Bone sarcomas - further information

This objective of this page is to help you understand how sarcoma can develop, based on its 'natural history'.

Sarcomas frequently recur. Some recurrences will be local and the treatment may be similar to that for the primary tumour although limb salvage may not be possible and amputation may be the only alternative. In these cases the long term prognosis for such patients is likely to be no poorer as a result.

About 50% of sarcoma patients will have a recurrence involving metastasis, or secondary disease, in a part or parts of the body distant from the site of the primary tumour. The most usual site for metastasis is the lungs. The first treatment option considered for lung metastasis will be surgery, if that is possible. However, many tumours will be unresectable or the recurrences may be too numerous or widespread to allow surgery. 

Some local recurrences cannot be fully resected, especially in cases where it was not possible to fully remove the tissue from the primary tumour or where bones which cannot be surgically treated are affected.

In most of these cases the usual course of treatment will then be chemotherapy. Bone sarcoma patients have frequently received chemotherapy during their initial treatment and some of the active agents are 'lifetime dose limited', meaning that they cannot be used again. The choice of chemotherapy agent to use will be carefully considered by your oncologist, relying on the latest evidence from worldwide clinical experience.

Sarcoma is regarded as an 'orphan' cancer, which means that it has few strong relationships with other more common cancers. It is also a rare disease and thus active research into new treatments is not regarded as a priority by many in the scientific or pharmaceutical world. This means that new treatments, particularly drug treatments for advanced sarcoma, are badly needed.

If you are considering chemotherapy ask the consultant or Clinical Nurse Specialist for any information they may have. There is also a very good booklet available from Cancer Bacup (call ) or look on their website.

Early stage clinical trials of new treatments are often undertaken at the principal specialist sarcoma centres. Information on clinical trials