma later in life.
• Exposure to Virus: The virus called herpesvirus 8 is also one of the biggest reasons behind the contribution of sarcoma. It causes Kaposi’s sarcoma which is a type that weakens the immune symptoms and makes you more prone to deadly diseases.
• Lymphedema: Lymphedema is a condition where swelling occurs due to the backup of lymph fluid when there's a blockage in the lymphatic system which leads to the risk of developing angiosarcoma (as discussed above).

Diagnosis

The diagnosis of sarcoma is done by various tests and procedures to comprehend the various stages of tumour development. Here are some of the common diagnostic steps for sarcoma identification:

• Physical Exam: Physical exams consist of checking the changes in the body such as the development of the lumps and other noticeable symptoms of sarcoma.
• Biopsy: Biopsy is a procedure that involves inspection of the suspicious tissue for lab testing to determine any growth signs and symptoms.

Biopsy is done by either piercing a needle through the skin or cutting away the tissue during operation depending on its location.

• Scans and other Imaging Tests: Imaging tests help to recognize the change in the body through X-rays and other tests depending on your situation. Imaging tests like MRI are helpful in identification of connective tissue problems. While other tests like ultrasound, scans and positron emission tomography scan also help to identify sarcoma better.

Treatment options of Sarcoma avialable at Oncoplus Hospital,Delhi.

Sarcoma is majorly treated by surgery through removing cancer. However, other treatments are used after or before the surgery. Not all surgery types work on all sarcoma as each one is different based on their situation. Here are some of the most common treatment for sarcoma:

Surgical Operation

Surgery helps to remove the cancerous cells of the sarcoma hence stopping it from spreading to the rest of the body. Sometimes when the condition is severe then there’s a need to amputate the arm or the leg of the body to stop cancer from growing to the other parts of the body. However recently the surgeons are trying to preserve the limp function to the extent that is possible. Surgical operation for sarcoma also results in hurting significant structures in the body such as nerves and organs to remove the sarcoma to the best way possible.

Chemotherapy

It’s one of the most common ways to treat cancerous cells through drug treatment with the help of chemicals to kill the growing cells. Chemotherapy can help with treatment for some types of sarcoma to stop its growth.

Radiation Therapy

Its a type of cancer treatment that involves the use of beams of intense energy to kill the growing cancerous cells in the body. Radiation therapy uses X-rays and also protons and other types of energy to neutralise the growing disease. It’s an external therapy where the radiation comes from the machine and moves around your body.

Immunotherapy

It’s a drug treatment that works by strengthening the immune system enough to fight out the cancerous cells.

Ablation Therapy

Ablation therapy involves destroying cancerous cells by the use of electricity to heat the cells, or use extreme cold liquid to freeze the cells. Even high-frequency ultrasound waves are also used to destroy the damaging cells to remove the growing tumour.

Consult the cancer specialist at Oncoplus Hospital, Delhi.

Depression In Cancer Patients

It is difficult to cope up with after effects of cancer for any patient. Some patients with cancer may experience depression before, during or some after the cancer treatment. Depression is a type of disorder which is associated with the patient’s mood and can affect the patients and their families to greater extent.

Hence, identifying and managing depression are also considered as an important parts of cancer treatment.

There are several treatment options available to cure bone cancer at Oncoplus Hospital, Delhi.

IMPORTANCE OF IDENTIFYING DEPRESSION IN CANCER PATIENTS

The cancer patients typically experience sadness and a sense of grief for many different reasons, such as changes in life plans, changes in self-esteem, bodily changes, repulsion in social roles, financial challenges and survival issues.

A cancer patient may show the symptoms of depression right after diagnosis or anytime during or after treatment. These symptoms may range from mild to severe. Severe depression may affect a patient's relationships as well as day-to-day life. This is termed as major depressive disorder.

Depression is a serious illness that can have a major impact on a cancer patient’s quality of life. As per a few studies,15-20% patients experience some sort of depression during or after their treatment. And depression during the treatment may impact the quality of treatment.

As Patient experience these changes and challenges, it is important to monitor the feelings the patient must be experiencing to ensure that patient’s medical care is not impacted due to these issues.

Book an appointment with the best oncologists for cancer treatment as well as diagnosis at best cancer Hospital in Delhi.

HOW TO DIFFERENTIATE DEPRESSION FROM NORMAL SADNESS

Depression is much more than the normal feelings of sadness. A patient is considered to be going with depression when he/she experiences one or more of the following symptoms for more than 2 weeks:

• Feeling upset most of the time
• Feeling of worthlessness
• Feeling of self-guilt without any reason
• Decreased ability to concentrate
• Changes in eating habits and sleeping patterns
• Lack of pleasure and interest in the activities he/she used to enjoy earlier
• Feeling of nervousness
• Delayed physical and mental responses
• Tiredness for no reason
• Suicidal thoughts

DETAILED SIGNS AND SYMPTOMS OF DEPRESSION

If patient suffers from any of these issues for more than 2 weeks, in addition if the symptoms are severe enough to cause noticeable problems in day-to-day activities of the patient’s life, it is really important to speak with the patient’s treating doctor.

