In this section, we discuss the different treatment options available for someone diagnosed with soft tissue sarcoma.
Learn more about:
Making treatment decisions
 | Find out moreIt can be hard to know which treatment is best for you. It’s important to talk to a sarcoma specialist team before making decisions. Ask them to explain your treatment options, the side effects and long-term impacts, and any costs involved. If you’re confused or want to check anything, ask for more information. This can help you make a decision you’re comfortable with. |
| Seek a second opinionSome people talk to several specialists before deciding on treatment. Getting a second opinion can help you feel more confident in your decision and reassure you that you have explored all your options. Specialists are used to people doing this. You can still be treated by the first specialist, even if you get a second opinion. |
| Get supportYou may have a lot of appointments. If you can, take a family member or friend with you. They can listen, ask questions and help you remember what the doctor said. Bring a list of questions, take notes or ask if you can record the discussion.See Making treatment decisions podcast and Cancer care and your rights. |
Your treatment options
Because soft tissue sarcomas are a rare group of cancers, it’s important to be referred to a specialist sarcoma unit or treated by a specialist sarcoma multidisciplinary team (MDT).
The MDT usually includes:
- a surgeon
- radiologist (who interprets scans)
- radiation oncologist (for radiation therapy)
- medical oncologist (for drug therapies, such as chemotherapy)
- a pathologist or histopathologist (examines tissue under a microscope to make a diagnosis)
- genetic specialist (checks for inherited risk factors)
- cancer nurse.
Other health professionals may be a part of the MDT. You may also receive care from a dietitian, social worker, psychologist or counsellor, physiotherapist and occupational therapist.
The treatment recommended for you will depend on:
- your test results
- the type of sarcoma
- where the cancer is
- whether it has spread
- your age and general health.
The main treatments for sarcoma include surgery, radiation therapy and chemotherapy. Targeted therapy and immunotherapy are sometimes used to treat sarcoma. You may have one treatment or a combination of treatments.
For an overview of what to expect during all stages of your cancer care, visit Sarcoma (Bone and soft tissue tumours) – Your guide to best cancer care. This is a short guide to what is recommended, from diagnosis to treatment and beyond.
If you need to travel away from home for treatment, you may be able to get help with transport or
accommodation costs. Ask your hospital social worker or call Cancer Council 13 11 20 to find out
more.
Surgery
Surgery is the main treatment for most soft tissue sarcomas. The operation you have will depend on the sarcoma type, where it is in the body, the size, and whether it has spread.
Many sarcomas are in the arm or leg. Limb-sparing surgery is used to remove the tumour in one piece, along with some surrounding healthy tissue.
Having part or all of an arm or leg removed (called an amputation) is only done if there are no other options. For large sarcomas, a skin graft or skin flap will be used to cover the area where the tumour was removed.
If the sarcoma is in the chest or abdomen, you may have open surgery (uses a larger cut) or keyhole surgery (which uses several smaller cuts).
Your surgeon will explain the type of surgery needed and any risks. Check that your operation will be done by an experienced surgeon at a specialist sarcoma unit. How long it takes to recover depends on the type of surgery and your general health, but most people stay in hospital for a few days. You’ll be given medicine to control any pain.
Learn more about surgery or call 13 11 20.
Support programs
If you need major surgery, it can help to talk to a social worker or counsellor. You may also find it helpful to talk to someone who has been through a similar experience.
Cancer Council offer a range of support programs including telephone, online, and peer to peer support groups. Call 13 11 20 and speak to a cancer health professional about what might suit you best.
Radiation therapy
What is radiation therapy?
This treatment uses a controlled dose of radiation to kill or damage cancer cells. The radiation is usually in the form of x-ray beams.
When is radiation therapy used?
Radiation therapy can be given before or after surgery to treat the sarcoma and surrounding area and reduce the risk of the cancer coming back.
Radiation therapy may also be used:
- if surgery isn’t possible because the sarcoma is in a hard-to-reach area
- on its own or at the same time as chemotherapy (called chemoradiation)
- in rare cases, internally (called brachytherapy) by placing the radioactive material near the tumour
- to kill any remaining cancer cells after treatment.
Planning and delivery
Radiation therapy needs to be carefully planned during your first appointment with a radiation oncologist. You’ll have a CT scan to map the area and help work out the radiation treatment plan. A radiation therapist will then deliver the radiation therapy. The number of treatments and how long you have radiation varies from person to person.
The treatment is done at a hospital or treatment centre on weekdays. Radiation therapy doesn’t hurt and you can go home afterwards.
Side effects
Radiation therapy often causes general side effects (e.g. fatigue, nausea), as well as side effects specific to the area being treated (e.g. sore skin on the arm). These side effects may not always happen straightaway. Many people feel very tired after radiation therapy, while others are able to continue working or doing their usual activities.
