Sarcoma

Treatment

Sarcoma is often hard to treat, so it’s important to receive care at a specialized center with sarcoma expertise. At Fred Hutchinson Cancer Center, our experts offer multidisciplinary, team-based soft tissue sarcoma treatment as well as bone cancer treatment, including advanced therapies and new options that are only available through clinical trials.

Treatment plan

Sarcoma treatment at Fred Hutch is customized for each patient’s needs.

How do we create your treatment plan?

Your Fred Hutch doctor works together with a group of other sarcoma specialists. They include medical oncologists, radiation oncologists, surgeons and researchers who are looking for better ways to treat this disease.

Every week, this team goes to a meeting called a tumor board. Together, dozens of team members discuss their patients’ treatment plans. This approach means each patient benefits from the experience of the whole group.

With support from the larger team, your doctor will:

  • Consider the standard therapy for your subtype
  • Find out if any clinical trials match your needs, so you can think about joining them

Your doctor will walk you and your caregiver through the treatment plan that the tumor board has recommended for you. You will have a chance to share your personal preferences and options, and you will decide together what happens next.  

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting. Radiation oncologist A physician who has special training in using radiation to treat cancer. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Why do treatment plans differ?

The treatment plan we make for you depends on many things, including:

  • Your type of sarcoma — either soft tissue or bone cancer
  • Your subtype of sarcoma
  • The grade of your tumor, either low-grade or high-grade
  • The stage of your disease
  • If you have had treatment for sarcoma in the past
  • Your age and overall health
  • Your needs and preferences, like what type of treatment schedule works in your life and if you want to join a clinical trial
Grade In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. Grading systems are different for each type of cancer. They are used to help plan treatment and determine prognosis. Also called histologic grade and tumor grade. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
What is the standard therapy for sarcoma?

Because there are more than 70 subtypes of sarcoma — depending on the nearby tissue, the affected area of the bone or the type of cells creating the tumor — there is no one way to treat everyone. 

However, many people have a combination of chemotherapy, radiation therapy, proton therapy, surgery and targeted therapy (also called immunotherapy). Sometimes, surgery is the only treatment that a person needs. 

At Fred Hutch, our standard always involves caring for you as a whole person. We help you get relief from side effects and provide many other forms of support, like integrative medicine, nutrition counseling and physical therapy.

You may also choose to have new sarcoma therapies that you can get only through a clinical trial. Many people come to Fred Hutch for access to these studies. Your care team will tell you about studies that might be right for you, so you can think about joining them.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Integrative medicine Combines conventional (standard) medical treatment with complementary and alternative (CAM) therapies that have been shown to be safe and to work. CAM therapies treat the mind, body and spirit. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies.

Learn About Subtypes

Each subtype of sarcoma acts differently. Fred Hutch doctors who specialize in sarcoma have a deep knowledge of these subtypes, and they know which therapies to use and when to use them. 

These sarcomas develop in soft tissues, like muscles, fat, nerves, blood vessels, fibrous tissues or deep skin tissues. About 80 percent of sarcomas are in soft tissues. 

The most common soft tissue sarcomas in adults are:

  • Gastrointestinal stromal tumors, which is the most common sarcoma of the gastrointestinal tract. 
  • Leiomyosarcoma, which develops from the smooth muscle in abdominal and pelvic organs and blood vessels. 
  • Liposarcoma, which develops from fat tissue. Most often, it is found in the back of the abdominal cavity, but it can also be found in the soft tissues of the arms and legs. 
  • Pleomorphic sarcoma, which is usually found in the legs, but can also be found in the arms and abdomen. 
Gastrointestinal Refers to the stomach and intestines. Also called GI.

These cancers, also called osseous sarcomas, start in the bone. Bone cancers are much less common than either benign (noncancerous) bone tumors or secondary cancers that spread to the bone from other locations (such as the lung or breast).

The most common bone cancer is osteosarcoma, which develops from cells that form bone.

Benign Not cancer. Benign tumors may grow larger but do not spread to other parts of the body.

