This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 6, 2022.
Surgery is typically the primary treatment for soft tissue sarcoma, used to remove tumors. Chemotherapy, radiation therapy and/or targeted therapy may also be recommended, either alone or in combination with surgery, depending on the stage and extent of the disease, along with other factors.
These factors include:
Based on all of these factors, the care team can recommend a personalized treatment plan. At any point, it’s OK to ask questions or seek clarification about the patient's medical care.
The goal of surgery is to locate and completely remove the soft tissue sarcoma tumor, along with some of the healthy tissue around the tumor. Pathologists then examine the tumor to determine whether or not additional treatment is necessary, and to reduce the risk of recurrence.
Chemotherapy may be used in combination with surgery and radiation therapy to treat advanced-stage soft tissue sarcoma. Chemotherapy drugs work to either destroy cancer cells or impede their ability to grow and reproduce.
Medical oncologists work closely with soft tissue sarcoma patients to determine if chemotherapy is an appropriate treatment option. Throughout the patient's soft tissue sarcoma treatment, the care team continually monitors the effect of chemotherapy on the disease, with physical exams, blood tests, CT scans, MRI scans and chest X-rays and imaging.
Depending on the type of soft tissue sarcoma the patient has and the extent of the disease, treatment of soft tissue sarcoma may include radiation therapy. Though surgery is usually the main treatment approach for soft tissue sarcoma, radiation treatments may also be used before (neoadjuvant therapy) or following surgery (adjuvant therapy).
Unlike standard chemotherapy drugs, which may affect all cells in the body, targeted therapy drugs are designed to seek out and kill specific cancer cells while sparing surrounding healthy cells. Targeted cancer therapies may be used alone, in combination with other targeted therapy treatments or with other soft tissue sarcoma treatments, such as chemotherapy, radiation therapy and surgery. Among the drugs used in targeted therapy are so-called kinase inhibitors, which target specific protein receptors that help regulate cell growth.
Also known as biologic therapy, immunotherapy uses the body’s immune system to attack cancer cells. With antibodies, doctors can improve the immune system to destroy tumors. Immunotherapy isn’t yet commonly used for soft tissue sarcomas, but for a small percentage of these cancer types, it may be an option.
Because medical research is constantly moving forward, the patient may consider getting involved with a clinical trial. This is an opportunity to access new drugs and treatments, and the research findings may also assist future patients.
Clinical trials are a safe and controlled way to treat cancer with innovative medical developments. Speak with the care team to learn about any current clinical trials that may be a fit.
The patient's care team can recommend treatments based on the sarcoma’s stage, which represents both the size of the cancer and its likelihood to spread to other parts of the body.
Stage 1 sarcoma: Sarcomas can usually be removed with surgery at this stage. Sometimes, radiation may also be used, before and/or after surgery.
Stage 2 sarcoma: These sarcomas are more likely to spread, which means there’s an emphasis on both removing the tumors and reducing the risk of recurrence. Often, both surgery and radiation are used.
Stage 3 sarcoma: This cancer may be larger and more likely to have spread into the lymph nodes. Treatment options at this stage vary, but may include surgery, radiation, chemotherapy and, if it’s spread into the lymph nodes, the surgical removal of the lymph nodes, known as a lymphadenectomy.
Stage 4 (metastatic) sarcoma: Also known as metastatic sarcoma, this cancer has spread farther away to other areas of the body. Treatment plans may include chemotherapy, targeted therapy and clinical trials. Surgery is also used for this type of cancer, particularly when it’s spread into the lungs. Treatments in stage 4 aren’t necessarily curative but rather palliative, providing an easing of symptoms so the patient may live more comfortably. Patients with metastatic cancer, should take their time to make a decision about treatment and consider a second opinion from another doctor.
In some patients, the cancer may return after the original treatment has finished. If this happens, the cancer is considered recurrent. It may reappear in the same place or in other areas of the body.
As with the original cancer, the treatment plan for recurrent cancer is based on the factors mentioned above—and additional tests may be done to learn more about the soft tissue sarcoma stage and type.
A combination of surgery and radiation is often used for recurrent cancer, but some patients experience more side effects after their second round of treatment. There also may be clinical trials for recurrent sarcomas.