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National Cancer Institute

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Adult soft tissue sarcoma


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is adult soft tissue sarcoma?
STAGE EXPLANATION
Stages of adult soft tissue sarcoma
Stage IA
Stage IB
Stage IIA
Stage IIB
Stage IIC
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How adult soft tissue sarcoma is treated
Treatment by stage
STAGE IA, IB, AND IIA ADULT SOFT TISSUE SARCOMA
STAGE IIB, IIC, AND III ADULT SOFT TISSUE SARCOMA
STAGE IV ADULT SOFT TISSUE SARCOMA
RECURRENT ADULT SOFT TISSUE SARCOMA
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is adult soft tissue sarcoma?

Adult soft tissue sarcoma is a disease in which cancer (malignant) cells are found in the soft tissue of part of the body. The soft tissues of the body include the muscles, connective tissues (tendons), vessels that carry blood or lymph, joints, and fat.

A lump or swelling in part of the body may appear if a person has a soft tissue sarcoma. The lump may not be painful. If there are symptoms, a doctor may cut out a piece of tissue from the swollen area. This is called a biopsy. The tissue will be looked at under a microscope to see if there are any cancer cells. A patient may need to go to the hospital for this test.

The chance of recovery (prognosis) and choice of treatment depend on the size and stage of the cancer (how far the cancer has spread), and the patient's age and general health.


STAGE EXPLANATION


Stages of adult soft tissue sarcoma

Once adult soft tissue sarcoma is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This testing is called staging. A doctor needs to know the stage of the disease to plan treatment. Unlike most other cancers, the size of a soft tissue sarcoma is not as important as how the cancer cells look under a microscope. The more different the cancer cells look from normal cells, the higher the stage. The following stages are used for adult soft tissue sarcoma:


Stage IA

The cancer cells look either very much like or somewhat different from normal cells (well-differentiated or moderately well-differentiated). The cancer is either near the surface or deep and is less than 5 centimeters in size (about 2 inches), but it has not spread to lymph nodes or other parts of the body (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).


Stage IB

The cancer cells look either very much like or somewhat different from normal cells (well-differentiated or moderately well-differentiated). The cancer is near the surface and more than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.


Stage IIA

The cancer cells look either very much like or somewhat different from normal cells (well-differentiated or moderately well-differentiated). The cancer is deep and more than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.


Stage IIB

The cancer cells look very different from normal cells (poorly differentiated or undifferentiated). The cancer is either near the surface or deep and is less than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.


Stage IIC

The cancer cells look very different from normal cells (poorly differentiated or undifferentiated). The cancer is near the surface and is more than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.


Stage III

The cancer cells look very different from normal cells (poorly differentiated or undifferentiated). The cancer is deep and is more than 5 centimeters in size, but it has not spread to lymph nodes or other parts of the body.


Stage IV

The cancer may have spread to lymph nodes in the area or may have spread to other parts of the body, such as the lungs, head, or neck.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the tissues where it first started, or it may come back in another part of the body.


TREATMENT OPTION OVERVIEW


How adult soft tissue sarcoma is treated

There are treatments for all patients with adult soft tissue sarcoma. Three kinds of treatment are used:

Surgery is the most common treatment of adult soft tissue sarcoma. A doctor may remove the cancer and some of the healthy tissue around the cancer. Sometimes all or part of an arm or leg may have to be removed (amputated) to make sure that all of the cancer is taken out. If cancer has spread to lymph nodes, the lymph nodes will be removed (lymph node dissection).

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the blood stream, travels through the body, and kills cancer cells throughout the body. Chemotherapy that is given after surgery when no cancer cells can be seen is called adjuvant chemotherapy. In soft tissue sarcoma, chemotherapy is sometimes injected directly into the blood vessels in the area where the cancer is found. This treatment is called regional chemotherapy.

Chemotherapy and/or radiation therapy may be used to shrink the cancer so it can be removed without taking off an entire arm or leg.


Treatment by stage

Treatments for adult soft tissue sarcoma depend on the stage of the disease, and the patient's age and general health.

Patients may consider standard therapy, because of its effectiveness in past studies, or participation in a clinical trial. Not all patients are cured with standard therapy, and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. For more information about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


STAGE IA, IB, AND IIA ADULT SOFT TISSUE SARCOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery with radiation therapy, before or after the surgery.

3. High-dose radiation therapy followed by surgery and radiation therapy.

If cancer is found in the head or neck or in the abdomen or chest, treatment may be one of the following:
1. Surgery to remove the cancer possibly followed by radiation therapy.

2. Radiation therapy followed by surgery.


STAGE IIB, IIC, AND III ADULT SOFT TISSUE SARCOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery to remove the cancer followed by radiation therapy.

3. Radiation therapy alone.

4. Radiation therapy and/or chemotherapy before surgery, possibly followed by radiation therapy.


STAGE IV ADULT SOFT TISSUE SARCOMA

If the cancer has spread to the lymph nodes, treatment may be one of the following:

1. Surgery to remove the cancer and removal of the lymph nodes where the cancer has spread (lymph node dissection), possibly followed by radiation therapy.

2. Radiation therapy before and after surgery to remove the cancer and lymph node dissection.

3. A clinical trial of surgery and/or radiation therapy followed by chemotherapy

If the cancer has spread to the lungs, treatment may be one of the following:
1. Surgery to remove the primary cancer followed by radiation therapy followed by surgery to remove the cancer from the lungs.

2. Surgery to remove the primary cancer.

3. Surgery to remove the primary cancer followed by radiation therapy.

4. Radiation therapy, possibly followed by chemotherapy.

If the cancer has spread to other parts of the body, treatment may be one of the following:
1. Surgery to remove the cancer with radiation therapy before or after the surgery, possibly followed by chemotherapy

2. Chemotherapy to reduce the pain and discomfort caused by the cancer.


RECURRENT ADULT SOFT TISSUE SARCOMA

Treatment depends on the kind of treatment the patient had before. Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery to remove the cancer followed by radiation therapy.

3. Chemotherapy alone.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about adult soft tissue sarcoma, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can help answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 09/1999


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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