Signs and symptoms a cancer patient may experience have been classified into the following categories:

1. SYMPTOMS ASSOCIATED WITH MOOD
   • Feeling low
   • Feeling worthless
   • Feeling upset most of the time
   • Feeling of hopelessness
   • Feeling of irritability
   • Feeling of numbness
2. BEHAVIOURAL SYMPTOMS
   • Lack of interest in activities the patient used to enjoy earlier
   • Frequent crying
   • Social withdrawal or withdrawal from friends or family
   • Lack of motivation to do daily activities
3. COGNITIVE or MEMORY RELATED SYMTPOMS
   • Difficulty in ability to focus
   • Finding it difficult to make decisions
   • Problems related to memory
   • Negative thoughts or self-destructive behaviour in extreme situations like thoughts of hurting patient’s ownself.
4. PHYSICAL SYMPTOMS
   • Tiredness for no reason
   • Loss of appetite
   • Insomnia-sleeping disorder when a person is not able to fall asleep and stay asleep.
   • Hypersomnia, a condition in which a person feels too sleepy most of the time.
   • Sexual dysfunctions including erectile dysfunction in males or lower sexual desire in both genders.
5. FEAR OF TREATMENT RELATED SIDE EFFECTS
   It is normal to fear treatment-related side effects as a patient prepares to start the cancer treatment. “Our team of Oncologists at Oncoplus Hospital, Delhi encourage our patients to discuss with us about the possible side effects and how to manage them instead of keeping a fear. Our patient’s health care team is focused on preventing and controlling side effects.”Some of the most common fears about side effects of cancer treatment include the following:
   • Loss of self-control
   • Not knowing what to expect.
   • Physical discomfort including pain, nausea, or tiredness.
   • Trouble in doing daily activities, such as going to work, completing household work and attending social events.
   • Changes in appearance, such as scars and hair loss.
   • Sexual problems
   • Fertility problems means difficulty becoming pregnant after treatment.
   • Anxiety about the process involved in the whole treatment.

RISK FACTORS FOR DEPRESSION

The following risk factors make cancer patients more likely to have depression. These include:

• Previous history of depression or anxiety
• Any history of depression or anxiety in family of the patient
• Lack of emotional support from friends or family
• Financial challenges

SCREENING FOR DEPRESSION

A few symptoms listed below may be as a result of the side effects of cancer or cancer treatment. Hence it is important to find the causative factor and confirm the diagnosis for a better plan of treatment.

Screenings should happen at the time of a cancer diagnosis as well as during and after treatment.

Treatment for depression depends on patient’s symptoms and how often patient has those symptoms.

Oncoplus Hospital, Delhi encourage our patients to discuss the following with the doctor:

• Your feelings
• Specific concerns which you do not want to share with anyone in your family
• Physical symptoms you are experiencing
• Effects on your daily life if any

TREATMENT OPTIONS FOR DEPRESSION

People with depression usually get benefits from specialized treatments. For patients with moderate to severe depression, a mix of psychological treatment and medication is often the most effective treatment approach. While for some patients with mild depression, interacting with a mental health professional may be enough to relieve depressive symptoms.

However, common treatment options that would definitely help any patient to cope up with the any sort of depression are discussed below:

1. Psychological treatment: Mental health professionals including licensed counsellors, psychologists, and psychiatrists can provide patients with tools to improve their coping skills, develop a support system, and reshape negative thoughts.Certain effective options include individual therapy, couples or family therapy, and group therapy. In addition, psychiatrists can prescribe medications too.Psychotherapy or counselling can occur one-on-one or in a group setting. Some common evidence-based forms of treatment that are effective for depression are cognitive behavioural therapy, acceptance and commitment therapy and interpersonal therapy.
2. Exercise: Exercise can also help in treating depression. Most studies show that exercising at least three times a week is good and ideal to cope up with depression. Patient should consult his/her doctor before engaging in any physical exercise.
3. Follow routines: A patient during or after the cancer treatment may experience negative thoughts so following a routine can help patient maintain a feeling of accomplishment and a sense of control. A routine can also help push a person to engage in activities he/she would not necessarily be motivated to complete.
4. Medications: Different types of antidepressant medications are available in market. The doctor defines the plan of treatment and select the most appropriate antidepressant based on the following factors:
   • Patient’s requirements
   • Potential side effects
   • Other medications patient is already taking
   • Patient’s medical history

Doctor should be informed about all the medications and supplements the patient is taking because some medicines may interfere with types of antidepressants.
Some patients may have improvement within 2 weeks after starting an antidepressant medication. However, it often takes up to 6 to 8 weeks for the medication to show its full effectiveness. Medication is particularly effective for improving mood related issues and other physical symptoms associated with major depressive disorder.

