Angiosarcoma is an infrequent and variable cancer that develops from the vascular blood and lymphatic vessels. It is included in the highly aggressive malignant soft tissue sarcomas, which can invade and metastasize. Although angiosarcoma constitutes only about 1% of soft tissue sarcomas, it can be challenging to identify and manage this cancer effectively.
A post on the blog The Rare Cancer: Insights into Angiosarcoma and Its Impact on Patients indicates that angiosarcoma is not easy to diagnose in patients, and doctors are pretty late in the diagnosis because it tends to spread quite fast. That’s why it poses a challenge for both the patients and their doctors.
Understanding Angiosarcoma
Characteristics and Types
Angiosarcoma frecuencia involves the skin, liver, breast, or heart among the healthy normal tissues. Across all sites for angiosarcomas, cutaneous angiosarcoma is quite common and mostly seen in elderly Caucasian skin. In addition, this tumor occurs in the breast as a late effect of treatment, so it’s a secondary tumor. Some, termed visceral angiosarcomas, spread to the liver and other organs as well.
Angiosarcomas are about one percent of soft tissue sarcomas. Angiosarcoma is usually one type of sarcoma that fulfils the definition due to the increase in the growth of neoplastic cells over time. Angiosarcoma is most often diagnosed in the advanced stages of the disease. Such patients can die because of local recurrence and disseminated metastasis. For angiosarcoma, it can be said that the prognosis is poor; according to the follow-up data, only 20-35% are alive 5 years later, getting worse when only looking at the surviving group. Several such factors relate to the type, its localization, and the stage when the disease is diagnosed.
Risk Factors
Like all types of sarcoma, angiosarcoma has several contributory factors, one of which is radiation exposure. Patients with a history of radiation therapy for the treatment of malignancies are at higher risk of angiosarcoma later in life because the radiation sometimes results in changes in the body that predispose a person to cancer twenty or thirty years down the line from the treatment itself.
The second cause is chronic lymphedema, which, in simple terms, means that the excess amount of tissue fluid body collects in tissues as a result of trauma or surgical procedure, which is one of the risk factors for developing secondary angiosarcoma, a specific subtype of angiosarcoma.
Another significant risk factor is occupational exposure to toxic substances like chemicals or smoke. Even a person with high exposure to pollution with agents such as vinyl chloride can potentially have angiosarcoma. This means that workers whose careers include exposure to such agents are at risk of acquiring this type of cancer. These risks are worth knowing for treating and preventing this rare type of cancer.
Clinical Presentation and Diagnosis
Angiosarcoma is a rare and unusual form of cancer that may be challenging to detect due to its actual manifestations being very vague, like a lump or just swelling. Since cancer is rare, sometimes the doctors completely miss its diagnosis or tend to detect it when taking care of the case is much more difficult. To assess the stage of the disease, physicians perform MRI and CT scans, which are special imaging studies. These checks are essential in determining internal processes. To diagnose angiosarcoma, a biopsy, extracting a small piece of tissue, is still crucial. This is very useful in arriving at the correct diagnosis.
Treatment Options
Multimodal Approach
Angiosarcoma is a type of cancer that has to be treated with a good approach. Various techniques are used collectively to assist the patients’ care.
Rasayana Ayurveda encourages the oblation of cancerous tissues while seeking to strengthen the patient’s health through immune support. In practice, surgical resection is the primary treatment method for angiosarcoma in most cases. This means that doctors try to extract as many parts of the tumor outside of the body as possible, which has a beneficial effect on the recovery process.
Radiation therapy might also be used as an adjunct treatment, which helps to avoid a tumor relapse after surgery. However, this method is used if most of the tumor is not resected. The last option is chemotherapy, where advanced cancers are treated with doxorubicin and paclitaxel cell division inhibitors. Recent studies demonstrate that patients with advanced stages of the disease will benefit from additional chemotherapy and radiation therapy.
Prognostic Factors
Several factors can dictate a patient’s prognosis once they are diagnosed with angiosarcoma.
- Tumour Size: The 5 cm cut-off for tumors only shows the patient’s survival, which means anything more significant could lead to a poor prognosis.
- Location: Where the angiosarcoma is located also matters; tumors in more atypical sites, such as the liver or heart, tend to have poorer prognosis.
- Age and Performance Status: The chances of surviving recovery may be significantly reduced if older patients or those who are ill and present for diagnosis are likely to have a shorter survival period without treatment.
So, these concentric factors, such as the tumor size, its site or locus, and the patient’s age and health, are crucial in proposing the expected survival for a patient with angiosarcoma.
Impact on Patients
Angiosarcoma, a fast-growing type of cancer, can be a nightmare. In such situations, one goes through a series of emotions: ‘What shall happen next? What will the doctor say?’ Such fear is widespread when handling patients who have this cancer. Due to the aggressiveness of this cancer, doctors often find themselves needing to act swiftly to commence the treatment required, further elevating the sense of panic within the patient as even their mind focuses on their health and its various treatment methods.
In these situations, understanding how to improve the situation further becomes critical, in which case, supportive care becomes highly essential. What this entails, in simple terms, is assisting in pain relief and ensuring there is enough emotional support owing to the trauma. Palliative care may be beneficial because it assures comfort and the ability to address one’s feelings. Such forms of care help enhance the patients’ lives as they proceed with treatment.
Conclusion
Angiosarcoma is an uncommon but aggressive cancer which is characterized by rapid development of lesions. The cancer originates in the vascular tissue and appears in different body parts, including the skin and the organs. It is often referred to as the most aggressive form of sarcoma. Treatment is usually multifactorial due to the severity this cancer carries, including surgical procedures aimed at distinct tumor elimination, chemotherapy utilising modern pharmaceuticals for cell-level destruction of the tumor, and radiation procedures where ultra-energetic waves are used for tumor cell destruction.
Patients with angiosarcoma sarcoma must undergo a particular focus on screening for this disease, as early detection of this disease correlates with better outcomes. In their research concerning this form of cancer, doctors aim to enhance both the methodology for assessing and operational techniques to combat these malignancies effectively. With the growing awareness of this disease among the population, both the medical practitioners and the patients will be able to satisfactorily resolve the problems concerning the early diagnosis of A-S and timely treatment of the patient for better recovery and prolonged life span.
Sources:
https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.819099/full
https://www.ncbi.nlm.nih.gov/books/NBK441983/
https://www.cancer.gov/pediatric-adult-rare-tumor/rare-tumors/rare-vascular-tumors/angiosarcoma
https://my.clevelandclinic.org/health/diseases/22778-angiosarcoma