Sarcoma Guide: Symptoms, Causes, Diagnosis, and Treatment
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
TL;DR
Sarcoma is a broad group of cancers that start in the bones and soft tissues — the muscle, fat, blood vessels, nerves, tendons, and joint linings that connect, support, and surround other body structures. There are at least 18 recognized types, including osteosarcoma, liposarcoma, Ewing sarcoma, and GIST. The main warning signs are a lump felt through the skin, bone pain, a bone that breaks without clear cause, belly pain, and weight loss. The exact cause is unknown — sarcoma starts with DNA changes that make cells multiply quickly and outlive healthy cells. Diagnosis runs through a physical exam, imaging tests (X-rays, MRI, CT, PET), and a biopsy. Treatment usually involves surgery — with surgeons working hard to save the limb — plus radiation, chemotherapy, targeted therapy, immunotherapy, or ablation, chosen by type, location, growth rate, and whether it has spread.
Quick Answer
Sarcoma is a broad group of cancers that begin in the bones or in soft tissues — the connective tissues that link, support, and surround other body structures. Warning signs include a lump felt through the skin (painful or not), bone pain, a bone that breaks with no clear cause, belly pain, and weight loss. The exact cause isn't clear; it begins when cells develop DNA changes that make them grow and multiply quickly and survive when healthy cells would die. Risk is higher for people with certain inherited syndromes (Li-Fraumeni, familial retinoblastoma, neurofibromatosis type 1), prior radiation therapy, lymphedema, and — for one type — human herpesvirus 8 exposure in the setting of weakened immunity. Treatment is most often surgery to remove the cancer — with limb preservation whenever possible — plus radiation therapy, chemotherapy, targeted therapy, immunotherapy, or ablation therapy, tailored to the sarcoma type, location, growth, and spread.
What Is Sarcoma?
Sarcoma refers to a broad group of cancers that start in the bones and soft tissues. Soft tissues are the tissues that connect, support, and surround other body structures — they include muscle, fat, blood vessels, nerves, tendons, and the lining of the joints. Cancer that starts in the soft tissue is called soft tissue sarcoma.
There are many types of sarcomas, and they can happen in many parts of the body. That diversity matters for one big reason: treatment for sarcoma varies depending on the sarcoma type, where it is, and other factors. So two people diagnosed on the same day can face very different plans.
What Are the Types of Sarcoma?
The family is large. Here are the recognized types.
Sarcoma type | Sarcoma type |
1. Angiosarcoma | 10. Liposarcoma |
2. Chondrosarcoma | 11. Malignant peripheral nerve sheath tumors (MPNSTs) |
3. Dermatofibrosarcoma protuberans | 12. Myxofibrosarcoma |
4. Desmoplastic small round cell tumors | 13. Osteosarcoma |
5. Epithelioid sarcoma | 14. Rhabdomyosarcoma |
6. Ewing sarcoma | 15. Soft tissue sarcoma |
7. Gastrointestinal stromal tumor (GIST) | 16. Solitary fibrous tumor |
8. Kaposi sarcoma | 17. Synovial sarcoma |
9. Leiomyosarcoma | 18. Undifferentiated pleomorphic sarcoma |
What Are the Signs and Symptoms?
Sarcoma's warning signs are easy to overlook because several of them mimic everyday complaints. The key ones to know:
Possible sign or symptom | What to watch for |
A lump felt through the skin | May or may not be painful — painlessness does not rule cancer out |
Bone pain | Persistent pain, especially if it worsens or occurs at night |
A bone that breaks with no clear cause | A fracture from a minor injury, or with no injury at all |
Belly pain | Abdominal pain, which can accompany internal soft tissue sarcomas |
Weight loss | Unexplained loss of weight |
When Should You See a Doctor?
Make an appointment with a doctor or other healthcare professional for symptoms that worry you. An important reassurance to hold alongside that: many lumps are not cancer — but any new, growing, or unexplained lump deserves a medical check rather than a wait-and-see approach.
What Causes Sarcoma?
It's not clear what causes sarcoma. What is known is how it starts: as a growth of cells in the bones and soft tissues, set in motion by changes in the cells' DNA.
A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate — and to die at a set time. In cancer cells, the DNA changes give other instructions. The changes tell the cancer cells to grow and multiply quickly, and to keep living when healthy cells would die. That combination causes too many cells.
