Why Sarcoma Patients Should Be Treated at a Center that Specializes in Sarcoma

For rare cancers such as sarcoma, it is important to get treatment at a center with multiple types of specialists.

Sarcomas, which are cancers of the tissues, are rarer forms of cancer than organ-based cancers, making it important to be treated at specialized centers. Since soft tissue sarcomas and bone sarcomas are much rarer, not as many doctors are experienced in diagnosing or treating them. A community hospital may not have any oncologist or surgeon who has treated sarcomas before. Since sarcomas can be aggressive cancers, often requiring surgery, it is crucial for a patient to be seen at a center that has multiple specialists with expertise in treating this type of cancer. 

“Not all cancer centers, or places that specialize in cancer, have a sarcoma specialist,” says Lee Zuckerman, MD, an orthopedic surgeon and orthopedic oncologist specializing in sarcomas at the USC Sarcoma Program, part of Keck Medicine of USC. 

The USC Sarcoma Program, which is also affiliated with the USC Norris Comprehensive Cancer Center, is one of the leading sarcoma programs in Southern California, with multiple doctors specializing in treatment and leading clinical trials to advance care for patients.  

“The benefits of clinical trial participation are multiple, including the ability for patients to get access to medications that are either not currently on the market or to use established drugs for new indications,” says Mark Agulnik, MD, a medical oncologist with the USC Sarcoma Program. “It allows them to complement current, established treatments with newer medications.” 

“Because sarcoma is a rare disease, you really need people who see it as often as possible to take care of it,” Dr. Zuckerman says.  

“Ideally, this is an entire team of clinicians who are both familiar with sarcomas and each other to work together for the patients,” says H. Paco Kang, MD, an orthopedic oncologist and orthopedic surgeon with the USC Sarcoma Program. 

“Multiple scientific studies have demonstrated that specialized sarcoma treatment centers have better outcomes, including increased survival and fewer complications,” says J. Dominic Femino, MD, chief of musculoskeletal oncology with Keck Medicine and the USC Sarcoma Program. 

Look for these types of specialists when choosing a center for sarcoma care

When you are educating yourself on types of centers to choose for your cancer care, you will want to ask to see if the treatment facility has multiple types of specialists who have experience with sarcomas. “In order to really have comprehensive care with sarcoma, you typically need a full team of people who specialize in sarcoma,” Dr. Zuckerman says.  

“This particularly extends to surgeons and medical subspecialists such as oncologists, radiologists and pathologists,” Dr. Kang says. 

When choosing a treatment facility, they recommend you look for a team of people who specialize in sarcoma, including:  

• A medical oncologist 
• An orthopedic oncologist 
• Pathologists 
• Radiation oncologists 
• Radiologists 
• Surgical oncologists 
• Thoracic oncologists 

Specialized sarcoma centers often offer new treatments

Another benefit of getting treated at a specialized center for sarcoma is that often these centers participate in clinical trials. When you are a patient at this type of center, you can participate in new advances and treatments that might not be available elsewhere.  

“Our specialists have had a lot of success with clinical trials in immunotherapy,” Dr. Zuckerman says. One new technique with good results involves giving a patient immunotherapy for an aggressive soft tissue sarcoma prior to, or after, surgery. 

“At any given time, our goals in choosing our clinical trials are to provide access for patients both with the most common types of sarcoma but also to explore new therapies for rarer sarcoma subtypes in order to provide access to clinical trials for nearly all sarcoma patients,” Dr. Agulnik says. 

The USC Sarcoma Program also offers other forms of chemotherapy that are less toxic than traditional chemotherapy, more targeted radiation therapies and new surgical techniques to help reconstruct limbs or bones after tumor removal. 

“Traditionally, bone reconstruction has been done with metal replacements,” Dr. Zuckerman says. “Here at the USC Sarcoma Program, we can use the patient’s own bone to reform the bone that had to be removed to cure the cancer — a procedure that is called distraction osteogenesis. Because we specialize in sarcoma, we also understand and treat survivorship issues and can use this technique to treat differences in arm or leg lengths.” 

Occasionally, doctors at the USC Sarcoma Program will also use 3D-printed reconstructions to help preserve a joint, rather than a standard metal joint replacement. “These implants are specific to a given patient’s anatomy and tumor shape, which allows us to preserve as much as the patient’s own bone as possible without worrying about whether standard implants will fit,” Dr. Kang says. Since patients are living longer after a sarcoma diagnosis, joint reconstructions are important to maintain a patient’s quality of life.

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