Treatment

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Treatment and care of children with cancer is usually provided by a team of health professionals called a multidisciplinary team. Members of this team are specialists in children’s cancers – they understand the differences between children’s cancer and adult cancer, and each team member brings different skills in managing care to meet the needs of both you and your child.

The team will be led by a childhood cancer specialist (paediatric oncologist). Other members of the team depend on the age of your child and their type of disease, and may change over time as your child’s needs change. A list of team members who might make up the multidisciplinary team can be found in The treatment team.

Treatment for soft tissue sarcomas depends on the age of your child, the stage of the disease, the biological features of the cancer and other factors identified during diagnosis. Treatment will be tailored to your child’s particular situation, and may involve one or more of the following (see How is cancer treated for more detail).

Surgery

Your child is likely to have surgery to remove all or part of the tumour.

Chemotherapy

Chemotherapy uses anti-cancer medicines to destroy cancer cells. It is often given as a combination of medicines to try to prevent the cancer cells from becoming resistant to just one or two medicines.

Chemotherapy medicines are given together in courses, often over a few days. Once the body has recovered from the side effects, the next course is given. Most children receive multiple courses of chemotherapy.

Chemotherapy may be used:

  • before surgery (to shrink the tumour and make it easier to remove)
  • after surgery (to destroy any remaining cancer cells)
  • as the main treatment (if the cancer has spread to other parts of the body, or if surgery is not a good option).

Most children with rhabdomyosarcoma will receive chemotherapy, but other types of soft tissue sarcomas do not respond to chemotherapy.

Radiation therapy

Radiation therapy (also called radiotherapy) uses high-energy X-rays or other types of radiation to destroy cancer cells or stop them from growing. It can be used for soft tissue sarcomas:

  • before surgery (to shrink the tumour and make it easier to remove)
  • after surgery (to destroy any remaining cancer cells)
  • as the main treatment (if removing the tumour with surgery would damage important organs or cause disfigurement, or if the tumour is likely to grow and spread quickly).

Radiation therapy may be used in combination with chemotherapy.

Radiation therapy can have long-term side effects in children. If radiation therapy is included in your child’s treatment, special care will be taken to reduce these risks.

Targeted therapy

Some medicines can target the specific changes in cancer cells that make them different from normal cells. This means that they work differently from standard chemotherapy, and they usually have fewer side effects, or the side effects are not as severe.

Drugs called tyrosine kinase inhibitors may be used to treat certain types of soft tissue sarcomas.

Other treatments

Some types of soft tissue sarcomas can be treated with hormone therapy or nonsteroidal anti-inflammatory drugs (which can stop the tumour growing).

Careful observation

For a few carefully selected patients, specific treatment may not be needed. If your child has a tumour that is not growing or spreading, they might be monitored closely but not given any treatment until they develop symptoms, or until their symptoms change .

published: Sunday, 23 August, 2015