Once your physicians know the type of bone sarcoma, the location of the primary tumor and if there are any metastatic tumors in the body, all the physicians who are involved in the multidisciplinary discussion of your case can come up with a plan for treatment.
Remember: the order of treatment is determined by the size of the tumor and its location, as well as whether there is metastatic tumor anywhere else in the body.
Surgery is considered to be the primary treatment for bone sarcomas, and for some, is the only treatment.
The first goal of the orthopedic surgeon is to remove the tumor, along with some healthy tissue around it. This ensures that no cancer cells remain.
The second goal is to retain as much function as possible to the operative site. Sometimes manmade material is used to replace bone, artificial joints and devices are inserted and sometimes amputation is needed. The involvement of the surrounding tissue, muscle, nerves and blood vessels determine the extent to which that is possible.
Prior to your sugery, your orthopedic oncologist will discuss all your options. A thoracic surgeon performs surgery for sarcomas inside the chest or lungs (usually metastatic tumors).
Radiation usually is administered after surgery, and is given to patients who are at risk for local tumor reoccurrence if only surgery was used for control of the tumor locally.
The goal of radiation therapy is to direct additional therapy at the tumor site to kill any remaining cancer cells that could remain after surgery.
The radiation oncologist uses your preoperative x-rays, information from your surgeon and their own treatment plan to determine the region that needs to be treated.
Radiation treatment is given daily Monday through Friday for 5-7 weeks depending on the plan discussed by your radiation oncologist.
Many factors influence the use of chemotherapy or drug treatment of sarcoma.
These factors include:
- the aggressiveness of the tumor or grade
- the size of the tumor and
- if the tumor has already spread to other areas in the body.
There are many cases in which chemotherapy is given prior to surgery to help shrink down the primary tumor so the surgeon can fully remove the tumor and maintain function of the affected area. It is also used after surgery to destroy any stray cancer cells and to prevent cancer from recurring.
Chemotherapy is often given in high doses and it can cause you to feel sick at times. The details of the chemotherapy regimen and toxicities (side effects) related to the chemotherapy will be discussed by your medical oncologist and staff. (you can also visit our web page: What to Expect: A Guide to Chemotherapy).
The chemotherapy is given to you in the outpatient clinic or in the hospital and the length of treatment is determined by which regimen your medical oncologist presents to you.
ConclusionHopefully this information has helped you better understand your sarcoma and has helped you understand how a treatment plan is formed.
You need to remember that every case is individualized.
Your team of physicians has worked closely together to come up with a plan that will give you the best chance of survival and a good quality of life. They are very willing to answer questions and want to be sure you understand exactly what is being recommended and why.
Please make sure to ask questions of the doctors and staff to be sure you understand all of your options.