Cancer scares us all a little, right? But not all cancers are the same. Today we are going to talk about a rare and complex type of cancer. It is called Sarcomatoid Carcinoma. The name may sound strange to you, but let's try to explain it simply. Doctors call this a very fast-growing, aggressive type of cancer .
What is Sarcomatoid Carcinoma?
Simply put, Sarcomatoid Carcinoma is a combination of two types of cancer. That is, it has characteristics of both carcinoma and sarcoma. Now let's see what carcinoma and sarcoma are.
- Carcinoma: This is the most common type of cancer. It starts in the tissues that cover the surface of our organs or skin. We call these tissues epithelial tissue because they are made up of epithelial cells.
- Sarcoma: This is less common than carcinoma. Sarcomas start in places like bone, connective tissue (e.g., cartilage, tendons), and soft tissue (e.g., muscle, fat, nerves). They are made up of a type of cell called mesenchymal cells.
So, in the case of sarcomatoid carcinoma, a tumor containing cells and tissues related to both carcinoma and sarcoma forms. These tumors grow very quickly and can spread (metastasize) to different parts of the body. When this spreads, healthy tissues in the body are damaged.
Where on the body does this occur most often?
When you hear the name sarcomatoid carcinoma, you most likely associate it with your lungs . However, this type of cancer, which has characteristics of both carcinoma and sarcoma, can also occur in other parts of the body. For example:
- Skin
- Bone
- Mouth
- Thyroid gland
- Breasts
- Stomach
- Small intestine
- Liver
- Pancreas
- Uterus
- Prostate
- Bladder
- Kidneys
- The space in the middle of the chest (this is called the ``Mediastinum''. Things like the heart, trachea, and thymus gland are here)
Sarcomatoid carcinoma, which begins in the lungs, is said to spread very quickly. In this way, it can spread to several places at once, such as the adrenal glands, brain, bones, liver, kidneys, peritoneum, pancreas, skin, and heart.
Are there different types of this too?
Yes, the World Health Organization (WHO) classified sarcomatoid carcinoma into five main types in 2015. Each of these types is called "poorly differentiated non-small cell lung carcinoma." "Poorly differentiated" means that the cells are so abnormally differentiated that it is difficult to say exactly what type they are. Non-small cell lung cancer is a common type of lung cancer that grows and spreads quickly.
These five types are:
- Pleomorphic carcinomas: These have mostly carcinoma features. However, at least 10% of them usually have sarcoma features. This is the most common type of sarcomatoid carcinoma.
- Spindle-cell carcinoma: This type of cancer gets its name from the way its cells look under a microscope. They are long, thin, and resemble the spindles of a spinning wheel.
- Giant cell carcinoma: This has large cells arranged in a pattern similar to sarcomas. These usually form in the upper part of the lungs.
- Carcinosarcoma: This includes tissue from some types of carcinoma, such as adenocarcinoma and squamous cell carcinoma. It also includes abnormal, poorly developed sarcoma tissue.
- Pulmonary blastoma: This is a type of adenocarcinoma that resembles the lung tissue of a fetus. Mesenchymal cells (like sarcomas) can also be seen.
Who is more likely to develop this?
Sarcomatoid Carcinoma is most common in men . It is especially common in people who currently use tobacco products or have used them in the past . The average age of diagnosis is around 65 years.
How common is this?
This is an extremely rare type of cancer . Sarcomatoid Carcinoma accounts for a very small percentage of all lung cancers, between 0.1% and 0.4%.
What are the symptoms of this?
The symptoms you experience depend on where the cancer has spread in your body. If you have sarcomatoid carcinoma of the lungs, you may experience symptoms like:
- Cough (persistent)
- Difficulty breathing (dyspnea)
- Chest pain
- Bleeding with mucus
- Weight loss without any reason
Why does something like this happen?
Doctors believe that a major cause of sarcomatoid carcinoma is a process called "Epithelial-Mesenchymal Transition (EMT)." Simply put, this is when the cancerous epithelial cells in non-small cell lung carcinoma change, and some of them transform into mesenchymal cells. The cancerous cells that have changed in this way spread very quickly throughout the body.
These cell changes and rapid growth are often associated with genetic mutations in the cells . You know, our genes are the instructions that tell cells how to behave. A genetic mutation is a change or error in those instructions. Scientists have found a number of genetic mutations associated with sarcomatoid carcinoma.
What are the risk factors that affect this?
A risk factor is something that increases the chance of developing a disease. In the case of sarcomatoid carcinoma, smoking is the main and best known risk factor. It is noteworthy that between 80% and 90% of people who develop this lung cancer are current or former smokers.
Don't forget that quitting smoking can protect you from many lung diseases, including cancer like this one.
How does a doctor recognize this?
Your doctor will first examine you and, if necessary, perform some imaging procedures. However, to be sure that this is sarcomatoid carcinoma, a biopsy is needed to examine the cancer cells.
- Imaging: The doctor may do a CT scan to see where the cancer is. To get a clearer view of the inside of the body, a CT/PET scan or an F-fluorodeoxyglucose (FDG)-PET scan may be done. A CT/PET scan combines two tests (CT and PET) at the same time. Fluorodeoxyglucose is a chemical that is injected into the body during a PET scan. It collects around cancer cells, making them more visible on the scan.
- Histopathology: Histopathology is the microscopic examination of a sample of cancer tissue taken from a biopsy. The appearance of the cells can help the doctor determine whether it is sarcomatoid carcinoma and, if so, what subtype it is (e.g., pleomorphic carcinoma, spindle cell carcinoma).
- Immunohistochemistry: This test looks for substances called antigens that are associated with certain types of cells. Some antigens can identify a cell as abnormal or malignant.
How is it treated?
The most effective treatment for this cancer is surgery to remove the entire tumor. Chemotherapy can help kill any remaining cancer cells after surgery. However, most of the time, the cancer has spread by the time it is diagnosed, so surgery may not be possible. If there are problems such as pain, bleeding, or difficulty breathing, radiation therapy may also be given.
In the case of sarcomatoid carcinoma, a clinical trial may be the best treatment option. A clinical trial is a study that tests the safety and effectiveness of new treatments. Scientists are currently researching treatments that can help extend the time you can live with this cancer. Two of them are:
- Targeted therapy: This involves targeting the specific characteristics that cause cancer cells to multiply uncontrollably.
- Immunotherapy: This stimulates your immune system, helping it find and destroy cancer cells.
What can we do to reduce the risk?
By choosing not to use tobacco products, you can reduce your risk of developing sarcomatoid carcinoma, as well as many other lung cancers. This is the most important step you can take.
Can this be cured completely?
In fact, sarcomatoid carcinoma is a type of cancer that is usually difficult to cure completely. However, as scientists learn more about the cellular characteristics of these tumors, such as genetic mutations, they are able to develop new treatments that target them. If you are diagnosed with this disease, you may be eligible to participate in a clinical trial that tests new treatments. Ask your doctor about this.
How long do you have to live with this disease?
It's hard to say how long you'll live in this situation, but it's important to be aware. On average, the median survival rate is about 10 months. The five-year survival rate is about 15%. However, these statistics don't apply to everyone the same. There are many factors that can affect your situation:
- The specific type of cell in cancer.
- What are the gene mutations that have occurred?
- How long it took from the onset of symptoms to the diagnosis of the disease.
- How far the cancer has grown and destroyed healthy tissue.
- How far the cancer has spread.
- Whether the doctor can completely remove the cancerous tumor.
Therefore, it is very important to talk openly about all of this with your doctor to gain a more accurate understanding of your condition.
What are the important questions to ask the doctor?
When you find out that you have sarcomatoid carcinoma, you may feel very anxious and confused because these cancers are so diverse and complex. It is important to talk openly with your doctor about your treatment options and the future course of the disease. Your doctor can explain to you what to expect based on the characteristics of your cancer cells and where the cancer is located in your body.
Here are some questions you can ask your doctor:
- Has my cancer spread?
- How severe is my cancer?
- What kind of treatment do you recommend?
- What side effects should be expected from the treatment?
- Do you think it would be a good idea for me to get a second medical opinion?
- Should I work with palliative care specialists?
- Am I eligible to participate in a clinical trial?
Your doctor can provide you with the information you need, refer you to clinical trials if you qualify, and help you get palliative care.
Things we need to remember
Okay, so, from what we've talked about about Sarcomatoid Carcinoma, here are the main things to remember:
- This is a very rare, aggressive type of cancer that spreads very quickly.
- This shows features of both carcinoma and sarcoma.
- Smoking is the main risk factor for this.
- Symptoms depend on where the cancer is located. In the lungs, symptoms may include coughing and difficulty breathing.
- Special tests (biopsy, imaging) are required to diagnose.
- Treatment options are complex. In addition to surgery, chemotherapy, and radiation therapy, new treatments (targeted therapies, immunotherapy) are also being considered.
- Although the chances of a complete recovery are low, new research offers hope.
- It is very important to talk openly with your doctor about your condition and find out everything clearly.
I hope this information is helpful to you. If you have any further questions regarding this, please feel free to consult a doctor.
` Sarcomatoid carcinoma, cancer, lung cancer, smoking, cancer symptoms, cancer treatment, carcinoma
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