reccurence of sarcoma

is it possible 24 days after neurofibrosarcoma surgery in arm the malignant tumour to start increasing on the same spot? i have noticed a little lumb on the same place that the surgery was done. and i really appreciate your opinion about my next step in case the malignant tumour is back. is the amputation of the arm recomandeable and are there any possibilities for metastasing? i am 37 years old.
thank you in advance

[Staschou]

I am sorry to tell you that some soft-tissue sarcomas do metastasize (or in my case
"metachronously" occur). BTW, amputation is not done - in favor of limb-sparing surgery that I had. Here is my 8+ year history of metachronous sarcomas -

Since April 2000, I have “metachronous” malignant fibrous histiocytoma (MFH)(aka undifferentiated pleomorphic sarcoma - NOS) - a soft-tissue sarcoma. The term - metachronous means “not synchronous; multiple separate occurrences, such as multiple primary cancers developing at intervals”. Metachronous is not the same as metastatic, although some people think so.

All of my MFHs were/are soft-tissue with pathology stating that the tissues varied from spindle-cell to myxoid. Since my MFH journey started in April 2000, I have had presentations in my right shoulder/arm interface, my right thigh/quad muscles, my left thigh resting on the femur bone, my left chest-wall between ribs (2x), my upper stomach wall, my right lung upper-lobe, my right buttock interior, my left paraspinal muscles (2x), my right forearm. I was a right-hander, but now I am a left-hander, but can still drive a car - the fingers can grip the steering wheel - other times, I have to hold a therapy ball to keep my fingers "extendable", including while sleeping.

Most of these were surgically removed - including limb-sparing surgery for my right forearm, and one was killed by radio-frequency ablation. Most occurrences had adjuvant radiation, including IMRT, Novalis stereo-tactic radiotherapy, and brachytherapy.

My only neoadjuvant radiation - to my right forearm severely ruined sub-surface tissue, blood vessels, tendons and nerves, - that the surgery “sew-up” was extremely difficult, and reconstructive surgery had to be done ~ 3 months later.. The radiotherapy only reduced the tumor size from 8.2 cm. to 7.8 cm. I will never again have neoadjuvant radiotherapy.

I had Novalis stereo-tactic radiotherapy that is reducing the existing MFHs in my left armpit area and the one in the upper lobe of my right lung.

Except for the Novalis treatment, all adjuvant radiation burned the area severely that I have had several instances for burn therapy.

I attribute my “long survival” to religious periodic CT scans (with MRIs to suspicious areas) and rapid treatment at a “somewhat” sarcoma-knowledgible facility, mostly at the Arizona Cancer Center/UMC, Tucson.

My only chemo “trip” was neoadjuvant to see if it can kill the MFH in my left thigh before surgery. I had 2 ½ months of Adriamycin (doxorubicin), continually via the P.I.C.C. procedure. Upon surgical pathology, the MFH  had < 20% necrosis. So, no more chemo for me - as recommended by the sarcoma ortho surgeon that did 3 surgeries on me.

I also had molecular profiling done on a tissue sample taken from my last back surgery. The “most-relevant” agent is Gemzar (gemcitabine). I looked up the side/after effects and they are very severe. So, I am not opting for this - or any agent! Not at my age - 77.

Now, I have a 2 cm. MFH “bump” on top of my head - only in the surface skin, that will be removed in a 1-hour out-patient procedure on Dec. 23, 2008.

And, for the past 3 + months, I am experiencing daily pain from the radiation-caused fibrosis of my left paraspinal muscles (thoracic and upper lumbar sections) and neuropathy damages to the various nerves in those areas. I will employ pain management therapy, at the clinic - starting Dec. 19, 2008.

What a life……….

Get treated at a sarcoma-knowledgable clinic/specialist.......

Stan