Sarcoma

We are the regional centre for STS diagnosis and treatment in Merseyside and North Cheshire.

Soft tissue sarcoma (STS) is a rare cancer that affects supportive tissues like muscles, nerves and fat. If you come to the hospital you can expect:

• Support - every step of the way - You’ll be assigned a specialist nurse who will be with you throughout your treatment journey, from your first appointment to aftercare. The nurse will help you with any problems or questions you may have.
• Experts giving you the best treatment - Specialists from different medical areas meet weekly. This is called a multi-disciplinary team meeting (MDT) and is central to the way we work. The MDT advise, support and create treatment plans that are personalised for every patient.
• Access to the latest treatments - The clinical trials programme makes new treatments available to patients – often giving them a better outcome. We aim to have a trial option open to patients wherever possible.
• Rapid investigation - As the regional centre for STS, we offer specialist techniques – like image-guided biopsies – that speed up diagnosis.
• Research-driven care - As a university hospital, we conduct research into soft tissue sarcoma diagnosis, treatment and prevention. We regularly publish research papers that help in the fight against cancer.
• Aiming for cancer targets - Our service aims to meet recommended levels in the National Institute for Clinical Excellence's (NICE) Improving Outcomes Guidelines.

Your doctor (GP) will send you to hospital for further investigations if you have a lump that may be a soft tissue sarcoma. Alternatively, you may be referred from another hospital. We will see you within two weeks of getting the doctor’s referral.

Soft tissue sarcoma clinic

After talking to you and examining the lump, we’ll organise a series of tests to determine the likelihood of you having a sarcoma. We use two main types of tests to look for sarcomas: imaging studies and biopsies.

Imaging studies

Imaging is the use of machines to capture pictures of inside the body. Ultrasound, and MRI scans are the most commonly used forms of medical imaging. The results of your clinical examination helps us decide what imaging technique(s) to use.

The scans will be performed within two weeks of your first visit to the sarcoma clinic. You may then require a biopsy, depending on the results.

Biopsy

This is when the doctor takes samples of tissue from the lump. The cells are then passed to a pathologist (tissue expert) for examination under a microscope.

Patients with suspected sarcoma usually have a needle biopsy of their lump. This is done using local anaesthetic to numb the skin before the needle is inserted. If the lump is deep within the body, an ultrasound scan or a CT scan can be used to make sure that the needle is in the lump.

Surgical biopsy

This is performed when needle biopsy fails to get enough cells for diagnosis. The doctor uses a scalpel (surgical knife) to make an incision (cut) in the tissue. A local or general anaesthetic is used, depending on the location of the lump.

The pathologist processes the tissue and examines the cells. Further tests may be required to define exactly what sort of cancer is present. This is essential to make sure that the best treatment is offered to each patient.

Test results

The results from most biopsies (pathology report) are available within one week of the biopsy. Occasionally, specialised tests take longer to complete. If the lump turns out to be cancer, soft tissue sarcoma treatment options will be discussed with you.

Many patients find that they don’t have cancer after investigation. Most are referred back to their GP or to another surgeon for treatment. Some patients will continue treatment with the sarcoma service.

Your test results are discussed by the multi-disciplinary team (MDT). This is a team of doctors and health professionals who specialise in different aspects of treating sarcoma.

The Multi Disciplinary Team give advice on treatment options that would benefit you the most. Of course, you have the final decision about the type of treatment you receive.

Treatment starts as soon as possible after the cancer is discovered. You are assigned a specialist nurse who stays with you every step of your treatment journey. The nurse is your key-worker and is available to answer any questions you may have along the way. The nurse also acts as your point of contact with the MDT.

Treatment types

• Surgery: the aim of surgery is to remove as much of the tumour as possible. Usually, an operation called a wide local excision is done. This means removing the cancer with a border (margin) of healthy, cancer-free tissue all around it.
• Limb sparing surgery: this is performed for sarcomas in the arms and legs. The primary aim is removing the tumour and preserving the limb so that amputation is not needed. It is usually given in combination with chemotherapy to make sure all of the cancer cells have been destroyed.
• Amputation: in rare circumstances, it is necessary to remove the limb or part of the limb where the sarcoma is growing. Our specialist team of doctors, nurses and physiotherapists will help you before your operation, with your recovery and with your rehabilitation.
• Plastic surgery: we may perform plastic surgery at the same time as your operation. This is because some operations remove a large area of tissue; we need to replace it with something similar to your original skin.
• Radiotherapy: this is the use of radiation to destroy cancer cells. It is often given after surgery to make sure that no cancer cells are left.
• Chemotherapy: chemotherapy is the use of drugs to destroy cancer cells. It is sometimes used in the management of sarcoma patients. It can be given by injection or taken orally (in tablet form).

Members of the MDT include:

• a sarcoma specialist nurse
• a consultant surgeon specialising in the care of patients with sarcoma
• oncologists specialising in radiotherapy and chemotherapy
• pathologists specialising in diseased tissue
• radiologists specialising in diagnosis of bone and soft tissue disease
• a palliative care worker who is an expert in managing non-curable illness
• a rehabilitation physiotherapist

Visit the Marie Curie website here

Visit the MacMillan Cancer website here 

Visit the Cancer Research UK website here

Visit the NHS Choices - Cancer website here