Psychological treatment may be helpful for managing negative thoughts and low self-esteem and finding better coping strategies.

COPING WITH PATIENT’S FEARS

Patients can often manage side effects with medication. And many side effects can be prevented before the treatment starts. It is advised to talk with the patient’s health care team about how to manage the common side effects for each treatment.

The following tips can help patient cope up with the fear of treatment related side effects:

• Ask the doctor for a list of symptoms that may require immediate care.
• Stay involved in Patient’s care and express Patient’s thoughts in the treatment decision-making process.
• And ask the doctor about visiting a fertility specialist before treatment begins.
• Stay focused on the present. Overthinking on things that may or may not happen will only worsen negative feelings.
• Try relaxing techniques, such as yoga, meditation, music etc.

CONSIDER TALKING TO OTHERS

Talk with Patient’s family and loved ones about Patient’s expectations and concerns. Their support can ease Patient’s fears about experiencing side effects from treatment. Patient might also talk with Patient’s employer about what Patient will be going through. Discuss adjusting Patient’s schedule while Patient during treatment.

HOW CAREGIVERS CAN HELP

If Patient are a caregiver, family member or friend to someone suffering from depression, there are many ways patient can help patient’s loved one. Encourage him or her to seek treatment for depression.

Also, provide a safe place for patient’s loved one to talk to patient about what he or she is experiencing and offer non-judgmental feedback. Show Patient’s loved one that Patient truly care about his or her physical and emotional well-being.

Consult the cancer specialist at Oncoplus Hospital, Delhi.

IMMUNE SYSTEM RECOVERY
Chemotherapy destroys the cancer cells because cancer cells cannot repair themselves very well. Chemotherapy medicines target rapidly dividing cells, which are cancer cells but also affect many of the normal cells in the patient’s blood, bone marrow, mouth, intestinal tract, nose, nails, vagina, and hair.

Patients with cancer often have a weakened immune system, putting them at risk for viral and bacterial infections.

“When the cancer itself or cancer treatment, like chemotherapy or radiation therapy, affects the bone marrow, the patient’s immune system gets weakened. “

This is because, blood cells are made in the bone marrow and when cancer or its treatment affects bone marrow, the number of red blood cells, white blood cells, and platelets that are produced by bone marrow becomes lower than normal. Typically, the greatest impact is on white blood cells, which are termed as our body’s defence system. When blood cell counts are low, patient’s body is more vulnerable to infection that means his/her body cannot fight off an infection very well.

After a certain period after chemotherapy, most patients assume their immune system has retrieved to normal. But research suggests that the patient’s immune system can be compromised for up to nine months after receiving chemotherapy, leaving patient prone to infections.

As per a few studies most of the patients recovers within nine months, if they do not smoke. That is the reason Oncologists and team at Oncoplus Hospital, Delhi always encourage our patients to quit smoking.

There are several treatment options available to cure bone cancer at Oncoplus Hospital, Delhi.

HOW DOES CHEMOTHERAPY AFFECT PATIENT’S IMMUNE SYSTEM?

Generally, chemotherapy medications can have an impact on immune system of the patient while or after receiving the treatment. How does the treatment affect the immune system depends on many factors including:

• Dosage of the chemo medicines
• Combination of medicines
• Longevity of the treatment
• Patient’s age and overall health
• other medical conditions if patient has

Book an appointment with the best oncologists for cancer treatment as well as diagnosis at best cancer Hospital in Delhi.

WHAT CAN BE DONE ABOUT CHEMOTHERAPY’S EFFECTS ON THE IMMUNE SYSTEM?

1. While receiving chemotherapy treatment, the oncologist or cancer specialist should review the medications patient is having and should inform the patient about the potential effects on immune system.
2. Chemotherapy brings a few side effects like fever, vomiting, nausea, loss of appetite, fatigue and a weakened immune system. There are certain ways that a patient can follow before, during, and after chemotherapy to take care of his/her immune system, such as getting enough rest, eating a healthy diet, exercising, and reducing stress as much as possible.
3. Before the start of chemotherapy, a complete blood count (CBC) of patient can be tested to check the baseline levels of different blood cells, including white blood cells. A series of blood test can be done periodically throughout the treatment to keep an eye on the white blood cells count.
4. A patient can get an infection with a weak immune system that can worsen quickly and even turn life-threatening in some cases. In case of fever higher than 100 a patient should seek urgent medical attention.
5. Immunotherapy is a treatment that works by boosting the immune system to response to help the patient’s body find and attack more cancer cells. However, immunotherapy does not necessarily boost the patient’s natural defence mechanism the way a normal healthy human has because a patient tends to take these newer immunotherapy drugs when other treatment options are failed.

