Chemotherapy for Soft Tissue Sarcoma

Chemotherapy is the use of drugs to kill cancer cells. For this treatment, you see a medical oncologist. This is a doctor who specializes in using drugs to treat cancer.

When you may need chemotherapy

Your doctor may suggest chemotherapy for any of these reasons:

  • To try to shrink a tumor before surgery — this is called preoperative or neoadjuvant chemotherapy

  • To try to kill any leftover cancer cells after surgery — this is called adjuvant chemotherapy

  • To treat sarcomas that have spread to an extent that surgery will not be able to remove all of the tumor 

  • As part of the treatment if you can’t have surgery

How you take chemotherapy

Chemotherapy for soft tissue sarcoma often involves getting a mix of drugs that kill cancer cells. You will likely take these drugs through an IV. Chemotherapy is called a systemic treatment because the drugs travel all through the body in the bloodstream. Most people with soft tissue sarcoma have chemotherapy in an outpatient part of the hospital, at the doctor’s office, or at home. In some cases, depending on your health or the drugs you take, you may need to stay in the hospital during treatment.

Doctors give chemotherapy in cycles. This means you will switch between getting chemotherapy and having a rest period. Each treatment and rest period make up 1 cycle. You’ll likely have more than 1 cycle of treatment. Your doctor will explain what your treatment plan will be and what you can expect. The length of each treatment period differs depending on which drugs you take. With many types of chemotherapy, monthly treatments are common. Sometimes you get chemotherapy more often.

What drugs are used to treat soft tissue sarcoma

Chemotherapy for soft tissue sarcoma may include one drug or a mix of drugs. When more than 1 drug is used, it is called combination chemotherapy. Two of the most common drugs used to treat sarcomas are doxorubicin and ifosfamide. Other drugs that may be used as chemotherapy for soft tissue sarcoma include, but are not limited to, the following:

  • Cisplatin

  • Dacarbazine

  • Docetaxel

  • Gemcitabine

  • Methotrexate

  • Oxaliplatin

  • Paclitaxel

  • Vincristine

  • Vinorelbine

  • Mesna — used in combination with ifosfamide to protect from severe bladder irritation

Potential side effects of chemotherapy

Side effects of chemotherapy are different for everyone and will depend on what drugs you receive. Your medical oncologist and chemotherapy nurse will discuss possible side effects with you before treatment begins. It is important to tell your doctor about any side effects you experience so he or she can help make your chemotherapy as comfortable as possible. Here are some common side effects that people with soft tissue sarcoma have with chemotherapy. Ask your doctor which ones are the most likely to happen to you:

  • Appetite loss

  • Bruising or bleeding

  • Depression or anxiety

  • Diarrhea

  • Hair loss

  • Infection

  • Infertility

  • Mouth sores

  • Nausea or vomiting

  • Numbness or tingling in the hands or feet

  • Smell changes, such as being more sensitive to certain odors

  • Taste loss

  • Tiredness or fatigue

The following are signs of excessive bleeding. If you notice them, report them to your doctor:

  • Unexpected bruising

  • Small red spots under the skin

  • Signs of blood in your urine (reddish or pinkish color)

  • Black tarry stools or blood on the toilet tissue after a bowel movement

  • Bleeding from your nose or gums

  • Vaginal bleeding not related to your period

  • Headaches or changes in vision

  • A warm to hot feeling in the arms or legs

Many of these side effects can be controlled. Most gradually disappear between treatments or after the treatment is completed. If you are having side effects, ask your doctor about drugs that can help reduce the side effects of chemotherapy.