Learn more about radiation therapy or call 13 11 20.
Find information on radiation therapy in Arabic, Greek, Simplified and Traditional Chinese, and Vietnamese.
Chemotherapy
What is chemotherapy?
Chemotherapy (also called “chemo”) uses drugs to kill or slow the growth of cancer cells. It may be used before surgery to help shrink the sarcoma and make it easier to remove. It’s also commonly used after surgery or other treatments to reduce the risk of sarcoma spreading or coming back.
The chemotherapy drugs used will depend on your general health and the type of sarcoma you have. You may have one drug or a combination of drugs.
How chemotherapy is given
Chemotherapy is usually given through a drip into a vein (intravenously). This may take a few hours during a day visit to the hospital or treatment centre. Occasionally you may need to stay in hospital for a few days while having chemotherapy. It may sometimes be given as tablets you take at home.
Treatment is given in cycles. For example, you may have one dose of chemotherapy every 3 weeks, over 6 months. How often, and for how long you have treatment will depend on the type of chemotherapy drugs used and your health.
Learn more about chemotherapy or call 13 11 20.
Find information on chemotherapy in Arabic, Greek, Simplified and Traditional Chinese, and Vietnamese.
Targeted therapy
Targeted therapy is a drug treatment that targets specific features of cancer cells to stop the cancer growing and spreading. Drugs are given as tablets or intravenously. They travel through the body like chemotherapy, but they work in a more focused way.
Targeted therapy may help slow the growth of some sarcomas. It’s mostly used for rare types of sarcoma, or when sarcoma is advanced, has spread or has come back.
Your doctor may suggest you have genomic tests to look for specific changes in the cancer cells. This helps to show whether targeted therapy is likely to work for you.
Learn more about targeted therapy.
Immunotherapy
Immunotherapy is a treatment that uses your body’s own immune system to fight cancer. It’s only used for some types of sarcoma and usually as part of a clinical trial. Your doctor will tell you if immunotherapy is suitable or available for you.
There are different types of immunotherapy. Checkpoint inhibitors help the immune system to recognise and attack cancer cells. Other types of immunotherapy stimulate the immune system to help it work better against cancer. Your doctor will explain whether immunotherapy is recommended for you.
Learn more about immunotherapy.
Should I join a clinical trial?
Your doctor may suggest you take part in a clinical trial. Clinical trials test new or modified treatments and ways of diagnosing disease to see if they are better than current methods.
For example, if you join a randomised trial for a new treatment, you’ll be chosen at random to receive either the best existing treatment or the modified new treatment. Over the years, trials have improved treatments and led to better outcomes for people diagnosed with cancer.
If you decide to take part in a clinical trial, you can withdraw at any time.
For more information, visit Australian Cancer Trials and the Australia and New Zealand Sarcoma Association (ANZSA).
For information on gastro-intestinal stromal sarcoma (GIST) clinical trials visit the Australasian Gastro-Intestinal Trials Group (AGITG).
Learn more about clinical trials and research or call 13 11 20.
Side effects of treatment
The side effects you have will depend on the type of treatment, the medicines used, the dose and how long your treatment lasts. For example, different chemotherapy drugs may cause different side effects. And people can react to the same treatment in different ways. Some people have very few side effects, while others have more.
Most side effects are temporary, but some can be permanent. Some don’t start until months or years after treatment ends. These are called late effects. Before you start treatment, ask your treatment team about what side effects to expect.
There are common side effects and others that are less common. For ways to manage them, see surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy, fatigue and heart health.
Some cancer treatments may affect your ability to have children (fertility). Ask your doctor if your cancer treatments could affect your fertility now or in the future.
Learn more about fertility and cancer or call 13 11 20.
→ READ MORE: Life after treatment
Podcast: Making Treatment Decisions
Listen to more episodes from our podcast for people affected by cancer
Key resource
The information on this page is also available for download.
More resources
A/Prof Richard Boyle, Orthopaedic Surgeon, Royal Prince Alfred Hospital and Sydney Children’s Hospital Network, NSW; Catherine Chapman, Adolescent and Sarcoma Cancer Specialist Nurse, Canberra Health Services, ACT; Belinda Fowlie, Bone Tumour Nurse Practitioner Candidate, SA Bone and Soft Tissue Tumour Unit, Flinders Medical Centre, SA; Leanne Goegan, Consumer; Jonathan Granek, Consumer; Prof David Gyorki, Surgeon and Director, Sarcoma Service at Peter MacCallum Cancer Centre, VIC; Prof Angela Hong, Radiation Oncologist, Chris O’Brien Lifehouse, Melanoma Institute Australia, GenesisCare and Clinical Professor, The University of Sydney, NSW; A/Prof Yeh Chen Lee, Medical Oncologist, Prince of Wales Hospital and UNSW, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA.
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