Health
Retroperitoneal Sarcoma: A silent cancer that has treatment at Quirónsalud Torrevieja
Dr. Paula Muñoz Muñoz, assistant of the General Surgery, digestive and Oncological Surgery Service of the Hospital Quirónsalud Torrevieja, explains what this disease consists of, what symptoms it presents and the solutions that exist.
Quirónsalud Torrevieja
What is retroperitoneal sarcoma?
Two groups are divided: bone sarcomas and soft tissue sarcomas.
The former originates in the bones; the second, in tissues such as muscles, ligaments, tendons, fatty tissue and blood vessels.
Peritoneal sarcomas are considered soft tissue sarcomas
Specifically, they are a heterogeneous group of tumours whose common characteristics are that they develop from mesenchymal cells (those that derive the supporting tissues of the body, such as fat, muscle or cartilage) and that are located in the retroperitoneum (virtual space delimited in front by the abdominal organs and behind by the spine, and which houses vital structures such as the aorta and kidneys).
Do you have symptoms?
The symptoms of retroperitoneal sarcomas are very nonspecific, since their location develops indolently, until they are usually diagnosed as giant abdominal masses.
The main symptom is the increase in abdominal circumference, although they can also produce specific symptoms such as abdominal or lumbar pain, oedema of the legs, venous thrombosis or even fever and weight loss unexplained by other causes.
What tests are performed to diagnose this tumour?
The test of choice for the diagnosis of retroperitoneal sarcoma is computed tomography (CT) with intravenous contrast.
The CT will be thoraco-abdominal, with the aim of evaluating in the same study that there are no metastases in lung and liver, the most frequent locations. This study can sometimes be supplemented with an MRI.
In retroperitoneal sarcoma, and as a rule in all sarcomas of any location, it is essential to perform a biopsy.
The information obtained in the biopsy will allow us to plan the most appropriate type of surgical intervention
Prognosis of peritoneal sarcoma
Retroperitoneal sarcoma is an aggressive and complex disease because it grows around vital structures and is diagnosed in advanced stages.
The prognosis will also be influenced by the type of sarcoma.
One of the factors that most influence the survival of these patients is that the first surgery is performed properly.
What is the key to treatment in sarcoma?
Surgery is the only curative treatment in retroperitoneal sarcoma, and it is essential to achieve a favourable evolution, that the surgery is adequate and manages to remove the entire tumour with a margin of healthy tissue. That is why it is recommended that these patients be treated in centres with great specialisation in cancer surgery.
The goal of surgery is to remove the entire tumour, without rupturing it, and with a margin of safety.
It is an aggressive surgery that can affect the quality of life of patients. For this reason, the surgeon who performs this intervention must know to have a wide knowledge in oncological surgery and make a preoperative plan personalized to the type of tumour and the type of patient.
What role does intraoperative radiation therapy play in the treatment of sarcoma?
Intraoperative radiation therapy is an intensive radiation therapy treatment given during surgery that allows radiation to be directed to a specific area of the body. It is performed with the patient anesthetized, once the tumour is removed.
The main advantage of this treatment is that it allows a high dose of radiation to be administered to the bed in which the tumour was located, avoiding unnecessary radiation from the uninvolved organs.
In Spain, less than 10 hospitals have this technology. Our hospital was the first to have a device in the operating room, and one of the first Spanish hospitals that began treatment with IORT, and we currently have more than 20 years of experience in this type of radiotherapy.
This procedure allows to eliminate possible microscopic tumour residues in order to avoid the relapse of the tumour.
Referents in oncological surgery
The Hospital Quirónsalud Torrevieja, and its Surgery service is a benchmark in our region in the treatment of cancer. The General Surgery Service is integrated into a Multidisciplinary Oncology Unit, which guarantees an optimal and personalized approach to cancer patients.
Health
Quirónsalud Torrevieja receives the golden seal of the Joint Commission International, the most demanding quality accreditation in the world in the health field
The Hospital Quirónsalud Torrevieja has been accredited with the golden seal of the Joint Commission International, the highest distinction granted by this body, after an exhaustive audit in which more than 1,200 quality standards have been analysed, which the hospital rigorously complies with.
This accreditation of the Joint Commission International is the most demanding worldwide for the health field and analyses that all the care and processes of the hospital are focused on safety and quality, and in a process of continuous improvement.
Continuous improvement of quality and safety in care at Quirónsalud Torrevieja
The achievement of accreditation means an official recognition of the great effort to improve the safety and quality of care, guaranteeing a safe patient care environment and permanent work for the reduction of risks.
The Hospital Quirónsalud Torrevieja has carried out multiple actions in order to promote a safety culture established throughout the organisation, working on the improvement of the six international safety objectives recognised by the World Health Organisation (WHO): unequivocal identification of the patient, effective communication between professionals, improvement of safety in the use of high-risk medicines, safe surgery, decreasing the risk of infections and reducing the risk of falls.