The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body — when cancer spreads, it's called metastatic cancer.
Who Is at Higher Risk?
Four factors can increase the risk of sarcoma.
Risk factor | Details |
Inherited syndromes | Some cancer-raising syndromes pass from parents to children; examples include Li-Fraumeni syndrome, familial retinoblastoma, and neurofibromatosis type 1 |
Radiation therapy for cancer | Radiation treatment for cancer raises the risk of getting a sarcoma later |
Lymphedema | Swelling that happens when something blocks or damages the lymphatic system; raises the risk of a type called angiosarcoma |
Exposure to certain viruses | Human herpesvirus 8 can raise the risk of Kaposi sarcoma in people with weakened immune systems |
How Is Sarcoma Diagnosed?
Sarcoma diagnosis often begins with a physical exam. Your healthcare professional may ask about your symptoms and your health history; the exam helps point toward the right next tests. Because sarcoma happens in the bones and soft tissues, the tests you have may depend on the part of your body that's affected.
Diagnostic step | What it does |
Physical exam | Symptoms and health history help the professional understand your symptoms and look for other diagnostic clues |
Imaging tests | Pictures of the inside of the body that help the team understand the sarcoma's size and location — X-rays are better for seeing bones, MRIs are better for seeing connective tissues, and ultrasound, CT, bone scans, and PET scans may also be used |
Biopsy | A procedure that removes a sample of tissue for testing in a lab; it may involve placing a needle through the skin or surgery, and is sometimes performed during surgery to remove the cancer |
How Is Sarcoma Treated?
Treatment for sarcoma often involves surgery to remove the cancer. Other treatments include radiation therapy, ablation therapy, and treatment with medicines — chemotherapy, targeted therapy, and immunotherapy. Which treatments are best for you depends on the type of sarcoma, where it is in your body, how fast it's growing, and whether it has spread.
Surgery
The goal of surgery is to remove all the cancer cells. Sometimes surgeons need to remove a limb, such as an arm or a leg, to get all the cancer — this is called amputation. But surgeons try to save the limb when they can. And sometimes surgeons can't remove all the cancer without hurting nearby nerves or organs; in that case, they work to remove as much of the sarcoma as possible.
Radiation Therapy
Radiation therapy treats cancer with powerful energy beams — the energy can come from X-rays, protons, or other sources. For sarcoma, you might have radiation therapy before, during, or after surgery to remove the cancer.
Chemotherapy
Chemotherapy treats cancer with strong medicines. Some types of sarcoma are more likely to respond to chemotherapy than others. Healthcare professionals might use chemotherapy before or after surgery, and it can also help treat sarcoma that grows large or spreads to other parts of the body.
Targeted Therapy
Targeted therapy uses medicines that attack specific chemicals in the cancer cells; by blocking these chemicals, targeted treatments can cause cancer cells to die. Your professional may have your sarcoma cells tested to see whether they are likely to respond, and this treatment may be used for certain sarcoma types — or if the cancer comes back or spreads.
Immunotherapy
Immunotherapy uses medicines that help the body's immune system kill cancer cells. The immune system normally fights off diseases by attacking germs and other cells that shouldn't be in the body; cancer cells survive by hiding from it, and immunotherapy helps the immune cells find and kill the cancer cells. Tests can show if a sarcoma is likely to respond, and this treatment might help control a sarcoma that has spread.
Ablation Therapy
Ablation applies treatment directly to the cancer cells to harm them. Some types apply energy that heats the cancer cells — procedures include radiofrequency ablation and microwave ablation. Using extreme cold to harm the cancer cells is called cryoablation, and sometimes ablation uses alcohol. Ablation might be used when surgery isn't an option, or when the cancer spreads to other parts of the body.
How Can You Cope and Find Support?
With time, you'll find what helps you cope with your sarcoma diagnosis. Three practices stand out.
Coping strategy | What it means |
Learn enough about sarcoma to make decisions about your care | Ask your healthcare team about your cancer, your test results, and the treatments you might have; ask about the likely outcome (prognosis) with and without treatment — as you learn more, you may feel better about making treatment decisions |
Keep friends and family close | Strong relationships help you deal with your cancer; friends and family can handle practical needs and offer emotional support when the cancer feels like too much |
Find someone to talk with | A friend, family member, counselor, medical social worker, clergy member, or cancer support group; in the United States, the National Cancer Institute and the American Cancer Society offer further information and connections |
How Should You Prepare for Your Appointment?
