NCCN Guidelines for Patients
Soft Tissue Sarcoma, Version 1.2014
Local treatments are used to treat a focused area of
cancer. Surgery and radiation therapy are common
local treatments. Ablation and embolization are
sometimes used for small tumors that aren’t near
to where the cancer started. One example is small
tumors in the liver.
Surgery has been used as a primary treatment for
sarcoma for a long time. Primary treatment is the
main treatment used to rid the body of cancer. As
such, the goal of surgery is to remove all the cancer.
Surgery may also be used to reduce symptoms
caused by the cancer or extend life. This is called
palliative or supportive care.
The method and extent of surgery for sarcoma varies.
Both depend on where the sarcoma is and the size of
the tumor. Ask your treatment team for details of how
the tumor will be removed.
Your surgeon will try to remove a cancer-free surgical
margin. A surgical margin is a ring of normal-looking
tissue around the tumor. Sometimes a cancer-free
margin can’t be removed. If this is expected, your
surgeon will place clips in your body after removing
the tumor. The clips help doctors give you radiation
therapy where it is needed. Sometimes, a second
surgery can be done instead.
Your doctor will also try to remove as little tissue as
possible. This is done so you can use your limbs or
other body parts after surgery. For some people, their
limb may need to be removed (amputated) in order to
remove all the cancer.
Side effects are unhealthy or unpleasant physical
or emotional responses to treatment. You may
experience side effects from the anesthesia or
the surgery. Often, general anesthesia is used for
surgery. General anesthesia is drugs that put you into
a deep sleep-like state so you won’t feel pain. Ask
your treatment team for a list of all rare and common
side effects of the surgery you will have.
Radiation therapy uses high-energy rays to treat
cancer. The rays damage DNA (
cid). DNA is a chain of chemicals in cells that
contains genes. This either kills the cancer cells or
stops new cancer cells from being made.
Radiation therapy has many uses for sarcomas. It
may be used as a primary treatment like surgery.
Radiation therapy given before surgery is called
neoadjuvant treatment. It is used to shrink the tumor
for surgery. Radiation therapy can also be given
during or after surgery to kill any remaining cancer
cells. Radiation therapy given during surgery is called
herapy). When given
after surgery, it is called adjuvant treatment. You
may receive a full dose of radiation, or if receiving a
“boost,” less than a full dose. A boost is only used for
There are two main methods to give radiation.
Which method you may get depends on the type of
sarcoma and the purpose of radiation therapy. The
two methods are discussed next. You may feel side
effects from radiation although not everyone does.
Ask your treatment team for a full list of common and
rare side effects.
External beam radiation therapy
Radiation is often given using a machine outside the
body. This method is called EBRT (
herapy). To receive EBRT, you first must
have a simulation session. For simulation, imaging
scans are used to help target the tumor with radiation.
Using the scans, your treatment team will plan the
best radiation dose, number and shape of radiation