The audit team has highlighted as a differentiating element of the Hospital Quirónsalud Torrevieja the great teamwork of the hospital, the excellence in the safety culture and the involvement and enthusiasm with the continuous improvement of the hospital.
The organisations accredited with this prestigious seal (which must be renewed every three years), respond to an international demand for evaluation in the health sector through quality levels based on evaluable standards and comparable with other countries, with the aim of stimulating constant improvement.
The Quirónsalud Group also holds this accreditation from the Teknon Medical Centre, the Dexeus University Hospital, the Quirónsalud Barcelona Hospital, the Quirónsalud Madrid University Hospital, the Quirónsalud Córdoba University Hospital, the Ricardo Palma Clinic in Lima (Peru), and the Imbanaco Clinic in Cali (Colombia).
Last year, Quirónsalud became the first private hospital group in the world to obtain the Joint Commission International Enterprise accreditation, as well as the first health entity in Europe to do so. The fact of having this recognition is an additional guarantee for patients seeking the best health care to treat their health problems.
What is Joint Commission International?
The Joint Commission International is a non-profit organisation, which has been working since the 90s in more than 100 countries to improve patient safety and quality of care, offering health accreditation services internationally. This organisation audits hospitals, health systems and agencies, government ministries and institutions, promoting rigorous standards of care. JCI is the most prestigious health accreditation in the world for its high level of demand, for the safety it provides to the patient and for the rigorous and exhaustive evaluation of all care processes.
The specialists of the Cardiology Unit at Quirónsalud Torrevieja answer the most frequently asked questions about cardiovascular diseases.
What is cardiovascular pathology?
Cardiovascular disease refers to the pathological process that affects the entire arterial system, not only the coronary arteries, but also the brain, legs and the rest of the body.
Therefore, when we talk about cardiovascular disease we refer to stroke, transient ischaemic attack, angina pectoris, myocardial infarction, intermittent claudication and arterial ischaemia as manifestations of cardiovascular disease, among others.
The pathological process involved is usually atherosclerosis, which is the accumulation of fats, cholesterol and other substances within the wall of the arteries, causing progressive narrowing and even complete obstruction, blocking the flow of blood that should reach a part of the body.
Prevention of cardiovascular diseases
In addition to exhaustively treating the classic risk factors such as arterial hypertension, diabetes mellitus, dyslipidaemia (hypercholesterolemia and hypertriglyceridaemia) and tobacco consumption, there are a series of measures that help prevent the onset and progression of cardiovascular disease. The cardiology experts at Quirónsalud have drawn up the following list:
– Nutrition: is the integrating pillar for both prevention and treatment of cardiovascular disease.
– Exercise: most cardiovascular risk factors are improved by a combination of aerobic exercise, resistance training and stretching.
– Mind-heart interactions: A clear association between emotional state and heart health has been observed. Stress can induce ischaemia by causing both epicardial and microvascular vasoconstriction.
How to prevent heart disease
At Quirónsalud, heart health experts and cardiologists recommend the benefits of a comprehensive lifestyle intervention programme, including: nutritional changes through a low-fat, vegetable-based diet, frequent physical exercise and stress management, all of which have shown the disappearance of angina pectoris in 74% of patients included in the study by Frattaroli et al.
In addition, as shown in the 2011 study by Sattelmair et al in the scientific journal Circulation, walking 30 minutes 5 days a week reduces the risk of ischaemic heart disease (angina pectoris or myocardial infarction) by 14%.
Risk factors for heart disease
There are certain risk factors for heart disease that are not within our control, such as genetic inheritance, age, gender and environmental pollution. However, by knowing these factors in each person’s specific situation, we can take appropriate measures to try to minimise the harmful effects of these risk factors.
Keeping the heart healthy
Stress is pervasive in our lives today and we need to learn how to manage it effectively. Stress can induce ischaemia by different mechanisms, but it also alters autonomic regulation and triggers the release of circulating catecholamines that can even trigger stress cardiomyopathy. In the 2012 study by Schneider et al, it was shown that meditating twice a day can reduce cardiovascular events by up to 48%.
Diet to prevent heart disease
One of the best-studied dietary approaches in cardiology is the Mediterranean diet, which consists of increasing vegetable and fruit intake, giving preference to whole grains over refined grains, reducing red meat and increasing fish consumption, with a predominant use of olive and rapeseed oil.
Sport for an active heart
The sport with the most cardiovascular benefits would be one that combines aerobic exercise, resistance training and stretching.
Walking 30 minutes a day 5 days a week has been shown to play a beneficial role in cardiovascular risk management. Thus, sports such as running, cycling, jogging, trekking or swimming would fulfil this role. A notable cardiovascular benefit has also been demonstrated with tai chi, a form of martial art from ancient China that is characterised by smooth, flowing movements.