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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 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

Treatment planning