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Carcinoma vs Sarcoma - What's the Difference?

22 Mar, 2024

Carcinoma and sarcoma are two distinct categories of cancers. The differences between sarcoma and carcinoma include differences in tissue of origin, cellular characteristics, and behavior. Understanding carcinoma vs sarcoma is crucial for accurate diagnosis and tailored treatment approaches.

What is Carcinoma?

Epithelial tissues are present at several places inside the human body. They form the internal linings of the hollow organs and body cavities, cover all body surfaces, and constitute major tissues in the glands. When the epithelial tissue cells divide uncontrollably, a mass is formed, and it is referred to as cancer, or more specifically, carcinoma. Carcinomas account for the majority of cancer cases and can occur in various organs, leading to different types of cancer. The causes of carcinoma involve a combination of genetic, environmental, and lifestyle factors.

Where is Carcinoma Found?

Carcinoma affects several organs in the body. These include skin (skin carcinoma), lungs (non-small cell lung cancer and small cell lung carcinoma), breast (breast carcinoma), colon and rectum (colorectal carcinoma), prostate (prostate carcinoma), ovaries (ovarian carcinoma), stomach (gastric carcinoma), liver (hepatocellular carcinoma), pancreas (pancreatic carcinoma), and kidneys (renal cell carcinoma).

What is Sarcoma?

Sarcomas develop from connective tissues such as bones, muscles, tendons, nerves, the lining of the joints, fats, cartilage, and blood vessels. These are known as soft tissue or bone sarcomas, depending on the tissue of origin. There are over 70 types of sarcomas, and the treatment depends on the type, location, and stage of diagnosis of specific sarcomas. The exact causes of sarcoma are not fully understood.

Where is Sarcoma Found?

Sarcomas can be found in various tissues throughout the body, but they primarily originate in the connective tissues. Connective tissues include bones, muscles, tendons, cartilage, blood vessels, and fatty tissue. Sarcomas occur in bone tissues (osteosarcoma), cartilage cells (chondrosarcoma), smooth muscles (leiomyosarcoma), fat cells (liposarcoma), and in the joints (synovial sarcoma).

Diabetes

Patients with poorly controlled diabetes are at increased risk of developing kidney disease. Almost 20 to 30% of patients with diabetes develop renal disease. However, not all cases of diabetic nephropathy progress to kidney failure. Over time, high blood sugar levels damage the filtering units of the kidney.

Types of Carcinoma and Sarcoma and Their Respective Body Afflictions

Although both sarcomas and carcinomas form masses in the body, they both affect the body differently. The following are the different types of carcinomas and sarcomas and their afflictions:

Carcinomas

Carcinomas can form in any part of the body, and their management demands a comprehensive approach. The following are the different types of carcinoma:

Adenocarcinoma

Adenocarcinoma forms in the glandular cells of epithelial tissues, which line various organs in the body. Adenocarcinoma may occur in the colon, breast, pancreas, lung, prostate, ovaries, stomach, and esophagus.

Basal cell carcinoma

It occurs in the basal cells that are present in the deepest layer of the epidermis. It is the most common type of skin cancer.

Squamous cell carcinoma

It arises from the squamous cells that are present in the outer layer of the skin (epidermis). This is the second most common type of skin cancer, and it has an excellent prognosis.

Transitional cell carcinoma

Transitional cell carcinoma (TCC) is a type of cancer that commonly affects the urinary system, specifically the bladder, ureters, and renal pelvis.

Sarcoma

Relatively less common than carcinoma, sarcomas demand an aggressive treatment regimen due to various factors. The following are the different sarcoma cancer types:

Undifferentiated pleomorphic sarcoma

Undifferentiated pleomorphic sarcoma is a type of high-grade soft tissue sarcoma. It lacks clear immunohistochemical differentiation. This type of sarcoma mostly forms in the arms and legs.

Leiomyosarcoma

Leiomyosarcoma originates in smooth muscle cells. Smooth muscles are found in the walls of the uterus, gastrointestinal tract, blood vessels, and other internal organs.

Osteosarcoma

Osteosarcoma develops in the osteoid tissue and is a common primary malignant bone tumor, typically affecting the long bones, such as the arms and legs.

Liposarcoma

Liposarcoma arises from the cells that form fat tissue. Liposarcoma is most commonly found in the retroperitoneum (the area behind the abdominal cavity), extremities (arms or legs), and the trunk.

How are Carcinoma and Sarcoma Diagnosed?

There are several methods to diagnose carcinomas and sarcomas. These tests support accurate diagnosis, staging, and treatment monitoring.

Carcinomas

Multiple tests are recommended for the diagnosis of carcinoma. Some of these tests are non-invasive, while others are invasive. These tests are important to arrive at a conclusive diagnosis. Oncologists may recommend the following diagnostic tests for carcinomas:

Biopsy

A biopsy is a process that involves obtaining the tissues from the affected location and examining them under a microscope for the detection of cancer cells. Types of biopsies include core needle biopsy, fine needle aspiration, excisional biopsy, incisional biopsy, and endoscopic biopsy. A biopsy is usually performed with anesthesia.

Blood tests

Although blood tests are not the primary tests for diagnosing carcinomas, they can play a role in detecting and managing carcinomas by providing information about the overall health and specific markers.

