At Dana-Farber Brigham 91精品, our expert team provides advanced treatments and state-of-the-art technology paired with personalized and compassionate care. Specialists from Brigham and Women’s Hospital and Dana-Farber Cancer Institute collaborate to guide patients through every step of their cancer journey, from diagnosis and treatment to follow-up care. Your team may include medical, surgical, and radiation oncologists, as well as experts in radiology, pathology, nursing, and more, ensuring comprehensive and seamless care across both institutions.
After diagnostic testing and staging are complete, our specialists work closely with you and your family to create a treatment plan tailored to your needs. We encourage open communication and welcome questions about your care and treatment goals. With facilities connected by a bridge, appointments at either Dana-Farber or Brigham are easily accessible, offering convenience and continuity throughout your treatment.
Your care plan will be designed based on your health history and the stage of your cancer, incorporating one or more treatment options best suited for you.
Surgery is the main treatment for soft tissue and bone sarcomas. The goal is to remove the entire tumor while preserving as much of the affected body part as possible. The size and location of the tumor often determine if surgery alone is sufficient or if additional treatments like chemotherapy or radiation are needed, either before or after surgery.
For sarcomas in the arms or legs, surgery options include:
Limb-Sparing Surgery: Limb-sparing surgery is a complex procedure requiring skilled surgeons. If the cancer has spread to nearby structures, those may need to be removed along with the tumor. Most patients with tumors in the arms or legs can undergo limb-salvage surgery, though the complexity depends on the tumor’s size and location. This surgery aims to remove the tumor while maintaining function. If the tumor has invaded nearby structures like tendons or nerves, amputation might be needed. Bone grafts or prostheses may be used to replace removed bone. However, limb-salvage surgery can have complications, such as infection or the need for future surgeries. Rehabilitation is crucial for recovery, especially after leg operations.
Amputation: In rare cases, may be necessary if the tumor is too large or has spread to critical structures like nerves or blood vessels, such that the tumor cannot be removed with sacrificing the limb. While amputation was once common, limb-sparing surgery is now the standard, and amputation is considered only when it offers the best chance for treating the cancer. However, if the tumor is extensive, amputation may be the best option to ensure complete removal of the cancer. In cases where amputation is necessary, prosthetic limbs can be used to restore function. For tumors in the shoulder or upper arm, amputation may involve reattaching part of the arm to preserve some function. Rehabilitation following amputation or limb-sparing surgery is crucial to recovery and mobility.
Tumors in the pelvic area can be difficult to remove. Chemotherapy or radiation may be used to help shrink the tumor before surgery to make removal possible. In rare cases, the entire pelvic bone or leg may need to be removed.
Sarcomas in the lower jaw may require removal of part or all of the jaw, followed by reconstruction.
Surgery in these areas is complex due to the sensitive nature of the nerves. Specialized techniques, like 3D visualization, are used to minimize risks.
Surgery in the retroperitoneum, an area behind the abdomen, often involves complex procedures involving removal all or part of multiple organs at the same time.
If sarcoma has spread to distant areas, surgery may be performed to remove tumors from organs like the lungs. However, surgery alone rarely cures metastatic sarcomas. Additional treatments such as chemotherapy and radiation are often needed to reduce the risk of recurrence.
If cancer has spread to nearby lymph nodes, those nodes may be removed during surgery. Post-surgery radiation may also be used to treat the affected area. However, most sarcomas do not spread to lymph nodes.
Minimally invasive procedures, such as laparoscopic or robotic surgery, may be suitable for some patients, especially those with gastrointestinal stromal tumors (GISTs). These techniques use small incisions and specialized tools to perform the same operations as traditional surgery, offering faster recovery and less scarring.
For sarcomas in the head and neck, Transoral Robotic Surgery (TORS) may be used in select cases. This method, often performed by ENTs (otolaryngologists), reduces the impact on essential functions like speaking and swallowing while effectively removing the tumor.
Learn more about otolaryngology-head and neck surgery.
Left to right: Dr. Elizabeth Lilley, Dr. Jiping Wang, Dr. Chandrajit Raut, Dr. Mark Fairweather
It's important to plan ahead. Arrange for someone to accompany you to and from the procedure. You will need help with tasks like grocery shopping, cleaning, and laundry after surgery, so having support is important.
Your physician will discuss any pre-operative tests or dietary instructions according to your medical history. You may need to undergo a bowel prep on the day before your operation, if you are having surgery for a sarcoma in the abdomen, pelvis, or retroperitoneum.
Before your surgery, you will have a virtual appointment scheduled at the Roberta and Stephen R. Weiner Center for Preoperative Evaluation. During this appointment, you will meet with a nurse practitioner who will review your medical history and the medications you are currently taking. You may also undergo lab tests and have an electrocardiogram (EKG) to check your heart health. This assessment helps us ensure that you are medically prepared for your upcoming surgery.
You will likely be placed on our sarcoma ERAS (Enhanced Recovery After Surgery) pathway, to help you recover faster. This involves drinking a particular beverage prior to surgery (as the only food or beverage on the day of surgery), finishing about 2 hours before your operation time.
On the day of your surgery, you will meet the nurses, surgeons and anesthesiologist who will be involved in your surgery. They will greet you and make sure you're comfortable and well-informed. The surgery usually takes a few hours, depending on the type of surgery needed, and our team will closely watch over you to make sure you're safe and comfortable.
After your surgery, you will be taken to a recovery area where nurses will monitor your vital signs as you wake up from anesthesia. Our nurses and pain management specialists will work to keep you as comfortable as possible during your recovery.
The length of stay at the hospital will depend on your type of surgery. You may be able to go home on the same day, but for more invasive operations, a hospital stay of one to seven days is possible.
We will give you detailed instructions on how to take care of yourself after surgery, including when to take medications and how to care for your incisions. Our goal is to make sure you have a smooth recovery and can get back to your normal activities soon.
Learn more about a typical hospital stay and returning home.
Recovery after sarcoma surgery will depend on the type of surgery you had or the location and difficulty of the surgery and your overall health. Your care team will follow up with information about rehabilitation services, prosthetic design and long-term care, if needed.
Taking care of yourself at home is crucial during this time. If you live alone, consider having another adult stay with you on your first night after discharge or arranging to stay with family or friends.
Contact your doctor immediately or go to the nearest hospital emergency department if you experience any of the following symptoms: increased bleeding, swelling, redness, pus, or drainage from the wound, a fever over 101.5°F, swelling in your limbs, sudden and severe pain, pain or burning when urinating, nausea or vomiting for 12 hours or more, or trouble breathing, walking or performing activities you could do before the surgery.
Rehabilitation is essential for both limb-salvage and amputation surgeries. For limb-salvage, physical therapy is often more intensive, and active participation is required to maintain function. Prosthetic use after amputation requires adaptation, particularly in growing children who need regular adjustments. Both surgery types come with challenges, but the goal is to ensure a good quality of life and recovery.
Most patients are able to go home after surgery, but some do benefit from a short rehabilitation stay to regain strength, independence, and mobility. Our works with patients and families to select the best facility for each patient. Duration of inpatient and outpatient rehab varies by patient.
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