Surgery removes a sarcoma from where it is. For some sarcomas, the best plan also includes systemic treatment — treatment that works through the whole body — or radiotherapy focused on the tumour site. The MDT may recommend these before surgery, after it, or occasionally instead of it.
If this is part of your plan, you will be referred to the appropriate team at Chris O’Brien Lifehouse — the comprehensive cancer centre directly beside RPA on Missenden Road — or, where possible, to a cancer service closer to your home.
Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. It is given intravenously (through a drip) and sometimes by mouth, usually in cycles with recovery time between them. For sarcoma it is most often used for bone sarcomas, such as osteosarcoma and Ewing sarcoma.
The timing has its own vocabulary, which you will hear at appointments:
- Neoadjuvant chemotherapy is given before surgery, to shrink the tumour and treat any microscopic spread early.
- Adjuvant chemotherapy is given after surgery, to reduce the chance of the cancer coming back.
If chemotherapy is recommended, you will be referred to a medical oncologist — a specialist in cancer drug treatment. They will explain which drugs, how many cycles, the likely side effects and how these are managed, and they will answer all of your questions about this kind of treatment.
Radiotherapy
Radiation therapy (radiotherapy) uses precisely aimed high-energy radiation beams to destroy cancer cells in a specific area. For sarcoma it is most often used for soft tissue sarcomas, and — like chemotherapy — it can be given before or after surgery.
Planning matters enormously in radiotherapy: the aim is to treat the tumour bed thoroughly while sparing the healthy tissue around it. This is one of the areas where the evidence shows specialist-centre treatment gives fewer side effects and better control.
If radiotherapy is recommended, you will meet a radiation oncologist, who will explain the process in detail — the planning scans, the daily treatment visits, and what to expect during and afterwards.
Living at a distance
Chemotherapy and radiotherapy involve repeated visits over weeks. If you live outside Sydney, tell the team early: treatment can sometimes be arranged closer to home, and where it cannot, the social work team can help with accommodation and with the IPTAAS travel and accommodation subsidy — both covered in the next step.