A rare type of soft tissue sarcoma, which is a rare and aggressive form of cancer that begins to develop in the smooth muscles of the hollow organs (including the bladder, stomach, uterus, intestines, or blood vessels), is called leiomyosarcoma (LMS). Doctors often prescribe radiation therapy, chemotherapy, and targeted therapy to treat this type of cancer. The only way to prevent serious complications is early detection and proper treatment.
Usually, the tumor grows quickly, and it can double its size in about 1 month. Sometimes, when the tumor grows large enough, it can break and spread through the bloodstream to other parts of the body. This cancer can be detected in advanced stages because, like many other types of cancer, it does not cause any symptoms in the early stages.
In general, this type of cancer occurs rarely. It affects about 15,000 people in the U.S., and it accounts for about 10% to 20% of all soft tissue sarcomas.
Types of Leiomyosarcoma
This type of cancer also has three subtypes. These include:
- Somatic soft tissue LMS – This subtype negatively affects the connective tissue. Furthermore, it is one of the most common forms of LMS.
- Cutaneous or subcutaneous LMS – In such cases, the cancer affects the piloerector muscles in the skin and eyes. These muscles give your skin goosebumps and make your pupils dilate.
- LMS of a vascular origin – This form of LMS causes a tumor to develop in a major blood vessel (such as pulmonary arteries, inferior vena cava, or peripheral arteries). Additionally, this is the rarest form of this type of cancer.
What Are The Symptoms of Leiomyosarcoma?
Commonly, people with leiomyosarcoma experience different symptoms because they depend on the size and location of the tumor, overall health, and age. Check some general symptoms below:
- A painless and firm lump in the affected area
- Fever
- Nausea
- Vomiting
- Weight loss
- Tiredness
- Abdominal bloating or pain
- Pain in other parts of the body
- Appetite changes
- Black stools
- Frequent urination
- Vaginal discharge
- Abnormal uterine bleeding
Immediately contact a healthcare professional if any of the previous symptoms appear. Leaving this type of cancer untreated may lead to serious complications.
Causes and Risk Factors
Healthcare providers do not fully understand what exactly causes leiomyosarcoma. They think certain abnormal genes and environmental factors could play a role. Sometimes, people may get abnormal genes from their biological parents that negatively affect cell growth and development.
Furthermore, experts have found connections between LMS and the following genetic disorders. These include:
- Hereditary retinoblastoma
- Werner syndrome
- Tuberculous sclerosis
- Li-Fraumeni syndrome
- Gorlin syndrome
- Gardner syndrome
- Neurofibromatosis type 1 (NF1)
Check below also other factors that could increase your risk for LMS:
- Prolonged exposure to certain chemicals (including dioxin, herbicides, arsenic, chloride, and others)
- Uterine fibroids
- HIV infection
- Chronic (long-term) inflammation
- Age – People who are over 50 years are more prone to LMS.
- Radiation therapy – This is a cancer treatment that delivers high doses of radiation to destroy cancerous cells.
What Happens if Leiomyosarcoma is Left Untreated?
People who develop this aggressive type of cancer may also experience some complications, especially if it is found in the advanced stages or is left untreated. Check some examples below:
- Organ compression and obstruction – When a tumor grows large, it may put pressure on nearby tissues and organs. As a result, it may lead to intestinal obstruction or urinary retention.
- Vascular complications – If a tumor develops in a blood vessel, it may cause a blockage, which often leads to edema (swelling), blood clots (including deep vein thrombosis and pulmonary embolism), or Budd-Chiari syndrome.
- Abnormal bleeding – This complication often occurs when LMS affects the uterus.
- Metastasis – In this case, the tumor breaks and spreads to other parts of the body.
- Recurrence – This type of cancer may return even after a successful treatment.
- Systemic symptoms – For example, extreme tiredness (fatigue), fever, weight loss, and others.
- Treatment complications – Some people may experience certain complications after treatment. These include severe anemia (low red blood cell count), severe fatigue, hair loss, and frequent infections.
The previous list does not contain all possible complications of leiomyosarcoma. In any case, you can talk with your physician about measures to reduce the risk or even prevent them.
How to Prevent Leiomyosarcoma?
