Treatment

As with other cancers, treatment for sarcomas depends on the size, type, location and stage of the cancer, including whether it has spread to the lymph nodes or other parts of your body.

• Surgery
  Surgery is the most common treatment for soft tissue and bone sarcomas. For both, surgery for cancer that hasn't spread may involve removing the cancer and some of the healthy tissue surrounding it. In the past, amputation was common for bone sarcomas and soft tissue sarcomas in an arm or leg. Today, advances in surgical techniques and chemotherapy before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) and radiation therapy make limb-sparing surgery possible in many cases. However, amputation may be necessary to remove all the cancer from soft tissue sarcoma in an arm or leg that has invaded nerves, arteries or muscles. With osteosarcoma, limb-sparing surgery involves replacing the cancerous bone with an artificial device (prosthesis) or bone from another part of your body or from another person (transplant).

• If osteosarcoma spreads, it often goes to the lungs. Treatment may involve surgical removal.

• Ewing's sarcoma has a tendency to metastasize rapidly. Treatment may involve chemotherapy with multiple drugs as well as radiation therapy and surgery to remove the primary tumor.

Radiation therapy

Radiation therapy — also called radiotherapy or X-ray therapy — involves treating cancer with beams of high-energy particles, or waves (radiation), such as gamma rays or X-rays. Although radiation can affect healthy cells as well as cancer cells, it's much more harmful to cancer cells because cancer cells divide more rapidly than healthy cells do. Cells are more vulnerable to damage when they're dividing, making cancer cells more susceptible to radiation than normal cells are. In addition, normal cells can recover from the effects of radiation more easily than cancer cells can.

• More than half of people with cancer undergo some type of radiation therapy. Your doctor may suggest using radiation therapy at different times during your cancer treatment and for different reasons, such as before surgery to shrink a cancerous tumor or after surgery to stop the growth of any remaining cancer cells. In addition, doctors sometimes use radiation therapy to shrink tumors to decrease the pressure, pain or other symptoms they may cause.

Chemotherapy

Chemotherapy uses medications to kill rapidly dividing cells. These cells include cancer cells, which continuously divide to form more cells, and healthy cells that divide quickly, such as those in your bone marrow, gastrointestinal tract, reproductive system and hair follicles. Healthy cells usually recover shortly after chemotherapy is complete — so, for example, your hair starts growing again.

• Unlike radiation therapy, which treats only the part of your body exposed to the radiation, chemotherapy's main advantage is that it treats your entire body. As a result, it treats cells that may have escaped from where the cancer originated.

• Depending on the type of cancer you have and whether it has spread, your doctor may use chemotherapy to:

• Eliminate all cancer cells in your body, even when cancer is widespread

• Prolong your life by controlling cancer growth and spread

• Relieve symptoms and enhance your quality of life

• In some cases, chemotherapy may be the only treatment you need. More often, doctors use it in conjunction with other treatments, such as surgery or radiation, to improve results.

• In addition to chemotherapy, some drugs inhibit certain enzymes that are critical to the development and growth of a tumor. One of these new drugs, imatinib (Gleevec), is used to treat a type of sarcoma called gastrointestinal stromal tumor, as well as chronic myelogenous leukemia.