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Soft tissue sarcoma - 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, rather than distant. These locally recurrent tumours can often be removed surgically, especially if they are on a limb, and the long term prognosis for such patients is no poorer as a result.
About 50% of sarcoma patients will have a recurrence involving metastasis, or secondary disease, in a part of the body distant from the site of the primary tumour. The most usual site for metastasis is the lungs although the liver and, more rarely, the lymph system, can be affected. Because many sarcomas are painless while they grow it is not uncommon for a patient to have disease which has advanced in this way when first diagnosed.
The first treatment option considered for metastasis will be surgery, if that is possible. As the most common metastatic site is the lungs the opinion of a specialist thoracic surgeon may be sought. However, many tumours will be unresectable or will be too numerous or widespread to allow surgery. Tumours can also recur again after a successful lung resection. In most cases the usual course of treatment will then be chemotherapy.
The two standard chemotherapy treatments available today are Doxorubicin and Ifosfamide. Response rates measured in clinical trials vary and trials comparing different dosages and patterns of dosage are still being undertaken.
Doxorubicin is usually administered as an out-patient. Ifosfamide may be given as an in-patient or as an out-patient, depending on the dosage decision. The standard treatment pattern is six cycles with treatment being repeated over a three week period.
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.
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.
Early stage clinical trials of new treatments are often undertaken at the principal specialist sarcoma centres. The most promising recent drug for soft tissue sarcoma is known as Yondelis (or ET743). It is not available in the UK or Europe at present as the results of trials in the USA are still awaited.