Sarcoma Treatment

Sarcoma treatments are as unique as the sarcoma tumor itself, and successful treatment depends on a multitude of factors that vary widely from patient to patient and from sarcoma type to subtype.

At Winship, Georgia’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, our team of sarcoma specialists is world-renowned, offering some of the best treatment options in the Southeast. In fact, as a high-volume center, Winship sees more sarcoma patients than any other hospital in the state.

Our physicians consider numerous factors when determining an appropriate, individualized treatment plan for patients with newly diagnosed or recurrent sarcomas. Key factors influencing sarcoma treatment options include tumor size, tumor location, involvement of critical neurovascular structures, the biologic aggressiveness of the tumor and whether the tumor has metastasized or spread to other parts of the body.

Winship’s highly experienced sarcoma team includes sarcoma pathologists, surgical oncologists, orthopedic oncologists, thoracic surgeons, sarcoma medical and radiation oncologists, musculoskeletal radiologists and supportive oncology specialists. The sarcoma team meets on a weekly basis at a multidisciplinary tumor board to discuss individual cases by reviewing pathology slides, treatment plans and assessing whether a patient is eligible for a clinical trial.

The first step of sarcoma treatment is to have the diagnosis confirmed by an expert sarcoma pathologist. Depending on the type of soft tissue or bone sarcoma present and its location, this may involve many specialists and surgeons across many disciplines. It is important to remember that each patient’s soft tissue or bone sarcoma treatment options will look different. One or more of the following types of treatment options can be used:

Surgery

For a soft tissue or bone sarcoma tumor that is located in the extremities (arm or leg), limb-sparing, function-preserving surgery is the standard of care and desired surgical approach. The tumor, along with a margin of normal tissue around it, is removed in its entirety. In the past, amputation was the standard surgical approach, but with limb-sparing procedures, an amputation is rarely needed nowadays.

For tumors that are in the retroperitoneum or abdomen, complex abdominal operations involving major organ and blood vessel resection and reconstruction are often required. The extent of such abdominal operations varies according to the type and location of the soft tissue sarcoma. Surgery, in certain circumstances, is also used to remove tumors that have spread (metastasized) to organs such as the lung and liver with the goal of improving survival.

Winship collaborates with highly specialized plastic and vascular surgeons if complex reconstruction is needed after more complex surgeries.

Chemotherapy

Cancer-killing drugs are commonly used to treat various types of bone and soft tissue sarcomas. Chemotherapy can be administered before surgery in an effort to reduce the tumor or inhibit the spread of cancerous cells. For patients with more advanced tumors where the cancer has either spread or the tumor is inoperable, chemotherapy is used as a sole treatment method.

Due to the rarity and diversity of sarcomas, chemotherapy should be administered by a medical oncologist with expertise and experience in the management of patients with soft tissue or bone sarcomas. At Winship, our sarcoma oncologists are up to date with the array of novel drugs being identified and used in sarcoma treatment and are actively involved in national and international sarcoma clinical trials.

Radiation Therapy

Radiation plays a key role in sarcoma treatment guidelines. It is sometimes used in conjunction with chemotherapy. Radiation is administered for many soft tissue sarcomas, and is an integral component in the management of patients with soft tissue sarcomas of the extremity and trunk. Radiation is also routinely used in palliative settings to help improve a patient’s quality of life.

Our radiation oncologists at Winship use cutting-edge techniques, such as intensity-modulated radiation therapy and proton therapy that reduce the potential toxicity of radiation to the surrounding normal tissues.

Proton Therapy

Proton therapy is a form of radiation that delivers treatment precisely to the tumor, reducing or eliminating radiation to nearby normal tissues. The Emory Proton Therapy Center is the only center in Georgia to offer this advanced form of radiation therapy. Proton therapy is often used in the treatment of chordomas and chondrosarcomas, as well as many other types of soft tissue sarcomas. Proton therapy is often integrated into treatment plans involving surgery, chemotherapy and immunotherapies.

Immunotherapy

For oncology teams treating sarcoma, the challenge has always been addressing metastatic disease where outcomes are less promising than they are for stages I and II. Immunotherapies, which involve the use of medications to enhance the body’s natural defenses to target and attack specific types of cancer cells, have been highly effective in treating certain solid cancers and leukemias.

In recent years, these techniques, which include immune checkpoint blockade (ICB), oncolytic virus therapy (OV) and adoptive cell transfer, have shown great promise in treating sarcoma in its later stages. Many of these investigations are in the clinical trial phase today. Luckily, Winship’s patients have access to these and other trials through our robust clinical trials program.

In addition to advanced sarcoma treatment options, Winship also offers a supportive oncology team of specialized doctors and nurses who can help with the physical, psychological and emotional aspects of living with cancer, including symptom management and counseling. We know that a sarcoma diagnosis is scary and stressful. That’s why Winship’s counselors, dietitians, social service professionals and others are with you every step of the way.