There are many treatment options available to treat soft tissue sarcoma. By doing research, you can ensure that you choose the option that is best suited to you. Taking on an active role in your treatment decisions is a great way to feel empowered.
Surgery
There are a variety of surgeries that can be performed to excise a tumour, but the surgeon’s goal will always be to leave behind a “clean margin”, meaning that enough normal tissue is removed to ensure that there are no tumour cells left in the area. Small sarcomas can usually be effectively eliminated by surgery alone, but aggressive sarcomas larger than 5cm may need a combination treatment or surgery and radiation therapy. If the cancer is growing in a limb, this may mean amputation. Radiation or chemotherapy can be used before surgery to shrink the tumor and make removal easier, or during and after surgery to kill any remaining cancer cells and prevent recurrence.
Radiation
Radiation therapy is the use of high-energy x-rays to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen usually consists of a specific number of treatments given over a set period of time.
Radiation therapy may be done before surgery to shrink the tumour so that it is easier to remove, or it may be done after surgery to kill any cancer cells left behind. Radiation can minimize necessary surgery; if there is sarcoma in a limb, this often offers the opportunity to preserve the limb. This therapy can also damage normal cells, but because the energy is focused around the tumour, side effects are usually limited to those areas.
In the short term, radiation can cause injury to the skin that looks like a sunburn and is usually treated with creams that keep the skin soft and helps relieve pain. Most radiation therapy side effects go away soon after treatment ends. In the long term, radiation can cause scarring that limits the function of an arm or a leg. In some cases, radiation can increase the risk of sarcoma or other cancers. We encourage you to talk with your doctor about the possible risks and benefits of radiation therapy.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells, usually by stopping their ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body, and can be given as an outpatient treatment. A chemotherapy regimen usually consists of a specific number of cycles given over a set period of time, much like radiation. Most chemotherapy drugs are given by intravenously, and a patient may receive one drug at a time or combinations of many different drugs at once. Different drugs are used to treat different types and subtypes of sarcoma.
Chemotherapy is often used when a sarcoma has already spread. In addition, certain types of sarcoma might be treated with chemotherapy before surgery to make tumour removal easier. Chemotherapy may be given alone or in combination with surgery and/or radiation therapy. If a patient has not received chemotherapy before surgery, chemotherapy may be given to destroy any tumor cells that remain after surgery.
Side effects will vary depending on the drug and the dose. Talk with your doctor about the potential side effects, how long they may last, and how they can be relieved.
Biological therapies
Targeted therapy is a treatment that targets the cancer’s specific proteins or its environment (which contributes to cancer growth and survival), usually by blocking the action of proteins in the cells. This type of treatment blocks the growth, division, and spread of cancer cells while limiting damage to normal cells.
Recent studies show that not all tumours have the same targets, so your doctor may run tests to identify the appropriate targets for your tumour. This results in personalized medicine, where each patient can be matched with the most effective treatment for them.
Information taken from Sarcoma Cancer Foundation Canada.
