Treatment for soft tissue cancer

Wednesday 31 October, 2012

Reviewed: Annie Angle, cancer nurse (Dip. Oncology Nursing, Royal Marsden, London)

On this page: Surgery ι Radiotherapy ι Chemotherapy ι Side effects


Your doctor will help you decide on the best treatment for your sarcoma depending on:

  • the type of sarcoma you have
  • where it is in your body
  • whether or not the cancer has spread (its stage)
  • your age, fitness and general health
  • what you want.

Treatment may include surgery, chemotherapy and radiotherapy. They can be given alone or in combination.

Surgery

Surgery is the main treatment for most types of soft tissue sarcoma. Surgery usually involves removing the cancer and some healthy tissue around the cancer. Doctors call this a wide local excision. The healthy tissue is removed to help reduce the risk of the cancer coming back in that area.

The type of operation depends on where the sarcoma is. Most sarcomas are in the arm or leg. This usually means having limb-sparing surgery; amputation is less common. But sarcoma can develop in other parts of the body, for example the chest or abdomen. Surgery to these areas will depend on where the cancer is and how big it is.

Your surgeon will discuss the type of operation you may need. 

The most important thing is that you have your surgery done by an experienced surgeon working in a specialist centre for sarcoma. Plastic surgeons are sometimes asked to work with surgeons to help restore parts of the body affected by surgery. This would be part of your main operation. The type of surgery you have will depend on where the sarcoma is and how much tissue needs to be removed.

Before you make any decision about treatment, your surgeon will discuss all your options.

Surgery for sarcoma that has spread to the lungs

Sometimes sarcoma spreads into the lungs. Unlike some other types of cancer, sarcoma lung cancers can sometimes be taken out using surgery. This depends on the size and number of cancers. You'll see a specialist lung surgeon for an opinion.

You may have chemotherapy instead of surgery to help stop the cancer coming back.

Limb-sparing surgery

This means taking out the cancer and a margin of healthy tissue while still keeping your limb. If necessary, bones may be rebuilt using a metal implant (prosthesis) or a bone graft. A graft means taking a piece of healthy bone from somewhere else in your body, or from a ‘bone bank'. Any other gaps in the tissue are usually reconstructed using plastic surgery.

After surgery, a physiotherapist will help you plan an exercise program so you can get strength and function back in your limb. There will be some changes in the way the limb looks, feels or functions. The aim is for your limb to be as normal as possible.

This complex surgery needs to be done by a surgeon with a lot of experience in treating sarcoma. This may mean that you have to travel to a treatment centre that has a team of experts. Surgery done well may decrease the risk of the cancer cells spreading to nearby areas or other parts of the body.

Amputation

Sometimes it's not possible to remove all of the cancer without badly affecting the arm or leg. The doctor may advise that the only effective treatment will be to remove the limb (amputation).

Amputation can be very distressing emotionally and physically. Most people will need a lot of support at this time. Amputation is likely to have a huge affect on you and the people who share your life.

After surgery you'll have a carefully planned rehabilitation program. This will include seeing a specialist who makes false (prosthetic) limbs. A physiotherapist will help you become as independent and mobile as possible.

It can take time to recover from major surgery. You may be hoping that your life will return to normal as soon as possible. However, you may need to allow yourself time to create a ‘new normal' after losing a limb. Try not to expect too much all at once. Accept support from those close to you as much as possible.

Other types of support are also useful. You may find it helps to speak with a social worker or counsellor, or you can call a Cancer Council nurse on 13 11 20 who may be able to put you in contact with someone else who has had the same operation. They may be able to offer advice on ways to cope and what to expect.

Radiotherapy

Radiotherapy uses high energy rays to destroy the cancer cells. Sarcoma is known to be very sensitive to radiotherapy. It may be used for several reasons, including:

  • if the cancer is too big to remove with surgery
  • if the cancer has spread to other parts of the body
  • after surgery, to destroy any remaining cancer cells and stop the cancer coming back
  • if the cancer is in a place in the body that's too difficult to get to using surgery 
  • before surgery, to destroy the cancer cells and create a ‘rind' around the cancer, which helps the surgeon to perform good surgery.

Radiotherapy can shrink the cancer down to a smaller size. This may help to make surgery easier and safer. Sometimes chemotherapy is given as well as radiotherapy, to help make the treatment more effective. This depends on the type of sarcoma.

For more details see our Understanding Radiotherapy section or call 13 11 20.

Chemotherapy

Chemotherapy drugs are given to destroy cancer cells. Chemotherapy is most commonly given to treat Ewing sarcoma and sarcoma in children.

Sometimes it's given to help control symptoms or slow down the growth of sarcoma that's spread. This is known as palliative chemotherapy. Chemotherapy may also help stop a sarcoma coming back after surgery. Your doctor will discuss your options with you.

You may also be asked whether you'd like to join a clinical trial.

Your treatment will depend on your situation and the type of chemotherapy you have. Your doctor will discuss these with you before you begin treatment. You may have one chemotherapy drug, or a combination of drugs.

For more details see our Understanding Chemotherapy section or call 13 11 20.

Side effects of treatment

All treatments can have side effects. Many are short term and will disappear once the treatment is over. For example, chemotherapy can cause a drop in your blood cell counts, putting you more at risk of infection, anaemia and bleeding problems. These usually return to normal once your treatment is over.

Some side effects are long term. This may mean a change in the way a part of your body looks, feels or functions.

The type of side effects that you may have will depend on the type of treatment and where in your body the cancer is. Some people have very few side effects and others have more. Your medical team will discuss all possible side effects (long and short term) before your treatment begins.

For more information see treatment and side effects or call 13 11 20.

Updated: 31 Oct, 2012