Unfortunately, there is no way to prevent this type of cancer because doctors do not know what exactly causes it. However, they may recommend some tips to reduce the risk. These include:
- Do not take any medicines without a doctor’s approval
- Limit or avoid exposure to radiation and chemicals
- Manage chronic health conditions (such as hyperlipidemia, hypertension, diabetes, and others)
- Treat viral infections (such as human herpesvirus 8 or HHV8)
Diagnosis
Commonly, the diagnosis starts with a physical examination in which doctors will check for abnormalities often found in people with leiomyosarcoma. Thereafter, they may ask some questions about family history and symptoms to gather more information about your condition. In any case, to exclude or confirm this type of cancer, doctors will perform the following tests. Examples include:
- Angiography
- PET (positron emission tomography) scans
- MRI (magnetic resonance imaging) scans
- CT (computerized tomography) scans
- Biopsy – During this procedure, physicians will take a small sample of the affected tissue for testing. They will check for cancerous cells.
Treatment
Most of the time, physicians recommend different treatment options for people with leiomyosarcoma because they depend on several factors. For example, the severity and subtype of the cancer, existing health problems, gender, age, and preferences. Check some examples below:
- Surgery – It is often a primary treatment for people with leiomyosarcoma. During this procedure, surgeons will remove the tumor as much as possible.
- Chemotherapy – This is a cancer treatment that involves strong medicines to destroy cancer cells throughout the body. While doctors may recommend it along with radiation therapy to improve the effectiveness of the treatment, it can be used to shrink a large tumor before surgery.
- Radiation therapy – This therapy is used to destroy cancer cells. It delivers high-energy beams that come from X-rays, protons, or other sources.
- Targeted therapy – Doctors often recommend this treatment option when the previous options do not work. It involves medicines that block a protein in the cancer cells, causing them to die.
Frequently Asked Questions
How long does it take to recover from leiomyosarcoma treatment?
Usually, the recovery time varies among people with this type of cancer because it depends on several factors. Examples include the size and location of the tumor, the type of treatment you receive, and your response to treatment. In some cases, it may take a few months to recover, but some people may need regular checkups to prevent the recurrence of leiomyosarcoma for the rest of their lives.
When should I see my healthcare provider?
It is advised to see your physician if the symptoms are worsening or the treatment you are already following does not work. You should also inform your doctor about any changes that you notice.
What is the survival rate for people with leiomyosarcoma?
The 5-year survival rate for people with an early stage is about 63%, but if the cancer spreads to other parts of the body, the same survival rate drops to 14%. Usually, the average survival in people with advanced metastatic LMS is between 12 and 18 months.
Can leiomyosarcoma be mistaken for other conditions?
Yes. Leiomyosarcoma can sometimes be mistaken for benign tumors, uterine fibroids, or other types of soft tissue growths because the symptoms are often similar. Imaging tests and a biopsy are usually needed to confirm the diagnosis and determine whether the tumor is cancerous.
Does leiomyosarcoma spread to other parts of the body?
Leiomyosarcoma is an aggressive cancer that can spread (metastasize) through the bloodstream. The lungs, liver, bones, and other soft tissues are among the most common sites of metastasis. Early diagnosis and treatment can help reduce the risk of cancer spreading.
Is leiomyosarcoma hereditary?
Most cases of leiomyosarcoma are not inherited. However, certain genetic conditions, such as Li-Fraumeni syndrome, hereditary retinoblastoma, and neurofibromatosis type 1, may increase the risk of developing this cancer. People with a strong family history of cancer should discuss genetic counseling with their healthcare provider.
Can leiomyosarcoma come back after treatment?
This condition has a relatively high risk of recurrence, even after successful treatment. The cancer may return in the same location or in a different part of the body. Regular follow-up appointments, imaging tests, and physical examinations are important to monitor for recurrence.
Are there any warning signs of metastatic leiomyosarcoma?
The symptoms of metastatic leiomyosarcoma depend on where the cancer has spread. For example, if it spreads to the lungs, a person may experience shortness of breath, chest pain, or a persistent cough. If it spreads to the liver, abdominal pain, swelling, or jaundice may occur.
What questions should I ask my doctor after being diagnosed with leiomyosarcoma?
You may want to ask about the stage and grade of the cancer, available treatment options, possible adverse reactions, expected outcomes, the risk of recurrence, and whether participation in a clinical trial is appropriate. Understanding your diagnosis can help you make informed treatment decisions.
Can lifestyle changes help during leiomyosarcoma treatment?
While lifestyle changes cannot cure leiomyosarcoma, they may help improve overall well-being during treatment. Eating a balanced diet, staying physically active as tolerated, getting enough rest, managing stress, and avoiding tobacco products can support recovery and help maintain quality of life. Always consult your healthcare provider before making significant lifestyle changes during cancer treatment. Ask your healthcare provider if you have additional questions.
