July Is Sarcoma Awareness Month: Interview with Dr. Ruzanna Papyan

July is Sarcoma Awareness Month, an important opportunity to once again raise awareness about this rare but aggressive group of malignant tumors. Although sarcomas account for only a small proportion of all cancers, early diagnosis can significantly improve treatment outcomes and patients’ quality of life.

As part of Sarcoma Awareness Month, we spoke with Dr. Ruzanna Papyan, Head of the Department of Pediatric Oncology at the Yeolyan Hematology and Oncology Center, to learn more about sarcoma, who is at risk, which symptoms should prompt medical evaluation, and what diagnostic and treatment options are available.

What is sarcoma, and how does it differ from other malignant tumors?

Sarcoma is a rare type of malignant tumor that develops in the bones or soft tissues. Some types of sarcoma can grow rapidly and follow an aggressive clinical course, requiring specialized diagnosis and treatment.

What are the most common types of sarcoma?

Sarcomas are generally divided into two major groups:

Bone sarcomas: osteosarcoma, Ewing sarcoma, chondrosarcoma.
Soft tissue sarcomas: rhabdomyosarcoma, synovial sarcoma, liposarcoma, leiomyosarcoma, and others.

Accurate classification of sarcoma is essential because the treatment approach depends on the tumor type, location, and stage of disease.

What early symptoms should prompt an immediate visit to a physician?

Patients should seek medical attention if they experience:

a newly developed or progressively enlarging mass;
persistent pain in a limb or bone, especially at night;
swelling without an obvious cause;
restricted movement or limping;
a previously painless mass that begins to enlarge or becomes painful;
a bone fracture occurring after minimal trauma.

Note: Any newly appearing, enlarging, or persistent mass should be medically evaluated.

Who is at higher risk? Can sarcoma occur at any age?

Yes. Sarcoma can occur at any age. Certain types are more common in children and adolescents, while others occur more frequently in adults.

In most cases, no specific cause can be identified. However, the risk may be increased in individuals with certain hereditary syndromes, a history of radiation therapy, or rare genetic alterations.

Can sarcoma remain asymptomatic for a long time?

Yes. Sarcomas arising deep within soft tissues or in the abdominal or pelvic cavity may remain asymptomatic for an extended period and may only be detected after they have grown considerably. For this reason, persistent pain and any new or enlarging mass should never be ignored.

What tests are required to diagnose sarcoma?

The diagnostic work-up usually includes:

physical examination;
ultrasound, X-ray, computed tomography (CT), or magnetic resonance imaging (MRI);
PET-CT when clinically indicated;
tumor biopsy;
histopathological and immunohistochemical examination;
molecular genetic testing in selected cases.

Important: A definitive diagnosis of sarcoma can only be established through biopsy.

What diagnostic and treatment opportunities does the Yeolyan Hematology and Oncology Center offer for patients with sarcoma?

At the Yeolyan Hematology and Oncology Center, patients with sarcoma are diagnosed and treated by a multidisciplinary team in accordance with international standards.

Since 2019, the Center has collaborated with specialists from Münster University Hospital and Charité – Universitätsmedizin Berlin. Every clinical case is discussed within an international multidisciplinary team, enabling diagnosis and treatment planning in line with global best practices.

The Center also serves as the lead and coordinating institution for POEM-OS, the first regional multicenter clinical study dedicated to osteosarcoma. The study currently involves 23 centers across 8 countries. The study evaluates treatment outcomes, safety, surgical timing, treatment response, adverse events, and long-term outcomes in children, adolescents, and young adults with osteosarcoma.

By leading POEM-OS and coordinating participating international centers, the Yeolyan Hematology and Oncology Center contributes to the continuous improvement of treatment quality, promotes international collaboration, and facilitates the implementation of modern therapeutic approaches for patients with osteosarcoma.