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Sarcoma is a relatively rare type of cancer, accounting for only about 1% of all malignancies in the U.S. While the term sarcoma may suggest a single disease, there are actually more than 70 subtypes of the disease that fall into two broad groups: soft tissue and bone. Around 80% of sarcomas arise from soft tissues, such as muscles, tendons, fat, blood vessels, skin and nerves. Bone sarcomas, which can also affect children and young adults, form in the cells that make hard bone tissue.

Florida Sarcoma Rates By County:

1. Miami-Dade: 686

2. Broward: 532

3. Hillsborough: 368

4. Duval: 302

5. Pinellas: 294

Source: FLHealthCHARTS figures (2013-17)

The American Cancer Society estimates 13,500 new sarcoma diagnoses this year. Florida does not report figure estimates in advance of a given year, but an analysis of state Department of Health data from 2013-17 shows more than 5,600 Floridians were diagnosed with sarcoma. The county with the most cases was Miami-Dade, followed by Broward and Hillsborough.

But when you take a closer look at the 15 counties in Moffitt Cancer Center’s catchment area, you see that several counties have a high number of sarcoma cases, including Pasco, Pinellas and Sarasota. Catchment area is a term the National Cancer Institute uses to define a geographic region in which a cancer center concentrates its research, education and outreach efforts.

For Sarcoma Awareness Month, Moffitt partnered with Charlotte County Board of Commissioners to educate and bring awareness to the disease. The county made a proclamation emphasizing the importance of knowing the signs and symptoms of the disease.

Charlotte County Commissioner presents Moffitt's Dr. Ricardo Gonzalez with a Sarcoma Awareness Month proclamation

Charlotte County commissioner Joe Tiseo, right, presents Moffitt's Dr. Ricardo Gonzalez with a Sarcoma Awareness Month proclamation.

Dr. John Mullinax, an assistant member in Moffitt’s Sarcoma Department, says over half of soft tissue sarcomas start in an arm or leg. A lump may grow over several weeks or months, and the person may not experience pain or other symptoms until the tumor is quite large. This is even more true if a sarcoma is growing in the abdomen where symptoms can occur infrequently.  As the sarcoma grows, it can press on blood vessels, nerves or nearby organs, which may produce symptoms such as pain, trouble breathing or inability to tolerate food.  Bone sarcoma symptoms are generally more consistent with localized pain and swelling in the affected area.

“From the top of your head to your toe, sarcoma can occur in any connective tissue,” said Mullinax. “When patients have a lump or mass, they’re often seen first by their primary care doctor or with an orthopedic surgeon. Because these tumors are rare, sarcomas are not commonly encountered by community physicians, making early referral especially important.  Moffitt is fortunate to have a comprehensive, multidisciplinary clinic that sees a high volume of sarcoma patients, making the rare diagnosis common for our physicians.  It is always important to get a second opinion from a specialized center like Moffitt, especially for rare diagnoses like sarcoma.”

image of Dr. John Mullinax

Dr. John Mullinax, surgical oncologist

Sarcoma treatment differs by patient and severity of the disease, but can include chemotherapy, radiation and/or surgery.

Moffitt has also been a leader in offering immunotherapy as another treatment option for sarcomas. The Sarcoma Department was the first in the country to open a sarcoma adoptive cell therapy clinical trial solely focused on sarcoma patients receiving an infusion of tumor infiltrating lymphocytes.

“Unfortunately, there are not a lot of effective treatments for metastatic sarcoma, but we have leveraged our experience with cellular immunotherapy in other diseases for our sarcoma patients,” said Mullinax. “That’s the beauty of receiving care at a place like Moffitt. These advanced clinical trials can only be done when everybody is on the same team when everyone is sharing data and sharing resources.”