Imaging Tests

Several imaging tests are recommended for the diagnosis of carcinomas. These include X-rays (for lung and bone cancers), magnetic resonance imaging (for spinal cord, brain, and pelvic organ tumors), positron emission tomography (to detect cancer metastasis), ultrasound (to evaluate the liver, kidneys, and uterus), and bone scans.

Sarcomas

Sarcoma diagnosis will need a comprehensive approach. These tests help in diagnosing, understanding the different tumor parameters, determining the extent of the disease, and devising the appropriate treatment plan.

Imaging Tests

Imaging tests help in determining the exact location of the tumor, its size, its stage, and other parameters. For sarcoma diagnosis, doctors may recommend X-rays, MRI scans, PET-CT scans, and bone scans for imaging.

Biopsy

A biopsy involves obtaining a tissue sample from a suspected tumor or abnormal area for examination under a microscope. The types of biopsies include core needle biopsy, excisional biopsy, incisional biopsy, image-guided biopsy, and surgical biopsy.

How are Carcinoma and Sarcoma Treated?

Both carcinomas and sarcomas need a multidisciplinary approach wherein specialists carefully study the case, understand its parameters, and devise a personalized care plan that precisely targets the disease. The following are the different treatment options available for carcinomas and sarcomas:

Surgery

The most commonly recommended surgical procedures for carcinoma treatment include lumpectomy or mastectomy (breast surgery), hysterectomy (uterine surgery), prostatectomy (prostate surgery), colectomy (colon surgery), lobectomy or pneumonectomy (lung surgery), and nephrectomy (kidney surgery). Commonly recommended surgeries for sarcoma treatment include wide local excision, Mohs surgery, limb-sparing surgery, amputation, lymph node dissection, bone tumor resection surgery, and debulking surgery.

Radiation

Radiation treatment involves destroying cancer cells with the assistance of high-energy radiation. Radiotherapy is often used along with surgery or chemotherapy. Radiation therapy may involve delivering the radiation from outside (external beam radiation therapy) or from inside the body (brachytherapy).

Chemotherapy

Chemotherapy is a process that involves delivering anticancer medications orally or through intravenous injection. Chemotherapy is the treatment of choice in the majority of cases involving metastatic cancer. The therapy is usually used along with surgery or chemotherapy.

Targeted Therapy

It specifically targets the molecules and pathways that are vital for the growth and survival of cancer cells. Targeted therapy interferes with specific molecular targets associated with cancer and controls cancer growth.

Immunotherapy

It re-engineers the body's immune system to recognize, target, and eliminate cancer cells. Immunotherapy aims to enhance or stimulate the immune response to target cancer cells specifically.

Carcinoma vs Sarcoma: Which One is More Dangerous?

There is no concrete evidence to suggest that one type of cancer, either carcinoma or sarcoma, is more dangerous than the other. Both carcinomas and sarcomas can vary widely in terms of aggressiveness and outcomes.

Carcinoma vs Sarcoma - A Comparison

Carcinomas and sarcomas are malignancies that have unique characteristic features in terms of their origin, their prevalence, age groups that they affect, the rate at which they progress, their prognosis, etc.

The following table elucidates various aspects of carcinoma vs sarcoma:

Feature Carcinomas Sarcomas
Origin Epithelial cells Mesenchymal (Connective tissues)
Frequency Most Common Very rare
Aggressiveness Relatively Less Aggressive Aggressive
Existence of pre-malignant stage Yes, pre-malignant or in situ stage exists There is no pre-malignant stage
Preferred route of metastasis Lymph system Commonly through the bloodstream; rarely through lymph system
Age Group More common among older population More common among younger population

Conclusion

Carcinomas and sarcomas differ in tissue origin, cellular characteristics, and behavior. Carcinomas arise from epithelial cells, while sarcomas originate from connective tissues. Both carcinomas and sarcomas pose specific challenges and demand individualized treatment strategies. Getting a detailed understanding of carcinoma and sarcoma differences can help one make informed health decisions.

Frequently Asked Questions

  1. Is breast cancer a carcinoma or sarcoma?

Breast cancers are usually classified as carcinomas as they originate from the epithelial cells lining the lobules or ducts of the breast. Rarely, do breast cancer cells have sarcomatoid characteristics.

  1. Is sarcoma a bad cancer?

While some sarcomas can be aggressive and have a higher potential for local invasion and metastasis, outcomes vary widely depending on factors like the type, stage, and response to treatment.

  1. What does stage 1 sarcoma look like?

Stage 1 is the initial stage of sarcoma, and the tumor is small and of low grade at this stage.

  1. How long can you have sarcoma without knowing?

The length of time someone can have sarcoma without knowing depends on several factors, including the type and location of the sarcoma, its aggressiveness, and the presence or absence of symptoms.

  1. Can you have both carcinoma and sarcoma?

Yes, an individual can have both carcinoma and sarcoma. However, it is relatively uncommon. Such cases are generally referred to as "collision tumors" or "mixed tumors."

  1. How long does it take to beat sarcoma?

The duration and prognosis of treatment for sarcoma depend on several factors, such as the type of sarcoma, stage at diagnosis, location, and response to treatment.

  1. What is the 3-2-1 rule of sarcoma?

The “3-2-1” rule states that there is a need for a biopsy if a mass has been present for three months or more after vaccination, is greater than 2 cm in diameter, or increases in size one month after vaccination.

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