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Treatments and drugs
By Mayo Clinic staffAs with other cancers, treatment for sarcomas depends on the size, type, location and stage of the sarcoma, including whether it has spread to the lymph nodes or other parts of your body, and your overall health.
Surgery
Surgery is the most common treatment for soft tissue sarcomas, especially if malignant cells haven't spread to other parts of the body. Surgery generally involves removing the cancer and some healthy tissue surrounding it. If the sarcoma has spread, surgical removal of the primary and secondary tumors may be possible.
Previously, amputation was a common treatment for soft tissue sarcomas in an arm or leg. Today, advances in surgical techniques and the combination of chemotherapy and radiation before surgery (neoadjuvant chemoradiotherapy) or after surgery (adjuvant chemoradiotherapy) make limb-sparing surgery possible in most cases. However, amputation may be necessary to remove all of the malignant cells from soft tissue sarcoma in an arm or leg that has invaded nerves, arteries or muscles.
Radiation therapy
Radiation therapy — also called radiotherapy or X-ray therapy — involves treating cancer with beams of high-energy particles, such as gamma rays or X-rays. Although radiation can affect healthy cells as well as cancer cells, it's much more harmful to cancer cells. In addition, normal cells can recover from the effects of radiation more easily than cancer cells can.
Radiation therapy may be recommended to treat your soft tissue sarcoma. Your doctor may suggest using radiation therapy before or after surgery to stop the growth of any remaining cancer cells. You may also receive chemotherapy at the same time as radiation in an effort to make the radiation more effective.
Side effects from radiation treatment depend on the area that's being treated, but may include fatigue, skin problems, headache, swelling, weakness, nausea, vomiting and slower healing after surgery.
Chemotherapy
Chemotherapy uses medications to kill rapidly dividing cells. These cells include cancer cells, which continuously divide to form more cells, and healthy cells that divide quickly, such as those in your bone marrow, gastrointestinal tract, reproductive system and hair follicles. Unlike radiation therapy, which treats only the part of your body exposed to the radiation, chemotherapy treats your body as a whole (systemically). As a result, it treats cells that may have spread beyond where the cancer originated.
The role of chemotherapy in the treatment of soft tissue sarcoma isn't clear, because not all studies have had positive results. However, chemotherapy has been found effective in treating rhabdomyosarcomas.
In addition to chemotherapy, some drugs inhibit certain enzymes that are critical to the development and growth of a tumor. One of these drugs, imatinib (Gleevec), is used to treat a type of sarcoma called gastrointestinal stromal tumor. Other types of cancer-fighting drugs and new combinations of treatments are being studied in clinical trials.
Possible side effects from chemotherapy include nausea, vomiting, hair loss, mouth sores, fatigue, increased risk of infection, weakness and increased bleeding.
- DeLaney TF. Overview of soft tissue sarcoma. http://www.uptodate.com/home/index.html. Accessed July 21, 2011.
- Sinha S, et al. Diagnosis and management of soft tissue sarcoma. British Medical Journal. 2011;342:157.
- Detailed guide: Sarcoma — Adult soft tissue cancer. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003138-pdf.pdf. Accessed July 21, 2011.
- Soft tissue sarcomas. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00508. Accessed July 21, 2011.
- Lahat G, et al. Sarcoma epidemiology and etiology: Potential environmental and genetic factors. Surgical Clinics of North America. 2008;88:451.
- Kenney RJ, et al. Soft tissue sarcomas: Current management and future directions. Surgical Clinics of North America. 2009;89:235.
- Thornton K. Chemotherapeutic management of soft tissue sarcoma. Surgical Clinics of North America. 2008;88:647.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. July 31, 2011.
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