With an objective to create public awareness about Sarcoma – “the forgotten cancer” and to stand in solidarity with the sarcoma community, July is observed as “Sarcoma Awareness Month”. Sarcoma is a rare and complicated type of cancer that can occur in various locations of the body. This type of malignant tumor develops in a variety of tissue structures in the body such as the muscles, nerves, cartilage, tendons, blood vessels and the fatty and fibrous tissues. It may also occur in the bones, which means sarcomas can arise anywhere, because these tissues are found everywhere on the body. Sarcomas can be benign (noncancerous) or malignant (cancerous). There are more than 70 types of sarcoma. Treatment for this condition depends on the type of cancer, its location and symptoms. If diagnosed at an early stage, before the sarcoma spreads to other parts of the body, treatments can be more effective. For correct clinical documentation of this condition, oncologists can utilize the support of professional companies that outsource medical billing services.

Sponsored by the Sarcoma Foundation of America (SFA), the 2021 month-long campaign is a unique platform to spread awareness about the different types of cancers and to educate people more about the causes and treatment of sarcomas. It aims to highlight the extraordinary challenges that sarcoma patients face and the need for more sarcoma research and better sarcoma therapies. The exact causes of sarcomas are not clear. In general, cancer forms when changes (mutations) happen in the DNA within cells. Mutations cause cells to grow and divide uncontrollably and the accumulating abnormal cells tend to form a tumor. In due course, cells can break away and spread (metastasize) to other parts of the body.

Typically, sarcomas are divided into two main groups – Soft Tissue sarcomas and bone sarcomas. Tissues that connect, support, or surround other structures and organs of the body are referred to as soft tissues and includes muscles, tendons, fibrous tissues, fat, blood vessels, nerves, and synovial tissues. Cancerous tumors that develop in these tissues are called soft tissue sarcomas. Bone sarcoma or osteosarcoma is a type of bone cancer that spreads to the bones in the later stages. According to the American Society of Clinical Oncology (ASCO), sarcomas account for around 1 percent of all adult cancers. It is more common in children, accounting for around 15 percent of all childhood cancers. In fact, 60 percent of sarcomas start in an arm or leg, 30 percent begin in the abdomen or torso, and 10 percent start in the neck or head. As per reports from the American Cancer Society, about 13,130 new soft tissue sarcomas will be diagnosed and about 5,350 people are expected to die of soft tissue sarcomas in the United States (2020 statistics).

Signs and symptoms associated with the condition will vary depending on the type of sarcoma and which specific body part the condition affects. A new lump that’s growing anywhere on the body or a lump that can be felt through the skin (that may or may not be painful) is one of the most common and initial symptoms of the condition. Other related symptoms include – bone pain; broken bone (that occurs unexpectedly, such as with a minor injury or no injury at all); abdominal pain; blood in the stool or vomit; black, tarry stools; and weight loss. Several factors can increase the risk of sarcoma and these include – radiation therapy, inherited syndromes, chronic swelling (lymphedema) and exposure to harmful chemicals and viruses.

Generally, sarcomas are often difficult to distinguish from other cancers. Their occurrence is probably underestimated when they are found within organs. Therefore, people with lumps and bumps should have them inspected by a physician at an early stage in case it is sarcoma. If a lump is noted that is more than 2 inches across and if the lump gets bigger with severe pain, it is important to consult a physician immediately. Initial diagnosis of this condition may begin with a detailed physical examination to study the symptoms and look for other evidence that will help with the diagnosis. Physicians will also ask about the patient’s personal and family medical history. Several imaging tests like – X-rays, MRI. Ultrasound, CT scan, bone scans and positron emission tomography (PET) scans may be performed to identify connective tissue problems. If a soft tissue sarcoma is suspected based on a physical exam and imaging tests, a biopsy would be performed to confirm whether it’s a sarcoma and not another type of cancer or a benign disease. Biopsy is done to remove a piece of tissue for testing and to determine whether the cells are cancerous and if so, what kind of cancer. As part of biopsy, if any cancerous cells are found to be present, physicians may recommend additional tests to identify the particular stage of cancer, how far it has spread, and to determine the future course of treatment.

Treatment for this type of cancer will depend on the type of sarcoma, its location, how aggressive the cells are and whether the cancer has spread to other parts of the body. In most cases, sarcoma is usually treated with a surgery to remove the cancer. Treatment for sarcoma may include – surgery (to remove the cancerous cells), radiation therapy, chemotherapy, targeted therapy, ablation therapy and immunotherapy. The screening and diagnostic tests performed as part of the treatment procedures must be correctly documented using the right medical codes. Medical billing companies can assist physicians with their medical coding and claims submission. ICD-10 codes for different types of sarcomas include –

• C49 Malignant neoplasm of other connective and soft tissue
• C49.0 Malignant neoplasm of connective and soft tissue of head, face and neck
• C49.1 Malignant neoplasm of connective and soft tissue of upper limb, including shoulder
• C49.2 Malignant neoplasm of connective and soft tissue of lower limb, including hip
• C49.3 Malignant neoplasm of connective and soft tissue of thorax
• C49.4 Malignant neoplasm of connective and soft tissue of abdomen
• C49.5 Malignant neoplasm of connective and soft tissue of pelvis
• C49.6 Malignant neoplasm of connective and soft tissue of trunk, unspecified
• C49.8 Malignant neoplasm of overlapping sites of connective and soft tissue
• C49.9 Malignant neoplasm of connective and soft tissue, unspecified
• C41.9 Malignant neoplasm of bone and articular cartilage, unspecified
• C46 Kaposi’s sarcoma
• C46.1 Kaposi’s sarcoma of soft tissue
• C46.2 Kaposi’s sarcoma of palate
• C46.3 Kaposi’s sarcoma of lymph nodes
• C46.4 Kaposi’s sarcoma of gastrointestinal sites
• C46.5 Kaposi’s sarcoma of lung
• C46.7 Kaposi’s sarcoma of other sites
• C46.9 Kaposi’s sarcoma, unspecified

The history of Sarcoma Awareness Month dates back to the year 2007. It was in November 2007 that a group of advocates joined together in Seattle to gather all the sarcoma non-profits under a single united effort. Together, they decided to dedicate a separate month for sarcoma awareness. As part of this effort, a petition was sent to the White House with the intent of gathering 100,000 signatures to officially declare July as “Sarcoma Awareness Month”.

Celebrating Sarcoma Awareness Month starts with spreading basic awareness about this condition. Since these forms of cancers are rare, most people don’t know much about them. Over the years, the scope of this campaign got widened with several healthcare organizations and individual communities joining hands to generate awareness about this rare disorder. People can get involved in this campaign by making a donation to sarcoma patients or communities, arranging fundraising activities, or individual volunteer movements to raise awareness within the community, and gathering support on prominent social media platforms.

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