Other common sarcoma subtypes include:

  • Angiosarcoma, which forms in the lining of blood or lymphatic vessels.
  • Chondrosarcoma, which develops from cartilage cells.
  • Ewing’s sarcoma, which comes from very primitive cells in the body. It can start in either soft tissue or bone.
  • Fibrosarcoma, which is a cancer of fibrous tissue. 
  • Malignant peripheral nerve sheath tumor, which comes from nerves or related tissue outside of the brain and spinal cord.
  • Rhabdomyosarcoma, which looks like developing skeletal muscle. Most often, it grows in the arms or legs, but it can also develop in the head, neck or urinary or reproductive organs. 
  • Synovial sarcoma, which is often found near large joints and is more common in young adults.

Treatment process

Different subtypes of sarcoma start, progress and respond to treatments in different ways. We choose, combine and schedule your treatments based on what works for your subtype. Your care team makes sure you understand each type of treatment and all of your choices.

Chemotherapy for sarcoma

Depending on what your doctor recommends, you may get chemotherapy before or after sarcoma surgery to reduce the risk of the cancer coming back or to make sure the tumor is completely gone. Chemotherapy may also be used to shrink your tumor and help with pain and other symptoms

Many chemotherapy medicines are given through an intravenous (IV) line in repeating cycles. There are also chemotherapy treatments for sarcoma given in tablet form.

Your Fred Hutch team will talk with you about which medicines we recommend for you, how you’ll receive them, your treatment schedule and what to expect. We’ll also explain how to take the best possible care of yourself during treatment and after, and we’ll connect you with medical and support resources throughout Fred Hutch.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.
Chemotherapy for sarcoma

Chemotherapy is a major and important part of sarcoma care. It may be given before or after surgery or when complete surgical removal would be difficult. 

Radiation therapy for sarcoma

Radiation therapy is an important treatment for many types of sarcoma. Depending on your treatment plan, it may be used before or after surgery, to control the tumor if surgical removal is not an option or to shrink the tumor to reduce pain and other symptoms

We use studies to test different combinations of radiation therapy and immunotherapy to find out what works best. We are always looking for new ways to make immunotherapy more effective and boost the body's immune response against cancer.

Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Radiation therapy for sarcoma

Radiation therapy may be used before or after surgery to reduce the risk of your sarcoma coming back. It may also be used to shrink your tumor and help with pain. 

Proton therapy for sarcoma

Proton therapy is a helpful treatment option in cases where getting the smallest amount of radiation exposure is especially important, such as when:

  • The tumor is close to critical organs
  • The patient is trying to save their fertility so they can have children
  • A patient has had radiation before
  • The disease is recurrent, and radiation is needed several times over many years

Since proton therapy is only appropriate for specific subtypes of sarcoma, your care team will let you know if it is an option for your treatment plan

Learn More

Conventional External-Beam Radiation Therapy (EBRT)

Conventional EBRT uses a machine called a linear accelerator to send beams of high-energy X-rays (photons) at the cancer. Usually, EBRT is given five days a week (Monday through Friday) for several weeks. The procedure doesn’t hurt, and each treatment takes only a few minutes.

There are several forms of EBRT. Your radiation oncologist will decide the form that’s right for your tumors, set the dosage and schedule for your treatments and help you manage any side effects

Intraoperative Radiation Therapy (IORT)

IORT is a fast, effective and exact form of radiation that is used during surgery to treat tumors. It may be used to treat tumors  that came into contact with the tumor during surgery.

IORT takes just a few minutes and uses only a fraction of the total radiation given over a traditional multi-week course of EBRT. UWMC is the only hospital in our five-state region  — Washington, Wyoming, Alaska, Montana and Idaho — to offer this treatment. 

Fast Neutron Therapy

Neutron therapy attacks cancer cells with neutrons. There are two advantages to using neutrons instead of photons or electrons: 

  • Neutron beams are much more powerful. They deposit about 20 to 100 times more energy into the target tissue than photons or electrons can. 
  • Neutron beams are more likely to damage both strands of a cancer cell’s DNA, rather than only one strand. This makes it harder for the cells to repair themselves and survive. 

