HOW many of us have heard of sarcoma?
Until a few days ago, I certainly had not.
Like many Filipinos, I was familiar with breast cancer, cervical cancer, lung cancer, leukemia, and other cancers that frequently appear in public health campaigns. Sarcoma, however, remained largely invisible. I suspect many readers would say the same.
My awareness changed after reading a Facebook post by my longtime friend, Dr. Elma P. Laguna, director of the University of the Philippines Population Institute and president of the Philippine Population Association. July is Sarcoma and Bone Cancer Awareness Month, and she courageously shared her experience with soft tissue sarcoma in the hope that others might recognize the warning signs sooner than she did.
Four months ago, surgeons removed a large tumor from her right thigh. More recently, she completed 33 sessions of radiation therapy. Her recovery continues through physical rehabilitation after two thigh muscles had to be removed during surgery. Today, she can walk independently again, although her mobility remains limited, and she has decided to take a sabbatical leave to regain her strength.
One detail in her story stayed with me.
Her first symptom was an involuntary muscle spasm, followed by a painless lump in her thigh. Because it did not hurt, she ignored it for several months. By the time she sought medical attention, the lump measured 7 centimeters. Two weeks later, an MRI (magnetic resonance imaging) scan showed that it had already grown to 9 centimeters. Had she delayed further, she might have lost her leg.
Many of us would probably have done the same. We instinctively associate danger with pain. Yet some serious illnesses progress quietly, making early consultation the difference between successful treatment and permanent disability.
After reading her post, I asked Dr. Laguna what she had learned from the experience. She replied that before becoming ill, she herself knew very little about sarcoma and had to understand how it differed from carcinoma and even the broader term, neoplasm.
The distinction is worth understanding.
A neoplasm simply refers to an abnormal growth of cells. Some neoplasms are benign, while others are malignant. Carcinomas arise from the cells lining organs and account for most cancers. Sarcomas, by contrast, develop from connective tissues such as muscles, fat, tendons, cartilage, blood vessels, and bone. They account for only about 1 percent of adult cancers but comprise more than 70 distinct subtypes, requiring highly specialized diagnosis and treatment. They are also proportionately more common among children and adolescents than among adults. Their rarity is precisely why public awareness remains limited.
In nearly five decades of working in public health, population and social development, I have learned that diseases are shaped not only by biology but also by what societies choose to know, to ignore and to prioritize. Rare diseases often receive less public attention than common ones, yet every patient deserves the same opportunity for early diagnosis, effective treatment and recovery.
What impressed me most about Dr. Laguna’s story was not only her courage but also her appreciation for the institutions that helped save her leg. She was referred to a musculoskeletal tumor specialist — an orthopedic oncologist — at the Philippine General Hospital (PGH). Her surgery was supported through the University of the Philippines’ E-HOPE program, together with the Philippine Health Insurance Corp. (PhilHealth). Her 33 radiation sessions at Cardinal Santos Medical Center, costing approximately P300,000, were fully covered through PhilHealth’s Z Benefits. These special benefit packages are designed for selected catastrophic and medically complex illnesses requiring expensive treatment. For eligible patients treated in accredited hospitals, they can prevent the financial catastrophe that so often accompanies serious disease.
This is a reminder that, when functioning well, our public health system can transform lives. Public hospitals such as the PGH continue to provide highly specialized care, while PhilHealth can protect families from devastating medical expenses.
Our conversation, however, led to a more difficult question.
I asked Dr. Laguna what happens to ordinary Filipinos who do not enjoy the same institutional support.
“They have to queue,” she replied.
There was no complaint in her voice, only a recognition that access to specialized care remains unequal. She also encouraged me that, should the need ever arise, consultation at the PGH’s new Faculty of Medicine Annex Building clinics would provide access to many highly qualified specialists.
Yet I could not help thinking about Filipinos living far from major medical centers. Imagine someone in Basilan, Sulu, Tawi-Tawi, or the island municipalities of the Bangsamoro discovering a painless lump. Where does one find an orthopedic oncologist? Where is the nearest MRI facility? How many days of travel and lost income are required before treatment even begins?
In many parts of the country, geography itself becomes a barrier to survival.
That is why Sarcoma Awareness Month should remind us of two equally important responsibilities. The first is personal: never ignore a lump simply because it does not hurt. The second is collective: universal health coverage must mean more than financial protection. It must also ensure equitable access to specialists, diagnostic services, treatment, rehabilitation and follow-up care, regardless of where Filipinos live.
As I reflected on Dr. Laguna’s experience, I realized that her story is ultimately about more than a rare cancer. It is about the life-saving value of early diagnosis, the dedication of our medical professionals, the importance of strong public institutions, and the difference that equitable health financing can make.
Health should never depend on luck. Every Filipino — from Diliman to Davao, from Metro Manila to the farthest islands of the Bangsamoro — deserves a fair opportunity to receive timely, high-quality care when it matters most.
