Why a Team Approach is Best in Deciding Treatment for Sarcoma

Better coordinated care leads to more positive outcomes

Sarcoma is a rare form of cancer that may occur nearly anywhere in your body — in soft tissues or in bones. And because it’s rare, if you or someone in your family has a sarcoma, research has shown that it’s best to find a multidisciplinary center with an experienced team to treat the condition.

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“Sarcoma is not treated everywhere,” says orthopedic surgeon Nathan Mesko, MD, Co-Director of Cleveland Clinic’s Sarcoma Center. “It’s not like breast cancer that doctors treat at any hospital in the country. It’s a unique and rare entity that requires treatment in an academic setting at a multidisciplinary center.”

Dr. Mesko and oncologist Dale Shepard, MD, PhD, who specializes in sarcoma treatment, discuss five key reasons why multidisciplinary centers improve outcomes for sarcoma patients.

1. You’ll benefit from timely treatment

A team at a multidisciplinary center can evaluate your condition and recommend a treatment plan faster than any other medical setting.

If you have a sarcoma, initial therapy should begin immediately, Dr. Shepard says. Whether you need surgery, radiation treatment or chemotherapy, delays can make things more difficult for two reasons:

  • A cancer diagnosis is frightening, and if you are like most people, you’ll want to begin treating it right away. “Oftentimes patients are experiencing symptoms from their disease and getting started on treatment will make that better,” Dr. Shepard says.
  • A swift diagnosis and treatment can improve your chances of a successful outcome. “With some cancers, if you have a delay of six weeks or longer from the time you’re diagnosed to the time you start your first treatment, your overall chances for survival decrease. Seeing a multidisciplinary team decreases that time,” Dr. Shepard says.

2. A team approach personalizes treatment strategies

At a center with a specialized sarcoma team, you see a variety of health care providers under one roof. Surgeons, medical oncologists, radiation doctors, radiation oncologists, pathologists and social workers work together to treat you.

The team will create a detailed treatment plan tailored to meet your specific medical needs. They also can help you make decisions not directly related to your cancer treatment, such as pre-treatment fertility choices, and can provide support for the emotional aspects of your diagnosis.

“You will receive a better treatment plan at a center that focuses on sarcoma because all providers involved in your care discuss various sarcoma cases weekly and work with each other on a regular basis,” Dr. Shepard says. “Together, they can come up with the right game plan for you.”

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One example of the need for a team approach to sarcoma is the decisions about how to proceed with a biopsy when a sarcoma is located in a limb bone.

The plan has ramifications later because the biopsy often is the first step to a limb-sparing procedure for reconstruction of the affected limb, Dr. Mesko says. The location of the biopsy incision and the technical aspects of obtaining tissue can have a major impact on subsequent surgeries, he says. With a team approach, the orthopedic surgeon, who oversees in the limb construction, can ensure that the right first steps are taken.

3. Pathology support opens clear treatment path 

Having expert pathology support is another benefit of getting treatment at a multidisciplinary center, Dr. Mesko says. Pathologists are physicians who use science-based laboratory methods to diagnose and characterize diseases. The pathologist is ultimately responsible for making a sarcoma diagnosis based on a microscopic examination of tumor tissue.

Sarcoma pathologists are specially trained in diagnosing these rare tumors. Because treatment protocols vary for the many different subtypes of sarcoma, correct identification is extremely important.

“Patients are first diagnosed from outside our multidisciplinary clinic,” Dr. Shepard says. “Then we like to examine their tissue here so our pathologists can confirm the diagnosis. While that might take a little extra time, it certainly allows us to make sure we are treating the right thing.”

4. Experienced team sees many sarcoma cases

At a center that specializes in this disease, the team’s experience works in your favor.

Yes, sarcoma is rare. But the specialists at multidisciplinary centers have treated many patients with this type of cancer. They also are familiar with the latest research, and have advanced medical training in this area.

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“One of the biggest things we see is delay getting to us because often physicians who don’t treat sarcomas or are not in an academic setting are at a loss as to where to refer patients,” Dr. Mesko says.

“Having the proactive spirit of saying you want treatment at an academic center specializing in sarcoma is very important from a patient perspective,” he says.

5. Clinical trials offer access to cutting-edge treatments

At a multidisciplinary center, you’ll also have access to clinical trials. A trial can give you new hope for a better outcome.

“Patients who may have failed several types of treatment are often entered into a novel study in an attempt to treat them in a unique and cutting-edge way,” says Dr. Mesko.

The treatment team will monitor you closely during a trial. So they can deal with any potential side effects right away, he says.

It’s understandable that most patients would prefer to be treated someplace close to home. However, when it comes to the treatment of sarcomas, find your way to a major medical center with a specialty in treating this rare, life-threatening cancer.

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