NCCN Guidelines for Patients
Soft Tissue Sarcoma, Version 1.2014
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 such a 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 chest, abdomen, and pelvis
Imaging tests make pictures (images) of the insides of
your body. If a tumor is likely cancer, you should get
an imaging scan of your chest, abdomen, and pelvis.
You may receive CT with or without MRI. CT takes
many x-rays of the same body part from different
angles to make detailed images. MRI uses radio
waves and powerful magnets to make 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 should 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
Sarcomas in the inner trunk