Sarcoma treatment depends on many factors such as type, size and location of the tumor, as well as health status of the patient. Soft tissue sarcoma treatment is mainly determined by the stage of the cancer, that is, size of the tumor, its depth in the tissue, and if the cancer is localized or metastasized: spreading to lymph nodes or other parts of the body. The most important characteristics the oncologist will consider to determine the stage of the sarcoma and adopt an appropriate treatment is its a grade, how abnormal the cells appear under the microscope and how quickly the tumor seems to grow and spread into the body.
But in general, sarcoma treatment options include surgery, radiotherapy and chemotherapy. Other options such as target therapy can be added if the medical team estimates it will be helpful in the fight against the cancer. To consider and recommend the most appropriate therapy, a multidisciplinary team of cancer specialists work together to identify all criteria and choose the treatment most suitable for the patient.
Surgical therapy – soft tissue sarcoma treatment can include surgery to remove superficial cancerous tissue, the entire tumor and surrounding tissue, or the entire organ. If the entire organ is removed, reconstructive surgery may be required subsequently. When it comes to sarcoma bonecancers, surgery is usually the main treatment, which can be performed to either remove the cancer or to obtain a biopsy of the tumor. Although biopsy and surgical treatment are separate procedures, it is usually planned and performed together, by the same surgeon. Otherwise, during the biopsy, the sample can be taken in a wrong place, thus cause problems when the surgeon performs the surgery to remove the cancer. Although rare, misplaced biopsy may even make it impossible to remove the cancer without amputating the entire diseased limb.
Radiotherapy – depending on the grade or stage of the tumor, radiation therapy can be performed after surgery to treat a tumor that has not been completely removed or to kill remaining cancer cells; or before surgery to reduce the size of the tumor in order to facilitate the surgical procedure for tumors that are too big or advanced to be surgically removed. The therapy consists of using high-energy radiation X-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and to decrease the size of a tumor. Radiation may come from a machine outside the body (external radiation) or may come from radioactive material placed inside the patient near the tumor (internal radiation or brachytherapy). Systemic radiation therapy uses radioactive substances such as monoclonal antibodies labeled with radioactivity circulating in the blood circulation throughout thebody. This procedure is also called irradiation.
Chemotherapy – this is a systematic therapy which can be given to the patient after surgery orradiation therapy. Chemotherapy is a powerful treatment that affects the whole body, even normal cells that reproduce rapidly, which lead to many side effects in any patient undergoing the treatment.But chemo drugs, taken by mouth or injection, can slow and even stop the progression of tumors andtheir spread to other parts of the body. Chemotherapy side effects are usually temporary and healthycells will repair themselves.
But there is little evidence demonstrating the efficacy of chemotherapy in treating soft tissue sarcoma, although it is often part of an aggressive treatment approach to fight the cancer.
Drugs mainly used to treat bone sarcoma (bone cancer) are:
• Doxorubicin (Adriamycin®)
• Cisplatin or carboplatin
• Etoposide (VP-16)
• Ifosfamide (Ifex®)
• Cyclophosphamide (Cytoxan®)
• Methotrexate
Targeted therapy: This is a type of chemotherapy that specifically targets the genetic and molecular changes in cancer cells, while doing less damage to healthy cells. The targeted drugs work differently from standard chemotherapy and have different side effects. Targeted therapymedications are found to be particularly important in diseases such as chordoma (a rare type of bone cancer that rises from the skull or spine) and other bone cancers, where chemotherapy has not been demonstrated to be ineffective.
Prognosis
When all stages combined, the overall survival rate of sarcoma at 5 years can be up to 65% in patient who receive proper care and live a healthy lifestyle. However, this estimate slightly varies from patient to patient, and some patients become completely free of the cancer.