Why a specialist sarcoma centre
Sarcoma is rare, and rare conditions are handled best where they are common. For that reason, Australian and international guidelines advise that anyone with a confirmed or suspected sarcoma be sent to a dedicated sarcoma unit rather than managed locally.
This is more than a matter of paperwork. Studies comparing specialist units with general hospitals point consistently in the same direction — people tend to do better when a sarcoma is operated on at a centre that treats it regularly:
- the tumour is more often fully cleared at its original site
- recovery from the operation tends to go more smoothly
- survival is longer on average
- when radiotherapy is planned and given at a specialist unit, the cancer is less likely to come back locally and side effects tend to be fewer
Royal Prince Alfred Hospital is one of those centres. Its Bone & Soft Tissue Sarcoma Unit treats bone and soft tissue tumours — malignant and benign — with surgery performed at RPA and the Institute of Rheumatology and Orthopaedics (IRO) on the same campus.
The multidisciplinary team (MDT)
No single doctor, however experienced, should plan sarcoma treatment alone. At RPA, every patient’s case is discussed at a regular multidisciplinary team meeting — usually called the MDT.
Around the table are the people whose combined judgement your plan needs:
- Orthopaedic and plastic surgeons — the operation and the reconstruction
- Medical oncologists — chemotherapy and drug treatment
- Radiation oncologists — radiotherapy
- Radiologists — reading your scans
- Pathologists — the exact diagnosis from your biopsy
- Clinical nurse consultants (CNCs) — coordinating your care and keeping you informed
The MDT looks at your scans, your biopsy results and your staging together, and agrees on a recommended plan: whether surgery should come first, whether chemotherapy or radiotherapy should come before or after it, and what kind of operation gives the best result.
What this means for you in practice
Your treatment plan may involve more than one kind of treatment, in a deliberate order. For some tumours, surgery comes first. For others, chemotherapy or radiotherapy is used before surgery to shrink the tumour and make the operation safer and more effective. The next two steps explain the surgery itself and these other treatments.
Your first consultation with the surgical team usually happens once the preliminary tests are done and there is enough information to begin forming a plan. Bring someone with you if you can, and bring your questions written down — no question about your own treatment is too small to ask.
Your clinical nurse consultant is your continuing point of contact throughout: if you are unsure who to ask about anything, start with them.