Start by making an appointment with a doctor or other healthcare professional if you have symptoms that worry you. When you book, ask if there's anything you need to do in advance, such as fasting before a certain test. Then bring prepared lists.
What to bring | Details |
Your symptoms | Including symptoms that don't seem linked to the reason for your appointment, and when they began |
Key personal information | Including major stresses, recent life changes, and family medical history |
All medications, vitamins or other supplements | Including the doses |
Questions to ask | Bring a family member or friend if possible to help you remember the information you're given |
Some basic questions to consider: What's likely causing my symptoms? Other than the most likely cause, what are other possible causes? What tests do I need? What's the best course of action? I have other health conditions — how can I manage them together? Should I see a specialist? Are there brochures, other printed material, or websites you suggest? Be sure to ask all the questions you have.
Expect your healthcare team to ask: do your symptoms occur all the time or do they come and go? How bad are they? What, if anything, seems to make your symptoms better or worse?
Conclusion
Sarcoma's challenge is its diversity — eighteen-plus types starting in bones or soft tissues, each with its own behavior and its own best treatment. But the path through it is consistent: know the five warning signs (especially a lump, bone pain, or a fracture without clear cause), get the full diagnostic workup (exam, imaging, biopsy), and let the plan be matched to your specific sarcoma — its type, location, growth rate, and whether it has spread. Surgery remains the cornerstone, with surgeons actively working to preserve limbs whenever possible, and radiation, chemotherapy, targeted therapy, immunotherapy, and ablation round out the toolkit. If a lump worries you or a bone breaks too easily, don't wait it out — make the appointment.
Frequently Asked Questions
What exactly is sarcoma?
Sarcoma is a broad group of cancers that start in the bones and soft tissues — the muscle, fat, blood vessels, nerves, tendons, and joint linings that connect, support, and surround other body structures.
What are the warning signs of sarcoma?
A lump that can be felt through the skin (which may or may not be painful), bone pain, a bone that breaks with no clear cause such as a minor injury or no injury, belly pain, and weight loss.
What causes sarcoma?
The exact cause isn't clear. Sarcoma starts as a growth of cells whose DNA has changed — the altered instructions tell cancer cells to grow and multiply quickly and to keep living when healthy cells would die, forming a tumor that can invade tissue and spread.
How many types of sarcoma are there?
There are many types — at least 18 are recognized, including angiosarcoma, chondrosarcoma, dermatofibrosarcoma protuberans, desmoplastic small round cell tumors, epithelioid sarcoma, Ewing sarcoma, gastrointestinal stromal tumor (GIST), Kaposi sarcoma, leiomyosarcoma, liposarcoma, MPNSTs, myxofibrosarcoma, osteosarcoma, rhabdomyosarcoma, soft tissue sarcoma, solitary fibrous tumor, synovial sarcoma, and undifferentiated pleomorphic sarcoma.
Who is at higher risk?
People with inherited syndromes such as Li-Fraumeni syndrome, familial retinoblastoma, or neurofibromatosis type 1; people who have had radiation therapy for cancer; people with lymphedema (which raises angiosarcoma risk); and people with weakened immune systems exposed to human herpesvirus 8 (a Kaposi sarcoma risk).
How is sarcoma diagnosed?
Diagnosis often begins with a physical exam, followed by imaging tests — X-rays for bones, MRIs for connective tissue, plus ultrasound, CT, bone scans, and PET scans — and a biopsy, in which a tissue sample is taken by needle or surgery and tested in a lab.
Does sarcoma always mean losing a limb?
No. The goal of surgery is to remove all the cancer cells, and surgeons try to save the limb whenever they can; amputation is used only when needed to remove all the cancer.
What treatments are available?
Surgery plus radiation therapy (before, during, or after surgery), chemotherapy (for sarcomas that respond or that have grown large or spread), targeted therapy (medicines that attack specific chemicals in cancer cells, sometimes after testing the cells first), immunotherapy (which helps the immune system find and kill cancer cells), and ablation therapy (heat, extreme cold, or alcohol applied directly to the cancer when surgery isn't an option).
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This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about any medical condition or treatment decision.
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