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Fewer than 1% of adult cancers are sarcomas, yet the disease includes over 150 distinct types, making each case unique. Dr. Priscilla Merriam, a medical oncologist at the Sarcoma Center of Dana-Farber Cancer Institute, explains that this variety makes diagnosis and treatment challenging.
The word “sarcoma” covers a broad range of tumors.
“Sarcomas are rare, and their many forms make it hard to understand what a diagnosis means or where to find help,” Merriam said. One patient might have leiomyosarcoma, a cancer of smooth muscle, while another has liposarcoma, which starts in fat cells. Some types grow slowly and others do not.
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This diversity means each subtype behaves differently. A doctor who sees one type annually may not recognize another.
Most sarcomas are found by chance—a lump, pain, or scan done for another reason. Since these cancers are uncommon, the first doctor may not suspect malignancy. A benign fatty growth called a lipoma can feel the same as a liposarcoma. A uterine fibroid, usually harmless, may look identical to leiomyosarcoma on an ultrasound.
If a surgeon assumes a mass is benign, the operation may not include the wide margins needed for cancer. This can leave microscopic disease behind, raising the risk of recurrence. Merriam advises patients and doctors to question anything unusual. A biopsy should be considered before deciding on treatment.
No single treatment works for all sarcomas. Surgery is common, sometimes combined with radiation to reduce recurrence. Chemotherapy, targeted drugs, immunotherapy, and cellular therapies are options for subtypes that respond to them. The American Cancer Society expects 13,910 new soft-tissue sarcomas and 4,110 new bone cancers in the U.S. in 2026.
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Merriam emphasizes that the best results come from teams of specialists. Medical oncologists, surgeons, radiation oncologists, radiologists, and pathologists should review each case together. A pathologist at a specialized center may have seen hundreds of a single subtype, while a general pathologist may have encountered it only a few times. That difference can affect how a tumor is classified and treated.
Clinical trials offer additional options. Since each subtype is its own disease, researchers search for what drives an individual type of the cancer, and whether that creates a vulnerability amongst the malignant cells that treatment could target. Trials are available at any stage, from initial treatment onward.
Most sarcomas appear without clear causes. “This can happen to anyone, and there’s often no explanation,” Merriam said.
