If you’ve been diagnosed with sarcoma, you have several treatment options available. There are many options for sarcoma that are standard of care, and new treatments are being tested all the time through clinical trials. Your care team will help you find the best options for you and your specific diagnosis.
Understanding Your Treatment Plan
Treatment for sarcoma often uses more than one approach. Your doctors might combine different treatments to give you the best results. The treatments you receive will depend on:
- What type of sarcoma you have
- Where it’s located in your body
- What stage your cancer is
- Your overall health
Surgery for Sarcoma
Surgery is often the main treatment for sarcoma. The goal is to remove the entire tumor and some healthy tissue around it to make sure all cancer cells are gone.
What to expect with surgery:
Every surgery to remove sarcoma will be different, but many share similar stages. Most patients who have sarcoma in an arm or leg (limb) can expect to have their surgeon:
- Remove the tumor and affected bone or tissue
- Replace what was removed with either:
- A bone graft (bone taken from another part of your body)
- An artificial implant (like artificial bone or a joint replacement)
Our Siteman experts can replace any joint in your body—knee, hip, shoulder, or elbow—with custom-designed artificial parts or bone grafts. This means many patients can keep the use and appearance of their arm or leg.
Types of Surgery
These are the most common types of surgeries you may encounter if your physicians determine them relevant for your case.
Wide local excision
This surgery removes the cancer and some healthy tissue around it. Taking out healthy tissue helps make sure no cancer cells are left behind.
Limb-sparing surgery
If you have sarcoma in your arm or leg, our WashU Medicine surgeons can often remove the tumor without removing (amputating) your limb. This is called limb-sparing surgery.
Lymph node removal
Sarcomas can spread in the body. If cancer has spread to your lymph nodes (small organs that filter your blood), they will be surgically removed.
Radiation Therapy for Sarcoma
Radiation therapy uses powerful energy beams (like very strong X-rays) to kill cancer cells and shrink tumors.
Types of radiation therapy are listed below.
External-beam radiation therapy
In external-beam radiation therapy, a machine outside your body aims radiation at the cancer. Doctors use special imaging techniques to make sure the radiation hits exactly the right spot.
Intensity-modulated radiation therapy (IMRT)
Intensity-modulated radiation therapy (IMRT) is a more precise type of external radiation that can target the tumor more accurately while protecting healthy tissue nearby.
Brachytherapy (internal radiation)
For brachytherapy, tiny radioactive materials are placed in or right next to the tumor. This allows doctors to give a high dose of radiation directly to the cancer while protecting nearby healthy tissue.
Proton beam therapy
Proton beam therapy is an advanced, precise way to use radiation. This is a special type of radiation that gives doctors even more control.
What makes proton beam therapy special:
- Doctors can control exactly how deep the radiation goes
- Most of the radiation stops right at the tumor
- Very little radiation goes beyond the tumor
- This protects healthy organs and tissues near the cancer
Typically, radiation passes all the way through your body, leaving radiation along its entire path. Proton beam therapy stops at the tumor, which is especially beneficial when the tumor is near important organs.
The S. Lee Kling Proton Therapy Center is one of the only proton therapy centers in Missouri and one of the few in the U.S. [add link]
Medical Therapy
Often patients will have a combination of treatments for their sarcoma, including chemotherapy. Chemotherapy is a kind of medical therapy and is used before and after surgery. It is a powerful drug that kills cancer cells wherever they are in the body. Patients receive chemotherapy through an IV, as a pill, or as an injection.
Before surgery, you might get chemotherapy to shrink the tumor. A smaller sarcoma tumor means less tissue to be removed, making surgery less difficult and helping speed recovery.
After surgery, you might get more chemotherapy. These rounds of chemotherapy can kill any cancer cells that are left or that have spread to other parts of your body. This acts to prevent the cancer coming back (recurrence).
Ablation techniques
Ablation procedures use extreme temperatures to kill cancer cells:
- Cryoablation: Uses extreme cold to freeze and kill tumor cells
- Radiofrequency ablation: Uses extreme heat to burn and kill tumor cells
Ablation is effective, precise, and does not use radiation, so it can be helpful interventions. There is a limit to how much radiation a person can be exposed to, and some patients aren’t able to have more. Ablations allow for new options for these patients.
Newer Treatment Options
Medical research has developed new ways to fight cancer that work differently than traditional treatments.
Targeted therapy
These treatments (like kinase inhibitors) find and attack specific cancer cells without harming your normal, healthy cells. Think of it like a smart missile that only hits the cancer.
Immunotherapy
Immunotherapy helps your own immune system (your body’s natural defense system) fight the cancer. Types include:
- Checkpoint inhibitors: Take the “brakes” off your immune system so it can attack cancer
- T cell therapies: Boost special white blood cells that fight cancer
- Personalized cancer vaccines: Custom vaccines made specifically for your cancer
Clinical trials
Clinical trials are research studies that test new treatments before they become widely available. They give you access to the newest treatments that might work better than standard options.
Important to know:
For sarcoma that has spread to other parts of the body or cannot be removed with surgery, clinical trials are considered the best, next treatment option. They offer cutting-edge treatments that aren’t available anywhere else.
Why consider a clinical trial?
- Access to new treatments before they’re available to everyone
- Close monitoring by a team of specialists
- You might help future patients by advancing cancer research
- Often the best option for advanced sarcoma
Ask your doctor if there are any clinical trials that might be right for you.
Combining Treatments
Most patients with sarcoma receive a combination of treatments for maximum benefits. For example:
- Chemotherapy to shrink the tumor + Surgery to remove it + Radiation to kill any remaining cells
- Surgery + Immunotherapy
- Targeted therapy + Chemotherapy
Your care team will create a personalized treatment plan based on your specific situation.
Things to Remember
Everyone’s cancer is different, which means everyone’s treatment plan is different too. At Siteman, your care team works with you to find the best treatment for your specific situation. Don’t hesitate to ask questions—understanding your treatment options is an important part of your care.