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:: Leiomyosarcoma (LMS) Defined ::

Leiomyosarcoma (Gr. Leio- =smooth, myo- = muscle, sarcoma = fleshy growth) is a type of sarcoma which is a neoplasm of smooth muscle. (When a uterine neoplasm is benign, it is a leiomyoma.) Smooth muscle cells make up the involuntary muscles, which are found in most parts of the body: in uterus, stomach and intestines, walls of all blood vessels, and skin. It is therefore possible for leiomyosarcomas to appear at any site in the body. It is however most commonly found in the stomach, small intestine and retroperitoneum.

Leiomyosarcoma is a very rare cancer. It makes up 5-10% of soft tissue sarcomas, which are in themselves rare cancers.

:: About Leiomyosarcoma ::

Leiomyosarcoma is a form of cancer that affects the smooth muscle of the body. It spreads through the blood stream and can affect the lungs, liver, blood vessels, or any other soft tissue in the body.

LMS is a type of sarcoma which is a neoplasm of smooth muscle. Smooth muscle cells make up the involuntary muscles, which are found in most parts of the body: in the uterus, stomach and intestines, walls of all blood vessels, and skin.

Leiomyosarcoma is a very rare cancer. It makes up 7% of soft tissue sarcomas; in all, LMS affects 4 out of 1,000,000 people.

Presently there is no cure. Remission can be attained, but this rare cancer can reappear at any time. Because of its rarity, few doctors know how to treat it and it attracts very little research.

Tuesday, March 16, 2010

Leiomyosarcoma Treatment

According to the June 2002 issue of Journal of Clinical Oncology: "Current treatment options for recurrent or advanced leiomyosarcoma (LMS) of uterine or other organ origin are limited. Although approximately sixty percent of women with uterine LMS present with disease that is limited to the uterus, cure ranges from twenty to sixty percent."
The type of leiomyosarcoma treatment depends on the stage of the cancer and whether leiomyosarcoma has spread to other parts of the body or not. Leiomyosarcoma treatment options include surgery, radiation therapy and chemotherapy.
Surgical Leiomyosarcoma Treatment
Surgery is the most common form of leiomyosarcoma treatment. Primary treatment involves removal of the tumor and a margin of adjacent healthy tissue.

Surgical treatment for uterine leiomyosarcoma involves total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH plus BSO), where the entire uterus, fallopian tubes and ovaries are removed. As a precautionary measure, nearby lymph nodes may also be removed during surgery. Despite the invasive nature of surgical treatment for uterine leiomyosarcoma, recurrence rates remain as high as seventy percent.

Adjuvant Radiation Therapy and Chemotherapy

Adjuvant therapy, chemotherapy or radiation therapy combined with surgery, is often used for patients with poor prognosis. Radiation therapy and/or chemotherapy may be administered either before surgery to shrink the tumor, or after surgery to destroy any remaining cancer cells.

Radiation Therapy for Leiomyosarcoma Treatment

Radiation therapy dosages need to be balanced carefully. Optimum levels of radiation will eradicate the tumor, but excessive dosages of radiation therapy might damage the surrounding healthy tissue. Radiation therapy is used routinely to treat more aggressive leiomyosarcomas and as part of a palliative care regimen after a curative attempt in cases where the prognosis is extremely poor.

Chemotherapy Treatment

Chemotherapy treatment for leiomyosarcoma uses anti-cancer drugs to kill the cancerous cells. Chemotherapy is a systemic leiomyosarcoma treatment, where the drugs enter the blood system and travel throughout the body.

Chemotherapy may be taken as a pill or injected into a vein or muscle. In leiomyosarcoma, chemotherapy drugs are often injected directly into the blood vessels at the site of the leiomyosarcoma. This type of leiomyosarcoma treatment is called regional chemotherapy.

Uterine Leiomyosarcoma and Chemotherapy

An article by Martee L. Hensley also in the June 2002 Journal of Clinical Oncology reports best response rates using the drugs doxorubicin combined with either dacarbazine or ifosfamide. Despite these advancements, however, response rates remain around thirty percent, with survival rates of approximately nine to twelve months.

Where the leiomyosarcoma has spread (metastasized) to other parts of the body, palliative chemotherapy, in combination with radiation therapy, may be used as adjuvant therapy to reduce pain. Chemotherapy, in these circumstances, is unlikely to remove the leiomyosarcoma.

Other smaller studies, of patients with advanced stages of leiomyosarcoma, have revealed improved response rates of around fifty percent, using a combination of gemcitabine and docetaxel.
Resources
Hensley, M. L., Maki, R., Venkatraman, E., Geller, G., Lovegren, M., Aghajanian, C., Sabbatini, P., et al.. (2002, June). Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: Results of a phase II trial. Journal of Clinical Oncology 20, 2824-2831.
Indiacancer.org. (nd). How is leiomyosarcoma of the uterus treated?. Retrieved September 3, 2003, from www.indiacancer.org/coca/u/uterus.html#f.