Sarcoma Treatments

Our team has developed a number of innovative surgical techniques to remove tumors safely and accurately. We use several types of sarcoma surgery:

Surgery is often combined with chemotherapy, radiation (mainly for soft tissue sarcomas) or, in the case of a soft tissue sarcoma called a gastrointestinal stromal tumor (GIST), a targeted therapy.

Thanks to advances in surgery, radiation, and chemotherapy, we can usually save arms and legs with sarcomas rather than amputate them. But limp-sparing surgeries remain complex and are best left to specialized experts like ours:

We have a 98 percent success rate when saving limbs, though patients still require full rehabilitation support to make their surgeries successful and to retain function.

On the rare occasions we need to amputate, we provide a full range of physical and emotional support, including reconstruction specialists.

After removing a tumor, our surgeons may need to replace portions of the skeleton with a man-made implant (an internal prosthesis, or endoprosthesis) to help with stability and function.

We specially select and customize each implant to ensure the best possible fit and performance for each patient. Many newer implants can even grow with younger patients, so we don’t have to perform more surgery to replace or adjust the equipment. But these prostheses may still need replacement with an adult model once a child stops growing.

After the limbs, the shoulder girdle (several major bones in the shoulder area) is the most common site for bone sarcomas. It is now possible to avoid amputation and maintain function of the shoulder, arm, wrist, and hand, removing the cancer and using a prosthesis to reconstruct the bone and joint.

But the shoulder girdle is a very complicated area and requires an experienced and skilled team. Our surgeons are world leaders in performing this complex surgery.

Sarcoma surgery is particularly complex when it involves large tumors or hard to treat areas, such as the pelvis and spine. Other centers (even some from around the country and the world) refer these cases to us because of our skilled orthopedic surgeons and their access to other MedStar Cancer Georgetown Network specialists.

This same experience is also useful for providing revision surgery—surgery to finish or redo a previous operation to correct problems or improve function, including for tumors that were only partially removed or have grown back.

Our team has a great deal of experience dealing with these cases and offers innovative solutions to very challenging problems. Many of the revision surgeries we perform are for patients who were treated at other institutions and then got referred to us.

Chemotherapy drugs are swallowed or injected then travel through the bloodstream to kill cancer cells. They are used to shrink sarcomas before surgery or given afterward to make sure the cancer does not return or spread. In some cases, chemotherapy is given by itself to treat a tumor.

The type of chemotherapy depends on the type of tumor, its stage, and whether the cancer is newly diagnosed or has returned. Drugs are typically given together, and we are studying new medications, new combinations, and more effective ways of delivering them.

While we always try to minimize the side effects of chemotherapy, we are particularly sensitive to limiting toxic exposure as much as possible for children who are still growing.

Radiation therapy uses high-energy X-rays or other radiation to kill cancerous cells. When needed in sarcoma treatment, we use it with surgery or chemotherapy to shrink tumors or prevent cancer from returning. In some cases, radiation is used by itself—usually when surgery is not an option.

Radiation treatment depends on the type of sarcoma and the cancer’s stage. While we always try to minimize the side effects of radiation, we’re particularly sensitive to the vulnerability of children who are still growing. We try to limit doses and, whenever possible, avoid the therapy altogether.

Radiation therapy is getting safer and sparing more healthy tissue, thanks to specialized, focused beams of radiation, sophisticated computer programs, and advanced imaging.

When needed, sarcomas are treated with external radiation delivered by a machine. We use two types:

Targeted therapy represents a new front in attacking cancer—drugs and other substances aimed at specific molecules that help tumors grow, progress, and spread. The idea is to target a tumor’s unique characteristics, including genes, proteins, supporting blood vessels, or host tissue, while limiting damage to healthy cells.

Targeted therapies may replace current sarcoma treatments, or complement them, and we are studying a number of new targets and approaches: