When Raphael Pollock, MD, PhD, began his career as a sarcoma surgeon in 1984, the outcome for patients was often quite poor. &ldquo;For about a third of all sarcoma patients, amputation was the first treatment,&rdquo; says Pollock, a renowned sarcoma expert and director of The Ohio State University Comprehensive Cancer Center (OSUCCC). &ldquo;Now, amputation is only very rarely considered, let alone used.&rdquo; Advances in surgical techniques, radiation therapy, chemotherapy and precision cancer drugs have led to better outcomes and quality of life for sarcoma patients. Sarcoma facts Sarcomas are rare forms of soft tissue cancer and bone cancer (osteosarcomas). There are around 13,000 new soft tissue sarcoma &mdash; and 800 to 900 osteosarcoma &mdash; diagnoses a year, according to the American Cancer Society. This represents about one percent of all cancer diagnoses in this country. Bone and soft tissue sarcomas all start in what are known as mesenchymal cells, while other forms of cancer (such as lung and breast cancer) begin in epithelial cells. Pollock specializes in soft tissue sarcomas, which are most often found in children and young adults, and then again in people 60 and older. &ldquo;The body contains about 75 percent soft tissue, such as tendons, muscles, nerve sheaths, fat and cartilage,&rdquo; Pollock explains. &ldquo;Bone is about five percent, and the rest is water.&rdquo; Other more common types of sarcoma include leiomyosarcomas, which start in smooth muscle, gastrointestinal stromal tumors that form in the gastrointestinal tract, and Kaposi sarcomas that start in the cells lining lymph nodes and/or blood vessels. Diagnosis Soft tissue sarcomas in the deep abdomen are hard to detect, and can initially be misdiagnosed. For example, Pollock says the symptoms of liposarcomas can be abdominal pain, intestinal blockages and internal bleeding, which are symptoms of several more common gastrointestinal disorders. &ldquo;They teach us in medical school that when you hear hoof beats, think horses and not zebras,&rdquo; Pollock says. &ldquo;In many cases, it&rsquo;s understandable that when a patient has chronic abdominal pain, most physicians will think of an ulcer, gall stones, inflammatory bowel disease or bowel obstruction, and not a sarcoma.&rdquo; This delay in diagnosis means that sarcoma patients are often diagnosed in the later stages of the disease, when treatment can be more difficult. Members of the OSUCCC &ndash; James multi-disciplinary sarcoma team meet early every Wednesday morning to discuss each patient&rsquo;s specific cancer and devise the best possible treatment strategies. &ldquo;Studies have shown that, because sarcomas are so rare, patients treated at a multi-disciplinary cancer center will have better results, and we have an extraordinary and very collaborative team here at The James,&rdquo; Pollock says. Chemotherapy The standard treatment for the past 30 years has been Adriamycin, a chemotherapy drug that can often have severe side effects, including damage to muscle tissue of the heart. Because of this, &ldquo;we now use Adriamycin in combination with other drugs to reduce the severity of the side effects,&rdquo; Pollock says. &ldquo;We can administer lower doses of multiple drugs without sacrificing the efficacy.&rdquo; There are new chemotherapy drugs in development that could be used for sarcoma patients in the future. &ldquo;One of the problems is that, with a rare cancer such as sarcomas with 100 subtypes all with a distinct biology, it&rsquo;s been hard to conduct clinical trials,&rdquo; Pollock says. In recent years, major cancer centers have joined forces and shared pathology reports to find patients with similar sarcoma subtypes. &ldquo;We&rsquo;re creating clinical trials that have broader applications.&rdquo; Genomic analysis Pollock&rsquo;s colleague, James Chen, MD, is a leader in a new and promising way to group seemingly different sarcomas together to advance research and treatment. &ldquo;Two sarcomas that may initially look different may be closely aligned in terms of their genomic profiles, and we may be able to use the same targeted therapies for two seemingly different sarcomas,&rdquo; Pollock says. Call 614-293-5066 or 800-293-5066 to make an appointment with the OSUCCC &ndash; James sarcoma team.