Surgery is often the first step in treating sarcoma.

• Some patients will undergo removal of all or most of their sarcoma as a first step in treatment. Others will have a biopsy first, where a portion of the tumor is removed so that the cells can be looked at under a microscope. If a biopsy was performed, further surgery may be done later to remove the rest of the tumor and some healthy tissue around it.
• Removing healthy tissue around your sarcoma tumor may create a “margin” to help ensure that there are no tumor cells left in that area
• Surgery is typically performed by a surgical oncologist or an orthopedic surgeon who specializes in sarcoma.
• Surgery might be the only treatment necessary in some small, low-grade sarcomas, but can also be combined with chemotherapy, radiation therapy, or targeted therapy (see below) in certain tumor types.

Radiation therapy is the use of high-energy X-rays or other ionizing particles to destroy cancer cells.

• Radiation therapy is guided by a radiation oncologist.
• A radiation therapy plan usually consists of a specific number of radiation treatments given over a set period of time.
• Radiation therapy may be done before surgery to help shrink a tumor for easier removal or after surgery to destroy any cancer cells left behind. It can also be used to treat the pain or side effects of tumors that may not be operable or treatable with chemotherapy.
• There are different types of radiation therapy so it’s important to discuss with your radiation oncologist the best type of treatment for you. It’s also important to discuss the specifics of your radiation treatment, including side effects, expectations, etc.

Chemotherapy is medication generally given orally or intravenously that may stop cancer cells from growing and dividing. Chemotherapy may be given prior to surgery to help shrink a tumor for easier removal or after surgery to destroy any cancer cells left behind.

• Chemotherapy may be given alone or in combination with surgery, radiation therapy, or both.
• Chemotherapy treatment “cycles” refers to a specific number of treatments given over a set period of time.
• Chemotherapy is coordinated by an oncologist.
• As there are both short and long-term side effects from having chemotherapy, it is important to discuss this information with your oncologist prior to starting these treatments.
• Many sarcomas are not responsive to chemotherapy.

Targeted therapy drugs treat cancer by acting on parts of cancer cells that help them grow and divide that may be different from normal, non-cancerous cells.

• Targeted therapies may treat cancer by interfering with specific proteins or genetic changes that help tumors grow and spread.
• There are several different types of targeted therapies, and use varies by sarcoma type and stage, so it is best to talk to your oncologist about which treatments may be right for you. They may look for certain changes in genes (mutations) in your cancer that help the cancer cells to grow and divide to determine if targeted therapy will be effective against your specific sarcoma.
• Some targeted therapies are pills that you can swallow, while other medications are given intravenously (through an IV).
• Targeted therapies can work in many different ways. For instance: o They can help the immune system destroy cancer cells.
  • They can stop cancer cells from growing and dividing.
  • They can stop the cancer cells from forming blood vessels.
  • They can deliver cell-killing substances to cancer cells.
  • They can prevent cancer cells from getting hormones they need to grow.

• Targeted therapy can have side effects even though they are designed to specifically target cancer cells. Sometimes, healthy non-cancerous cells can be inadvertently targeted as well.
• • As research studies continue to identify more targets and develop more targeted therapies, this treatment option is constantly evolving. There may be clinical trials testing new targeted therapy for your sarcoma.
  • Example of targeted therapy: o Monoclonal Antibodies: Monoclonal antibodies are proteins designed to attach themselves to specific targets on cancer cells. There are different types of monoclonal antibodies that perform different tasks. One way these can be used in cancer treatment is by attaching a cancer-killing medication to the antibody, so when the antibody binds to the specific target on the cancer cell, it kills the cancer cell.

  For additional information, visit The National Cancer Institute at cancer.gov/about-cancer/treatment/types/targeted-therapies