In this edition of The Onco’Zine Brief, Peter Hofland, Ph.D., talks with Vince McRuiz and Margo Shoup, MD, FACS.

Margo Shoup is a nationally recognized surgical oncologist who specializes in gastrointestinal cancers and sarcomas. She is also the senior vice president, and system chair of the Nuvance Health Cancer Institute, where she provides strategic and clinical leadership for all aspects of Nuvance Health’s cancer services.

Vince McRuiz is a patient of Dr. Shoup.

In March 2020 just as the COVID-19 pandemic was ramping up in the northeastern United States, Vince was diagnosed with a retroperitoneal sarcoma — a rare abdominal cancer —that develops in the lining of the abdominal wall and the soft tissues that surround the kidneys, pancreas, and blood vessels.

Vince needed surgery to remove the tumor.

But removing this kind of cancer requires one of the most complex types of surgery. And while a diagnosis of cancer alone can be daunting, what if the cancer is rare and you’re diagnosed during a pandemic?

In this edition of The Onco’Zine Brief Hofland talks about that experience with Vince McRuiz, a father of three and grandfather of four, who has experienced several health and personal challenges over the past several years.

In 2013 Vince was diagnosed with ulcerative colitis and in 2019 he underwent major colon surgery, which required a three-week hospital stay. In 2018, Vince also lost his wife, Cynthia, to complications from Parkinson’s disease.

And, then, in March 2020, during a routine CT scan to follow up on the colon surgery, doctors discovered a mass in Vince’s abdomen. Biopsy results confirmed that the mass was malignant.

About retroperitoneal sarcoma

The retroperitoneum is the space between the peritoneum and the posterior abdominal wall that contains the kidneys and associated structures, the pancreas, and part of the aorta and inferior vena cava.

According to the American Cancer Society, 15% of all diagnosed soft tissue sarcomas arise in the retroperitoneum. And approximately one-third of malignant tumors that arise in the retroperitoneum are sarcomas. With approximately 8,600 patients diagnosed each year in the United States, representing less than 1% of all newly diagnosed malignancies, soft tissue sarcomas, including retroperitoneal sarcoma, are considered rare.

The most common types of retroperitoneal sarcomas diagnosed in adults are liposarcomas, leiomyosarcomas, and malignant fibrous histiocytomas.

Patients diagnosed with retroperitoneal sarcoma are often diagnosed in later stages with advanced disease because these tumors arise in the large potential spaces of the retroperitoneum where they can grow very large without producing symptoms.

Furthermore, because retroperitoneal sarcoma is a rare disease in an anatomically complex location, evaluation, and treatment is challenging.

The overall survival rates of patients are affected by the tumor size on presentation, the inability to achieve wide surgical margins, and the limitations of treating retroperitoneal sarcoma with radiation and chemotherapy.

After surgery patients are scheduled for quarterly follow-up CT scans to make sure they are healing well and to determine if additional treatment is required.

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