Sarcoma treatment depends on many factors including the type, stage, age and overall health of the patient. Since sarcomas are rare, patients should seek the advice of an expert. Your doctors may have your tumor biopsy looked at by an expert to confirm the diagnosis. Sarcoma advocacy organizations can help you seek out second opinions on treatment recommendations.
Surgery is a very important part of sarcoma treatment. Since sarcomas can arise anywhere in the body, different types of surgeons may perform sarcoma surgery. For instance, doctors who operate on bones (orthopedic surgeons) often treat patients with sarcomas of the arms or legs, while general surgeons may treat patients with sarcomas of the abdomen.
Small (less than 5 cm) or grade 1 sarcomas may be treated with surgery alone. Sarcomas that are larger or higher grade usually require combination treatments (multimodality) such as surgery plus radiation therapy.
If a sarcoma spreads outside of the area where it started, these other tumors are called metastases. Sarcomas most commonly spread to the lungs and surgery may be done to remove metastases in the lung.
Radiation is generally a non-invasive treatment that uses high-energy X-rays or other particles to treat sarcoma tumors. Sometimes a special type of radiation called brachytherapy can also be used. During brachytherapy, radiation is delivered through flexible tubes or devices inserted directly in to the site of surgery. This type of treatment is usually only offered at highly specialized centers.
Radiation therapy kills cancer cells by damaging their DNA and limiting their ability to grow. When cancer cells die, your body naturally gets rid of them. Radiation therapy is performed by a radiation oncologist and their treatment team.
Radiation is often used in combination with surgery to try to cure sarcomas. A course of radiation may be given before or after surgery. Radiation therapy can also be used for patients with metastases from sarcoma. Sarcoma tumors that have spread to the lung can be treated with stereotactic body radiation therapy (SBRT). Radiation therapy can also be used to reduce painful or growing areas elsewhere in the body.
There are several types of medications that are used to kill sarcoma cancer cells. These medications are prescribed by a medical oncologist who may specialize in the treatment of soft tissue sarcoma. Medical therapies are the most common treatment for patients with sarcomas that have spread to other parts of the body (metastasized).
Chemotherapy remains the standard medical therapy for sarcomas, but new research is testing other medications. These include immunotherapies, which are medications that help your own body’s immune system fight the cancer cells. Targeted agents are medications that target specific errors in the cancer’s genes (gene mutations) to stop them from growing. Sometimes, medical oncologists and radiation oncologists work together to treat patients with radiation and medical therapy together. This strategy is called chemoradiation therapy.