PRECUATIONS TO BE TAKEN BY PATIENTS TO COPE UP WITH A WEAK IMMUNE SYSTEM

During and even after cancer treatment, patient’s body might temporarily be unable to fight bacteria, viruses, fungi, and other germs. Hence, it is really important to take certain steps to protect oneself against infection when a patient’s immune system is weakened by the cancer treatments. In addition, these steps become absolutely critical if it is confirmed that the white blood cells count is low.

Below are some of the precautionary measures most often recommended for patients whose immune system is weakened by the ongoing cancer treatments. These measures cannot eliminate the infection completely but can help lower the risk of infection.

1. Sound Sleep

A 7 hours of sleep a night is really important for the patients after chemotherapy. It is not bad to get less sometimes, but getting not enough sleep most nights, it could strain the immune system. And as a result, patient is more likely to get sick from colds, flu, and more serious infections. Also, the recovery is slower as compared with a healthy person.

2. Balanced and healthy diet

Eating a healthy diet including a wide range of fruits, vegetables, and protein is important. The objective is to get different nutrients to support the immune system. Patient can try to have small amounts of foods which is good for his/her system even if he/she is not that hungry.
Patient should follow smart eating which means knowing what to avoid, for example, supplements that claim “immune support” on the label can be avoided as these could affect the treatment nor they are likely to boost the health.

3. Exercises

For many patients with cancer, exercise is key for a healthy immune system. We advise to consult your treating doctor on the same. One should keep in mind when to skip exercises program, for example;

• In case of extreme fatigue
• In case of anaemia /Low haemoglobin
• In case of poor muscle coordination
• In case of low white blood cells count

4. Stress management

Emotional stress is common in cancer patients which is obviously not good for the health. This may flood the patient’s body with chemicals that can affect his/her immune system, digestive system and more. You can read our blog on how to manage the stress.

5. Personal hygiene

• It is advised to wash your hands frequently throughout the day with soap and warm water especially before cooking or eating, before touching eyes, face, or nose, after using the bathroom, after coughing; and after being in a public place or at a public gathering.
• In absence of soap and water, hand sanitizer can be used.
• It is recommended to use an extra-soft toothbrush to brush the teeth. A gentle mouthwash can be used by the patients after consulting it with their treating doctor.
• Keep the area clean and dry if patient has a chemotherapy port.
• Patient should clean himself/herself well after going to the bathroom.
• A warm shower, or sponge bath is recommended every day.

6. Avoiding cuts or skin breaks

• Do not cut, bite, or tear the nail cuticles.
• Avoid manicure and pedicure.
• Use knives, scissors, or needles carefully.
• Wear protective gloves for activities like cleaning or washing dishes or gardening or chopping vegetables.
• Do not touch or scratch pimples, rashes, or bug bites.
• Use insect repellents that do not contain harsh chemical ingredients.
• Use a gentle body lotion to moisturize the skin daily to keep it supple and prevent cracking.
• Wear shoes inside and outside the house.
• Apply antibiotic ointment to any insect bites, torn cuticles, or cuts. Cover cuts with a band-aid and report any signs of infection to the doctor.

7. Avoiding germs

• Avoid large crowded places like concerts, cinema halls, school events, airports as much as possible.
• Stay away from people suffering with contagious illness such as cold, flu, virus, or any sickness the cancer patient is prone to catch.
• It is advised to stay away from people who have recently been vaccinated against chicken pox, smallpox, polio, measles-mumps-rubella, or shingles because these vaccines are made from live viruses.
• While gardening or cleaning, or helping kids with the bathroom/diapering, wear protective gloves.
• Wear protective gloves while picking up the pets, throwing the garbage or collecting trash.
• Clean frequently touched items at home and work such as door handles, phone receivers, keyboards, and TV remotes.
• Avoid going into pools, hot tubs, water parks, lakes, or ponds.
• Do not share towels, drinking glasses, or utensils with others in house

8. Practicing food safety

• One should wash his/her hands well after handling and preparing foods.
• Foods or drink juices such as milk, cheese, yogurt, and fruit juice that have not been pasteurized should not be consumed.
• Cook meat thoroughly.
• Eat vegetables after cooking rather than eating them raw.
• Dispose the outdated or stale food.
• Avoid nuts and raw sprouts.

Consult the cancer specialist at Oncoplus Hospital, Delhi.