Chemotherapy for Sarcoma

Chemotherapy kills cancer cells that may have spread from your primary cancer, and also makes it less likely that your cancer will return in the future.

If your doctor suggests chemotherapy after cancer surgery, the reason is to increase your chances of a cure. Chemotherapy is also sometimes used before surgery to see how well the tumor will respond to chemotherapy and to shrink a tumor so that the cancer can be more easily removed. This is called neoadjuvent chemotherapy.

Chemotherapy is called a "systemic" treatment because the drug circulates throughout your bloodstream to attack cancer cells wherever they may have spread. Chemotherapy for bone cancer is usually given by injection into a vein.

Chemotherapy works by killing fast-growing cells, which include cancer cells, but also other fast-growing cells such as hair follicles. That is one reason for many of the typical side effects of chemotherapy, including hair loss.

Ewing's Sarcoma is usually treated with a combination of chemotherapy drugs given intravenously, including a combination called VadriaC, which is Vincristine (Oncovin®, Vincasar®), doxorubicin (Adriamycin®), and cyclophosphamide (Cytoxan ®), alternating with ifosfamide (IFEX®) and etoposide (VePesid®, Etopophos®,Toposar®).

Osteosarcoma is usually treated with Ifosfamide (Ifex®), cisplatin (Platinol®), methotrexate or doxorubicin (Adriamycin®).

Chemotherapy is given on various schedules. If your doctor recommends inpatient chemotherapy, you will be hospitalized for four or five days every month to receive this treatment, which will continue for three to four months before your surgery and six to eight more months after surgery. SCCA adult patients receive inpatient chemotherapy at University of Washington Medical Center.

Outpatient chemotherapy is given in the Infusion Suite on the fifth floor of SCCA. You may bring a friend or family member to sit with you during your treatment, which may last several hours.

Neoadjuvant Chemotherapy

Your doctor may recommend that you have chemotherapy before your cancer surgery. This is called neoadjuvant chemotherapy.

There are several advantages to giving chemotherapy to people with bone cancer before they have surgery to remove the cancer. "The timing is important," says Dr. Earnest Conrad, director of the Sarcoma Service at SCCA. "It is important to start treatment quickly. That's the most important reason."

In addition, Dr. Conrad says, if doctors give chemotherapy before surgery, while the tumor is still in the body, they can see if the chemotherapy is working. If the chemotherapy is effective it will shrink the tumor making it easier to remove. This means that less tissue needs to be removed, giving a better outcome both in terms of appearance and of function.

A third reason is that neoadjuvant chemotherapy reduces the risk that the cancer will return, either in its original location or at distant sites.

If you have bone cancer, your doctor may recommend that you have chemotherapy both before and after your cancer surgery. This is necessary to give you enough chemotherapy to kill all the tumor cells circulating in your body.