The Sarcoma Program
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Services We Offer

The following services are offered as a part of the Sarcoma Program:

Evaluation and Diagnosis
The best way to determine whether a mass is benign or malignant is through a biopsy. During this procedure, a doctor makes an incision or uses a special needle to remove a sample of tumor tissue. A pathologist examines the tissue under a microscope and if cancer is present, the pathologist can usually determine the type of cancer and its grade.

The grade of the tumor is determined by how abnormal the cancer cells appear when examined under a microscope. The grade predicts the probable growth rate of the tumor and its tendency to spread. Low-grade sarcomas, although cancerous, are less likely to metastasize or spread. High-grade sarcomas are more likely to spread to other parts of the body. Other methods that may be used to determine the size and extent of tumor include X-rays, computed tomography (CT) scan, positron emission tomography (PET) scan, magnetic resonance imaging (MRI) and bone scan.

The Abramson Cancer Center at Pennsylvania Hospital's Sarcoma Program assembles all the doctors and other health care professionals needed to accurately diagnose your particular condition. After your initial examination, the doctors and staff meet as a group to discuss your case. Together, they review their findings as well as any medical documents you have provided and develop an individualized plan of care.

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Treatment Approaches
The goal of any cancer treatment is to eliminate the cancer and prevent or reduce its chance of spreading. The treatment for sarcomas depends on the type, size, location, and stage of cancer, as well as the patient's age and general health. Treatment options include surgery, radiation therapy and chemotherapy.

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Surgery is the primary treatment for both bone and soft tissue tumors. If possible, the surgeon will remove the cancer and a safe margin of the healthy tissue around it. Depending on the location and size of the sarcoma, it may be necessary to remove or amputate all or part of an extremity.

Chemotherapy and/or radiation therapy received before surgery may make it possible to prevent amputation. When the tumor involves the bone, surgeons may be able to avoid amputation by removing only the cancerous section of the bone and replacing it with a prosthesis or artificial bone.

Following surgery, you will receive in-depth instructions that will ensure a smooth transition once you are home. At-home nurse visits and home or outpatient physical therapy can be arranged, if needed.

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Chemotherapy treatment uses drugs to kill cancerous cells. These drugs travel through the bloodstream so they can kill cancer cells throughout the body. Chemotherapy can be given orally or through a needle in the vein. If the cancer has spread to other parts of the body, chemotherapy may be used to shrink tumors and reduce the pain and discomfort.

If chemotherapy is indicated, a medical oncologist will direct this aspect of your care. Your medical oncologist also will oversee your progress throughout treatment and follow-up.

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Radiation Therapy
Radiation therapy utilizes high energy X-rays to kill cancer cells in specific areas of the body. This may be done before surgery to shrink the tumor or after surgery to kill any cancer cells left behind. Radiation therapy can be used alone, or in combination with other treatments, such as chemotherapy.

Our radiation oncologists use special techniques to minimize the effect on normal surrounding body tissue. The sophisticated equipment used aims just the right amount of radiation at the precise location of a tumor.

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After surgery, an experienced team of physical therapists and occupational therapists will develop a plan to maximize your strength, mobility, independence, and overall function. Therapy usually begins in the hospital after surgery and frequently continues after discharge.

Your therapist assists in arranging outpatient therapy and ordering any needed equipment. If surgical braces or an artificial limb (prosthesis) is needed, specialists certified in these items are consulted.

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Living After Treatment
Follow-up care after treatment for sarcoma is essential. This involves periodic checks with a medical oncologist or evidence of disease recurrence. Sarcomas may recur locally (at the original site of disease) or distantly (in other parts of the body). The risk of this diminishes significantly over time.

Imaging studies are used to evaluate the area of local disease. The most common site of metastasis in sarcoma is in the lungs. This is why you may have a chest scan or chest X-ray at regular follow-up intervals. Other aspects of follow-up care include monitoring quality of life, functioning, as well as potential delayed effects of chemotherapy and radiation.

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Patient and Family Services
Being diagnosed with cancer can be emotionally and physically challenging. You may feel angry, depressed or anxious. All of these responses are normal. Joan Karnell Supportive Care Services offers educational programs, counseling and other activities to help patients and their loved ones cope with cancer diagnosis and treatment.

Social workers offer counseling in private and family sessions and can help you with financial issues, transportation for treatment, community-based services, insurance issues, and transition from hospital to home. In addition, support groups offer an opportunity to share experiences with others who face similar situations. Psychological counseling, music therapy and shiatsu massage are also available.

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