About soft tissue sarcoma chemotherapy | Cancer Research UK
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About soft tissue sarcoma chemotherapy

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. You usually have chemotherapy as a course of several cycles of treatment. Depending on the drugs you have, each treatment lasts from a few hours to a few days. Treatments can be given weekly or every 2, 3 or 4 weeks, depending on the drugs and your treatment plan.

For soft tissue sarcoma, chemotherapy may be used

  • Before surgery to try to shrink the tumour (neoadjuvant therapy)
  • After surgery, to try to stop the sarcoma coming back (adjuvant therapy)
  • To shrink the sarcoma after surgery if it was not possible to remove all of it
  • To reduce or control symptoms in advanced sarcoma
  • To slow the growth of an advanced sarcoma

You have nearly all chemotherapy for soft tissue sarcoma as injections into a vein, or through a drip. But a few come as tablets or capsules. How you have your chemotherapy will depend on the particular drug or combination of chemotherapy drugs your doctor prescribes.

There is more information in the chemotherapy section.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating soft tissue sarcoma section.

 

 

How chemotherapy works

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. They work by disrupting the growth of cancer cells. The drugs circulate in the bloodstream around the body.

 

How you have chemotherapy

You usually have chemotherapy as a course of several cycles of treatment. Depending on the drug or combination of drugs, each treatment lasts from a few hours to a few days. Treatments for sarcoma can be given weekly or every 2, 3 or 4 weeks, depending on the drugs and your treatment plan.

There is information about the drugs used for sarcoma and their side effects on the next page in this section. You have most chemotherapy drugs as injections into a tube put into your vein, or through a drip. There is information in the chemotherapy section about giving chemotherapy into the bloodstream. A few drugs come as tablets or capsules. How you have your chemotherapy will depend on the particular drug, or combination of chemotherapy drugs, that your doctor prescribes.

 

Chemotherapy before surgery

Chemotherapy before surgery is called neoadjuvant chemotherapy.  It is not commonly used for all types of soft tissue sarcomas but doctors sometimes use it to shrink a tumour before surgery to make it easier for your surgeon to completely remove it.  If you have a sarcoma in a limb, it may mean that you can have just the tumour removed (limb sparing surgery), rather than having the whole limb or part of it removed (an amputation). 

If you have a soft tissue Ewing's sarcoma or a type of rhabdomyosarcoma called embryonal rhabdomyosarcoma, you usually have chemotherapy before surgery.

For other types of soft tissue sarcoma, radiotherapy, rather than chemotherapy, is generally used to shrink a tumour before surgery. But this depends on your individual situation. You may even have radiotherapy and chemotherapy combined. If you do, it may be as part of a clinical trial as this is not yet standard treatment.

Occasionally people have chemotherapy to shrink their sarcoma before surgery using a technique called isolated limb perfusion. This is a way of giving chemotherapy into just one arm or leg. It is complicated to do and is only available as a treatment for sarcoma at a couple of hospitals in the UK at the moment.

 

Chemotherapy after surgery

With any cancer, there is a risk of it coming back even though it has been completely removed. If you have a high risk of the sarcoma coming back, your doctor may suggest chemotherapy after surgery. This aims to reduce the risk of the sarcoma coming back and is called adjuvant therapy. The aim is to kill off any cancer cells that may have been left behind after your operation but are too small to see.

A review of chemotherapy trials in 2008 found that a drug called doxorubicin could lower the risk of sarcoma coming back for some people after surgery. Combining doxorubicin with ifosfamide can lower the risk further but has more side effects. Overall, research in this area suggests that adjuvant chemotherapy is only likely to help people with the highest risk of their sarcoma coming back. Research is continuing to try to improve the results of chemotherapy treatment for sarcoma.

 

If your sarcoma was not completely removed

If your surgeon could not remove all of your sarcoma, you might have chemotherapy to try to shrink the cancer that was left behind after the operation. But it is more usual to have radiotherapy in this situation. The aim of treatment is to try and slow down the growth of the cancer. Even if the chemotherapy shrinks it completely, there is a high risk of the cancer coming back at some time in the future.

 

Chemotherapy to relieve symptoms

If you have a sarcoma that cannot be removed with surgery, you may have chemotherapy to try to shrink the cancer, control its growth, or relieve any symptoms it is causing. You may have radiotherapy as well.

The National Institute for Health and Care Excellence (NICE) has approved trabectedin (Yondelis) as an NHS treatment for advanced soft tissue sarcoma. It is for people who have already had other chemotherapy treatments or who can't have those treatments. Research suggests that trabectedin may help people live for at least 3 months longer compared to other current NHS treatments. The Scottish Medicines Consortium (SMC) has not recommended trabectedin for use within the NHS in Scotland as they say it is not cost effective.

 

Clinical trials for chemotherapy

Your doctor or nurse may ask you to take part in a clinical trial to test new chemotherapy drugs. This is because it is important for doctors to find out which treatments work best. They aim to get the best results with the fewest side effects. You can find out about these trials on our soft tissue sarcoma research page. You can search for trials for sarcoma - soft tissue on our clinical trials database.

 

Dietary or herbal supplements and chemotherapy

We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed therapies by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

Some studies seem to suggest that fish oil preparations may make chemotherapy drugs work less well. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.

 

More information about chemotherapy

For detailed information about chemotherapy look at the main chemotherapy section. It explains the treatment, including information about

If you would like more information about your particular chemotherapy, you can look at the information in our cancer drugs section. Or you can phone the Cancer research UK nurses on freephone 0808 800 4040. The lines are open from from 9am to 5pm, Monday to Friday. 

Our soft tissue sarcoma organisations page gives details of other people who can also give information. Some organisations can put you in touch with a cancer support group. Our soft tissue sarcoma reading list has information about books and leaflets on treatments. 

If you want to find people to share experiences with online, you could use CancerChat, our online forum.

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Updated: 12 February 2015