Your first appointment at Fred Hutch Cancer Center is a time for you and your medical oncologist to meet. You might meet your advanced practice provider, too.
You will talk about your diagnosis, sarcoma type, grade, stage and likely treatment. This visit is also a time for us to start getting to know you as a person. This helps us fit our recommendations to you. Together, you and your care team will decide what needs to happen next.
We encourage you to bring a family member or friend to your first appointment (and any future visits).
What to Expect
Your first appointment usually takes one to two hours. You will spend about one hour with your doctor. The rest of your visit may involve checking in, going to an exam room and getting settled in there, meeting other members of your team and setting up your next appointments. Here is what you can expect to happen.
To check your sarcoma diagnosis, your doctor may use different tools to find out more information about the tumor, which could lead to either a soft tissue sarcoma diagnosis or a bone cancer diagnosis.
For soft tissue sarcomas, your doctor may use magnetic resonance imaging (MRI), computed tomography (CT) scans or positron emission tomography (PET) scans to see the tumor. Then, a biopsy will remove cells from the tumor so we can look at them with a microscope.
For bone cancer diagnosis, the process is similar. Both imaging and a biopsy will be used. Adults over 40 who have a bone tumor or other bony abnormality that might be a tumor should be examined carefully to see if they have primary lung cancer, kidney cancer, breast cancer or prostate cancer that may have spread to their bones. This means having a CT scan of the lungs and abdomen and a total body bone scan.
Testing the DNA of your cancer can give your doctor information about what caused your disease and which therapies will work best against it.
UW-OncoPlex is a diagnostic tool that uses genetic sequencing to look for mutations (changes) that cause cancer. These “genetic profiles” of cancer cells help doctors figure out which mutations are causing tumors.
Some people have an inherited (passed down in the family) risk of cancer, including sarcomas. Your Fred Hutch doctor may refer you to a genetic counselor who can talk with you about your genetic risk.
Grading and staging are important next steps in deciding on the right course of treatment. During your biopsy, doctors will see how abnormal the cancer cells look. This helps them describe your tumor as either low-grade or high-grade. Then, staging shows us how far the cancer has spread within the tissue where it started or to other parts of the body.
The treatment we recommend for you depends on your sarcoma type, grade and stage. After your biopsy and staging is done, we’ll meet with you to talk about your personalized treatment options.
These appointments are also a time for you to tell us about yourself. Each patient and family has their own needs and preferences. We want to get to know you, so we understand the best way to care for you.
Starting with your first appointment (and after), we are here to answer your questions. We want to help you understand as much as you want to know about your disease, your treatment and how care happens at Fred Hutch. We invite you to bring a friend or family member with you to help keep track of your questions and the information that your team gives you.
We also encourage you to talk with your care team about your hopes and concerns. Knowing more about you helps your team recommend the right treatment for you.
Before you leave, we will make sure you know what is going to happen next and how you can reach us if you have questions later. We will also schedule your next visit.
Staging means finding out how far your sarcoma has spread within the tissue where it started or to other parts of your body. Accurate staging helps your doctor predict which treatments are most likely to control your disease or put it into remission.
Sarcoma staging can be complicated, and it can be different depending on your subtype. In general, doctors use Roman numerals I (one), II (two), III (three) and IV (four) to name the stages of sarcoma. Stage I is the least advanced, and stage IV is the most advanced. Some stages can be subdivided even more, based on the unique features of your diagnosis.
To find out the stage of your sarcoma, you will need imaging tests and a biopsy. Imaging tests give your care team a visual of your tumor, so they can see its size and how far it has spread.
Then, a biopsy will confirm that there are cancer cells and show how abnormal the cancer cells look.
If your sarcoma is in a bone and you are over 40 years old, your doctor will recommend that you have a CT scan of the lungs and abdomen and a total body bone scan to see if your cancer may have started somewhere else in the body and spread to the bones.
Imaging tests to stage sarcoma
Imaging tests to stage sarcoma may include:
- Magnetic resonance imaging (MRI)
- Computed tomography (CT) scans
- Positron emission tomography (PET) scans
- Bone scans
Either with surgery or guided by an X-ray machine, a sample of the tumor is taken. This allows pathologists to examine and understand your cancer so they can classify it for treatment.
Resources for Patients and Caregivers
Here are tips about how to get ready for your first appointment at Fred Hutch and what to bring.
Just like every patient’s situation is different, every caregiver may be asked to help with different tasks. Learn how you can offer support during a first visit.
As a caregiver, you can give your loved one both emotional and practical support for their first appointment. Ask them if you can help with things like these:
- Helping them manage their stress, worry or other feelings.
- Planning how to get to and from the appointment, what time to leave home and where to park.
- Making a list of questions they want to ask the doctor. (Fred Hutch’s Guide to Your Care (PDF) has a list of questions they may want to ask the care team.) At the appointment, make sure that all their questions get answered.
- Taking notes during the visit. The doctor will be giving a lot of details, which can be hard to remember later without notes.