UW Medicine is the only place in the U.S. to offer neutron therapy, and the doctors here are internationally known as experts in neutron therapy. We sometimes use neutron therapy to treat sarcomas when we believe this may work better than conventional forms of radiation therapy. 
 

Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Proton therapy for sarcoma

For some subtypes of sarcoma, proton therapy can save healthy tissue and reduce exposure to radiation.

Surgery for sarcoma

Our sarcoma patients have their surgeries done by UW Medicine surgeons who provide care at both Fred Hutch and UW Medical Center – Montlake. 

We offer the latest surgical options, including limb-sparing surgery, bone transplants and metallic implants, if you need them. We use minimally invasive techniques, such as laparoscopic surgery (through small "keyhole" incisions), as much as possible.

The exact surgery you need will depend on many things, including the location and size of your tumor. Your team will explain:

  • The details of your procedure
  • The benefits and risks
  • How to get ready for surgery
  • What to expect during your recovery and beyond

During surgery, intraoperative ultrasound helps our surgeons see the borders of your tumor more clearly, so they can remove the whole tumor while saving healthy structures nearby. After your surgery, your care team follows evidence-based guidelines to improve your recovery.

Sometimes, a tumor cannot be removed with surgery because of its size or location or how aggressive it is. In these cases, we’ll find another course of treatment to control the sarcoma, shrink it and help with pain and other symptoms.
 

Laparoscopic surgery A surgery done with the aid of a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Surgery done with the aid of a laparoscope. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain. Ultrasound A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. A procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen (sonogram). Ultrasound may be used to help diagnose diseases, such as cancer. It may also be used during pregnancy to check the fetus (unborn baby) and during medical procedures, such as biopsies. Also called ultrasonography.
Surgery for sarcoma

Surgery is the most common treatment for sarcoma, and it may be curative for some people. Chemotherapy, radiation therapy or both may be given before or after surgery to reduce the risk of the cancer coming back.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for sarcoma

CRS-HIPEC may be able to control advanced disease while also giving you a good quality of life. Our experienced CRS-HIPEC team combines two parts into one operation:

  • Surgery to remove all the cancer the surgeons can see
  • Chemotherapy, in liquid form, that is warmed up and then put into your abdomen to kill any cancer cells that are left behind after surgery

Learn More

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy.
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for sarcoma

This treatment is for people with sarcoma that has spread to the abdominal lining (peritoneum). Cancer that has spread here is called peritoneal carcinomatosis, or peritoneal cancer.  

Targeted therapy and immunotherapy for sarcoma

Targeted therapy and immunotherapy for sarcoma can be used on both soft tissue sarcoma and bone cancer. Often, olaratumab and pazopanib are used for soft tissue sarcoma, and denosumab is used for bone cancer. 

Because there are many types of sarcoma, there are targeted therapies designed for different types, such as sorafenib for desmoid tumors and imatinib, sunitinib, regorafenib and pazopanib for gastrointestinal stromal tumors. 

Fred Hutch has one of the largest sarcoma immunotherapy research programs anywhere, which means there may be immunotherapy clinical trials you can join. 

Gastrointestinal Refers to the stomach and intestines. Also called GI. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies.
Targeted therapy and immunotherapy for sarcoma

Targeted therapies are another type of medicine that can be used in sarcoma treatment. These therapies look for a gene or protein that is responsible for allowing cancer to grow — and they damage any cancer cells they find. Or they prompt your immune system to attack particular cells (also called immunotherapy).

Monitoring your health

While you are in active treatment, your sarcoma care team will see you regularly for exams and tests to check:

  • How well your treatment is working
  • If there is any reason to change your treatment
  • If you need help with side effects or supportive care services, like nutrition care or mental health counseling

We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.

What about “cured”? Sometimes doctors use the word “cured” if you have been in complete remission for at least five years. After 10 years, cancer is less likely to come back (recur), but recurrence is still possible.

