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General Treatment Overview

Collaboration of Experts in Soft Tissue Sarcoma

TREATMENT OF LEIOMYOSARCOMA

  • BIOPSY –  tissue and fluid may be removed and tests to confirm the diagnosis.
  • Core Needle Biopsy –  removes tissue samples with a hollow needle- usually the preferred biopsy method for sarcoma.
  • Incisional biopsy – removes a small amount of tissue
  • FNA – fine-needle aspiration biopsy – uses a thin needle to take a tissue sample, guided by ultrasound.
  • PATHOLOGY –  The IMPORTANCE OF HAVING AN  ACCURATE PATHOLOGY REPORT: The biopsy samples are sent to the pathologist, who is an expert in examining cells to find disease.  There are pathology specialists in sarcoma tumor tissue evaluations.  From a clinician’s perspective, the pathology report impacts treatment decisions.
  • Molecular Pathology/testing:  Some sarcoma specialists send in the primary tumor for Genetic profiling.  Some may not because LMS does not have an “actionable” mutations that would make a difference in the treatment protocol planning of your oncologist.

Dr. Alexander Lazar, renowned Research Pathologist at MD Anderson explains:

https://www.youtube.com/watch?v=WBbm2oO9290

– From the National Cancer Institute –  Information from A – Z on What Pathology means and how it can impact treatment decision-making: https://www.cancer.gov/about- cancer/diagnosis-staging/diagnosis/pathology-reports-fact-sheet

  • The STAGES AND GRADES OF SOFT TISSUE SARCOMA are well-defined/explained by the American Society of Clinical Oncology (ASCO) – CANCER.NET:

https://www.cancer.net/cancer-types/sarcoma-soft-tissue/stages-and-grades

  • SURGERY

The primary treatment for Leiomyosarcoma.  The goal of surgery is to remove the tumor with “clear margins” –  a wide resection to “get it all out.”  The method and extent of surgery varies and depends on where the tumor is and its size.  Getting complete information from your surgical oncologist will be helpful to you in knowing the details of the tumor removal process/plan as well as the potential side effects after surgery.

Note: IF A SURGERY IS ANTICIPATED / REQUIRED –  PLEASE TAKE NOTE OF THIS IMPORTANT CONTRIBUTION YOU CAN MAKE TO RESEARCH THROUGH TUMOR TISSUE DONATION:
See how you can impact the future of research through a simple patient consent for tumor tissue donation –  only your signed consent is required and the Rare Cancer Research Foundation takes care of the coordination.
Learn more:  https://leiomyosarcoma.info/cancer-cell-line-project/

  • CHEMOTHERAPY

Different types of chemotherapy drugs work in different ways to kill abnormal cells or stop new ones from forming.  There can be a combination of chemotherapy agents used.  When only one chemotherapy drug is used it is called a “single agent.”  Chemotherapy is given in cycles of treatment dates followed by days of rest, in order for the body to recover before the next cycle begins.  The number of treatment days per cycle and the total number of cycles given will vary.

  • CHEMORADIATION

When chemotherapy and radiation are given together – sometimes at the same time or staggered – one after the other.

  • TARGETED THERAPY

Stops molecular activity involved in the growth of cancer cells, and sometimes blocks the chemical signals that tell the sarcoma cells to grow; may block signals that cause new blood vessels to form.  Other drugs target hormones.  Such therapy is not used for every sarcoma.  Side effects can be significant and differ between drugs  Targeted therapy harms normal cells less than chemotherapy.  Pill form or injections are administered in targeted drug therapy.

ALWAYS IMPORTANT TO ASK YOUR ONCOLOGIST TO PREPARE YOU WITH INFORMATION ON POTENTIAL SIDE EFFECTS AND SYMPTOM MANAGEMENT.  ALWAYS COMMUNICATE WITH YOUR CARE TEAM TO LET THEM KNOW YOUR SIDE EFFECTS SO THEY CAN RESPOND AND HELP YOU.

  • RADIATION THERAPY

This is high-energy rays treatment the tumor site.  The rays damage DNA – a chain of chemicals in cells that contains genes.

This type of therapy either kills the cancer cells or retards new cancer cells from forming.   Your radiation oncologist can explain the different forms of radiation listed here, the different ways to give radiation, and the potential side effects of each:

  • Neoadjuvant therapy – before surgery to shrink the tumor
  • Primary treatment- the main treatment to rid the body of cancer
  • IORT – Intraoperative radiation therapy – during surgery
  • Adjuvant treatment – after surgery is completed to kill any remaining cancer cells
  • EBRT –  External Beam Radiation Therapy- 3D-CRT or three-dimensional radiation therapy using beams that match the shape of the tumor
  • IMRT – Intensity-Modulated Radiation Therapy –  small beams of different radiation strengths
  • SBRT –  Stereotactic Body Radiation Therapy – involves high- dose radiation within one or more sessions

BRACHYTHERAPY –  Placement of small radioactive objects next to cancer cells using small tubes (catheters) placed during surgery.
This can be given in low-dose rate or high -dose rate – the intensity level of treatment determines the dose rate.

ABLATION –   Destroys small tumors with little harm to nearby tissue.  Cryoablation –  kills cancer cells by freezing them with liquid nitrogen. Radiofrequency ablation  – kills cancer cells with high-energy radio waves.  A probe placed into the tumor emits the waves, and is guided into place by ultrasound or CT scanning, removed when treatment is finished.

EMBOLIZATION – Cutting off the tumor’s blood supply.  A catheter is inserted into the artery and guided to the tumor.  Beads will be inserted to block the blood flow.

  • Chemoembolization –  the beads are coated with chemotherapy
  • Radioembolization – uses small radioactive beads

Highlights from the NCCN Guidelines for Patients  (2018)

Tumor-Agnostic Treatment for Cancer: An Expert Perspective

Some recent FDA approvals have made many people aware of tumor-agnostic treatments. But what does that mean and how could it benefit someone with cancer? ASCO Chief Medical Officer Richard L. Schilsky gives insight into this new way of thinking about cancer treatment.Cancer.Net

You will also be able to scroll down below this article to access other important information shared by the American Society of Clinical Oncology (ASCO):