Sarcoma

Treatment

Sarcoma is often hard to treat, so it’s important to receive care at a specialized center with sarcoma expertise. 

Seattle Cancer Care Alliance (SCCA) experts offer comprehensive, team-based soft tissue sarcoma treatment as well as bone cancer treatment, including advanced therapies and new options available only through clinical studies.

In most cases, you have time to consider your options and get a second opinion — even a third opinion — before deciding what kind of treatment is right for you.

A diagnosis of cancer can feel overwhelming. We have an experienced, compassionate team ready to help. 

Sarcoma expertise at SCCA

Everything you need is here

We have surgeons, medical oncologists and radiation oncologists who specialize in sarcoma; the most advanced diagnostic, treatment and recovery programs; and extensive support. Every year we treat more sarcoma patients than any other cancer center in the region.

Innovative sarcoma therapies

SCCA offers a range of clinical studies that may be appropriate for your type of sarcoma. Patients who participate in clinical studies have the first chance to benefit from treatments that have shown promise in earlier research.

Sarcoma treatment tailored to you

We view treatment as a collaborative effort. Your SCCA doctors will explain all your options and recommend a treatment plan based on the size, location, grade and subtype of your tumor; whether it has spread; and the possible impact of treatment on your body and general health.

A team of experts all in one place

We bring everyone to you — your surgeon, medical oncologist and radiation oncologist — on the same day whenever possible. Your personal team will talk with each other and with you to help you make treatment decisions. Additional experts who specialize in treating people with cancer will be involved in your care if you need them — experts like a palliative care professional, social worker, physical therapist or dietitian.

Learn More About Supportive Care Services

Setting the standards for care

Not only do our doctors provide the most advanced sarcoma treatment, they also help set the internationally recognized standards by which others treat this disease through our membership in the National Comprehensive Cancer Network. 

Ongoing care and support

After treatment, your team continues to provide follow-up care on a schedule tailored to you. The SCCA Survivorship Clinic is also here to help you live your healthiest life as a sarcoma survivor.

Treatment types

Treatment looks different for different people depending on your diagnosis. We tailor your treatment plan to you. Learn more about the treatment types offered at SCCA. 

Surgery

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.

UW Medicine surgeons who provide care at both SCCA and University of Washington Medical Center perform surgery for our sarcoma patients. They perform more surgeries on adults with sarcoma than surgeons at any other cancer center in the Northwest.

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

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

  • The details of your procedure
  • The benefits and risks
  • How to prepare before surgery
  • What to expect during your recovery and beyond

During surgery, intraoperative ultrasound helps our surgeons better delineate the borders of your tumor to more effectively remove the whole tumor while saving healthy structures nearby. After your surgery, your care team follows evidence-based guidelines to enhance your recovery ("early-recovery after surgery" protocols).

In some situations, a tumor cannot be removed surgically because of its size or location or how aggressive it is. In these cases, a multidisciplinary team can identify another course of treatment to control the sarcoma, reduce its size and relieve pain and other symptoms.

Learn more about surgical oncology.

Surgery

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.

Chemotherapy

Chemotherapy is a major and important component of sarcoma care. It may be given before or after sarcoma surgery to reduce the risk of the cancer coming back or to allow complete surgical removal when this would otherwise be difficult. Chemo may also be used to reduce the size of tumors or to relieve 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 SCCA team will talk with you about the specific 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 SCCA.

Learn more about chemotherapy in our medical oncology section. 

Chemotherapy

Chemotherapy is a major and important component of sarcoma care. It may be given before or after sarcoma surgery to reduce the risk of the cancer coming back or to allow complete surgical removal when this would otherwise be difficult. Chemo may also be used to reduce the size of tumors or to relieve pain and other symptoms.

Targeted therapy and immunotherapy

Targeted therapies are another type of medicine that can be used in sarcoma treatment. They target a gene or protein responsible for allowing cancer to grow, they seek out and damage cancer cells, or they prompt your immune system to attack particular cells (also called immunotherapy).

Targeted therapies for sarcoma include:

  • For bone cancer — denosumab (Xgeva)
  • For soft tissue sarcoma — olaratumab (Lartruvo) and pazopanib (Votrient)

There are many different types of sarcoma, and other targeted therapies are used to treat particular types, such as:

  • For gastrointestinal stromal tumors — imatinib (Gleevec), sunitinib (Sutent) and regorafenib (Stivarga), as well as pazopanib 
  • For desmoid tumors — sorafenib (Nexavar)

SCCA has one of the most comprehensive sarcoma immunotherapy research programs anywhere. We have multiple immunotherapy clinical trials, testing a wide range of options, such as T-cell therapy, immune checkpoint inhibitors, vaccines, virus therapies, additional antibody therapies and other medicines that boost the body’s anti-cancer immune response. 

Learn more about immunotherapy.

Targeted therapy and immunotherapy

Targeted therapies are another type of medicine that can be used in sarcoma treatment. They target a gene or protein responsible for allowing cancer to grow, they seek out and damage cancer cells, or they prompt your immune system to attack particular cells (also called immunotherapy).

Radiation therapy

You may have radiation therapy before or after surgery to reduce the risk of your sarcoma coming back. If your tumor cannot be removed surgically, doctors may use radiation therapy to control it. Radiation may also be used to reduce the size of the tumor or to relieve pain and other symptoms.

We've opened several studies looking at combinations of radiation therapy and immunotherapy — using radiation to make immunotherapy more effective, increasing the body's immune response against cancer.

Conventional external-beam radiation therapy (EBRT)

Conventional EBRT uses a machine called a linear accelerator to send beams of high-energy X-rays (photons) toward the cancer. Typically, EBRT is given five days a week (Monday through Friday) for several weeks. The procedure is painless, and each treatment lasts only a few minutes.

There are several forms of EBRT. Your radiation oncologist will determine the form that’s most appropriate for your tumors, set the dosage and schedule for your treatments and help you manage any side effects. Learn more about EBRT.

Intraoperative radiation therapy (IORT)

IORT is a fast, effective and precise form of radiation 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 to deliver and uses only a fraction of the total radiation given over a traditional multi-week course of EBRT. UWMC is the only hospital in the WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho) to offer this treatment. Learn more about IORT.

Proton therapy 

Proton therapy delivers radiation with great precision, significantly limiting radiation exposure to surrounding healthy tissues. This may reduce side effects from treatment and make proton therapy a better choice for certain sarcomas that are anatomically complex, such as those in the skull or spine. Learn more about proton therapy.

Fast neutron therapy

Neutron therapy bombards 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 as much energy into the target tissue. 
  • Neutron beams are more likely to damage both strands of a cancer cell’s DNA, rather than only one strand, making it harder for the cells to repair themselves and survive. 

UWMC is the only place in the United States to offer neutron therapy, and doctors here are internationally recognized for their neutron therapy expertise. We sometimes use neutron therapy to treat sarcomas when we believe this may be more effective than conventional forms of radiation therapy. Read more about fast neutron therapy on the UW Medicine website.

Radiation therapy

You may have radiation therapy before or after surgery to reduce the risk of your sarcoma coming back. If your tumor cannot be removed surgically, doctors may use radiation therapy to control it. Radiation may also be used to reduce the size of the tumor or to relieve pain and other symptoms.