Recurrence Cancer that has come back, usually after a period during which it could not be detected. It may come back to the same place as the original (primary) tumor or someplace else. Also called recurrent cancer. Remission A decrease in, or disappearance of, signs and symptoms of cancer. A decrease in, or disappearance of, signs and symptoms of cancer. In partial remission, some (but not all) signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Caregiver icon
Caregiving during treatment

If the person you are caring for is having surgery or getting treatments like chemotherapy, targeted therapy, immunotherapy, proton therapy or radiation therapy, there are many ways you can help. Caregiving often means doing tasks like these:

  • Keeping track of their appointments and driving them to and from treatment
  • Watching for changes in their condition and telling their care team about any symptoms
  • Providing physical care, like helping them take medicines
  • Spending time with them and encouraging them
  • Taking care of things at home that they may not be able to do, like grocery shopping and cleaning
Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies.

Supportive Care Services

Along with treating your sarcoma, Fred Hutch provides a range of services to support you and your caregiver before, during and after treatment. This is part of how we take care of you — not just your disease.

From dietitians to chaplains, we have experts who specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need. 

Learn More

Managing side effects

You may be wondering about possible side effects from treatment, like hair loss or nausea from chemotherapy. If you are, it might be helpful to know that many of today’s treatments are more targeted to cancer cells, so they don’t cause as many side effects as standard chemotherapy. 

You are always at the center of everything we do. Sarcoma doctors, nurses and advanced practice providers are here to help prevent or help with side effects of treatment. 

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores.
How to get help with side effects

Before you begin treatment, we will talk with you about what to expect, based on your treatment plan, and what can help if you do have side effects.
At your appointments, we want you to tell us about any side effects you are having. If you have questions or concerns between appointments, you can call or email us. We will make sure you know how to reach care providers at Fred Hutch after hours, if that is when you need us. 

We have many tools to help you feel better, such as:

  • Antibiotics, vaccines and antiviral drugs to prevent or treat infections
  • Transfusions, steroids and medicines that help the immune system treat low levels of blood cells (low blood counts)
  • Nutrition care and medicines to help with digestive problems
  • Conventional and integrative therapies for pain

Learn More

Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Steroid A type of drug used to relieve swelling and inflammation. Some steroid drugs may also have antitumor effects. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

Continuing Care

When your disease is in remission and your active treatment ends, it is still important to get follow-up care on a regular basis. At follow-up visits, you will see the same Fred Hutch team who treated your sarcoma. They will check your overall health and look for signs that your cancer has come back (signs of recurrence). 

Your team will also help with any long-term side effects (which go on after treatment ends) or late effects (which may start after treatment is over).

Recurrence Cancer that has come back, usually after a period during which it could not be detected. It may come back to the same place as the original (primary) tumor or someplace else. Also called recurrent cancer. Remission A decrease in, or disappearance of, signs and symptoms of cancer. A decrease in, or disappearance of, signs and symptoms of cancer. In partial remission, some (but not all) signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose.
Schedule for follow-up visits

Just like we personalize your treatment plan for you, we personalize your follow-up schedule, too. Your provider will base your schedule on many things, including:

  • Your sarcoma type and subtype
  • Which treatments you had and how your disease responded 
  • How the disease and treatments affected you 
  • How long it has been since your treatment ended

Our Sarcoma Surveillance Clinic offers monitoring for patients who are done with their sarcoma treatment. 

Learn More

Surveillance Closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. In medicine, surveillance means closely watching a patient’s condition but not treating it unless there are changes in test results. Surveillance is also used to find early signs that a disease has come back. It may also be used for a person who has an increased risk of a disease, such as cancer. During surveillance, certain exams and tests are done on a regular schedule. In public health, surveillance may also refer to the ongoing collection of information about a disease, such as cancer, in a certain group of people. The information collected may include where the disease occurs in a population and whether it affects people of a certain gender, age or ethnic group. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.