Sarcomas are tumours that usually present as a lump that may be painful or painless. The diagnosis is usually made by tissue biopsy. It is recommended that the biopsy be performed after consultation with a sarcoma expert if the lump is in bone or is larger than a golf ball.
Your specialist will usually arrange staging studies before the biopsy if there is a strong suspicion of sarcoma.
Treatment of sarcomas is primarily surgical. In most sites this will be undertaken by an orthopaedic oncologist - a surgeon trained in the treatment of tumours. Depending on the type of tumour, your specialist may also recommend treatment with either radiation therapy or chemotherapy and this may take place before the surgery.
Radiation therapy is administered to sterilise the tissues around the tumour mass to facilitate surgery and reduce recurrences. Conventional radiotherapy is conducted as an outpatient using external beam (EBRT) in small doses called fractions. Treatment may take up to 5 1/2 weeks. In some cases radiation may be administered to the surgical site at the time of operation by a technique known as brachytherapy. Some centres also offer radiation to bones affected by cancer by taking the bone outside the body and then re-implanting it. This is known as extracorporeal radiation.
For certain types of sarcoma, particularly some paediatric tumours, chemotherapy is an important part of treatment and has improved the chances of cure. Cytotoxic chemotherapy targets rapidly growing cancer cells but also has side effects on the rest of the body. It will often take many months to complete. Intravenous drugs are usually given via a "port" - a small chamber inserted under the skin to make access easier. Chemotherapy will often entail inpatient admission. Most adult soft tissue sarcomas do not incorporate chemotherapy as a routine part of treatment.
More recently, targeted therapies against certain types of tumours have been developed. These are also administered by medical oncologists and may be part of international trials.
Treatment of sarcomas is complex and often requires multi-disciplinary care. Best results are obtained within specialised sarcoma units and ASG recommends contacting one of the Units listed in your state.
