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NCCN Guidelines for Patients


Soft Tissue Sarcoma, Version 1.2014


Multidisciplinary team

Treatment of sarcoma takes a team of experts

who have experience with this cancer. If you have

sarcoma, it is important that all the experts meet

before your treatment is started to create the best

treatment plan. Your treatment team will also meet

while you are going through treatment and afterward

to discuss the treatment results and the next steps of

care. Your team of experts may include a:

In most cases

• Pathologist—an expert in testing cells and

tissue to find disease,

• Radiologist—an expert in imaging tests,

• Oncology surgeon—an expert in operations

that remove cancer,

• Medical oncologist—an expert in cancer


• Radiation oncologist—an expert in radiation

treatment, and a

• Nurse—an expert trained to care for the sick.

In some cases

• Thoracic surgeon—an expert in operations

within the chest,

• Gastroenterologist—an expert in digestive


• Plastic surgeon—an expert in operations to

improve function and appearance,

• Social worker—an expert in meeting social

and emotional needs,

• Occupational therapist—an expert in helping

people live life unaided or with devices,

• Physical therapist—an expert in helping

people move better,

• Nutritionist—an expert in healthy foods and

drinks, and a

• Genetic counselor—an expert in explaining

testing for hereditary diseases.

Medical history and physical exam

Your medical history includes any health events in

your life. It also includes any medications you’ve

taken or are taking. Since some health problems run

in families, your doctor will ask about the medical

history of your blood relatives.

Sarcoma often occurs for unknown reasons. But

some people have syndromes that increase their

chances of getting sarcoma. Li-Fraumeni syndrome

is one such syndrome. It can be passed down from

parents to child (inherited) or caused by other factors.

It is very rare. Your doctors will assess if you likely

have Li-Fraumeni syndrome.

Doctors often perform a physical exam along with

taking a medical history. A physical exam is a review

of your body for signs of disease. During this exam,

your doctor will listen to your lungs, heart, and gut.

Parts of your body will likely be felt to see if organs

are of normal size, are soft or hard, or cause pain

when touched. Your lymph nodes may feel large if

cancer has spread to them.

Imaging of tumor

Imaging tests make pictures (images) of the insides of

your body. If a tumor is likely cancer, you should get

an imaging scan of the tumor. You may receive an MRI

with or without CT. MRI uses radio waves and powerful

magnets to make images. CT takes many x-rays of the

same body part from different angles to make detailed

images. These tests can show your doctors how large

a tumor is and how close it is to other tissues. For

some people, less detailed imaging scans, such as an

angiogram or plain radiograph, may be enough.

A contrast dye may be used to make the images

clearer. The dye will be injected into your vein, mixed

with a liquid you drink, or both. The dye may cause

you to feel flushed or get hives. Rarely, serious

allergic reactions occur. Tell your doctor and the

technicians if you have had bad reactions in the past.


Sarcomas in limbs, outer trunk, head, or neck Treatment planning