Jul 17, 2020 12:00 PM


Photo of John Groundland

Video Transcript

I’m John Groundland. I’m a musculoskeletal surgical oncologist here at Huntsman Cancer Institute. I’m part of a multidisciplinary sarcoma team that is dedicated to the treatment of sarcoma.

Sarcomas are a group of cancers that come from the connective tissues of the body—the connective tissues being cartilage, fat, muscle, blood vessels, nerves, and all the fibrous tissues that connect them together. What these tissues share is a common ancestor line of stem cells. Cancer arises when a genetic aberration occurs anywhere along that development from the stem cell up to the mature tissue, and when it occurs in this kind of tissue line, we call that a sarcoma. Sarcoma can affect anybody, and it does affect all populations. It is non-discriminatory. There are patients as young as several months old all the way up to the oldest patient I’ve had is a hundred and four.

The vast majority of sarcomas—well over 90 percent—are sporadic, meaning they just occur randomly and without any known cause or insult. There are a few cases where there can be an inciting event—exposure to radiation being one of the most common causes. There are some genetic familial or family inherited causes of sarcoma, but they are the minority.

Sarcoma treatments are divided very broadly into two groups—there’s the sarcomas that occur in bones and sarcomas that occur in the soft tissues. Bone sarcomas, broadly speaking, are treated with a combination of chemotherapy administered by a medical oncologist specializing in sarcoma, and either surgical resection or radiation, depending on the type and location. On the other hand, there’s soft tissue sarcomas that are treated predominantly with radiation and surgical resection. There are many exceptions to this generalization, however, and that is the importance of seeking care and evaluation in a dedicated sarcoma program with a multidisciplinary approach.

The National Comprehensive Cancer Network is a group that outlines and makes recommendations for cancer treatments. They recommend that anyone with a suspected sarcoma be evaluated at a dedicated sarcoma specialty center. This entails a multidisciplinary team that meets on a regular basis. This would include the medical oncology team, radiation oncology team, the surgical oncologists, which include orthopedic oncologists, general surgeons, cardiothoracic surgeons, and then pathologists and radiologists—all with sub-specialization in sarcoma care. Here at Huntsman we have such a team and we meet every Monday to discuss all of our patients and come to a consensus opinion as to what the optimal treatment recommendations would be and then we have the capacity to implement those plans.

One of my mentors would always say to his patients whenever they thanked him, he would respond by saying, “It’s a privilege.” He would never say, “You’re welcome.” And over the years that I trained with him and now that I am in practice myself, that resonates quite strongly. It is an absolute privilege to take care of good people—often in their hour of most need. Sarcoma is a very tough diagnosis. It requires a huge dedication on the part of the patients to go through the treatment regimens that we lay out for them. And being a part of that team with the patient, as well as the other medical providers on the team, is just a wonderful privilege that I do not take for granted and hopefully never will.


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