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>> Sarcoma is known as a cancer site that
benefits from having what we call a multi-disciplinary approach.
You want specialists from
all the various disciplines of
medicine coming together as a team making
a decision about what is the best management for
this patient.. My role here
at Sibley Radiation Oncology is to
treat the patients that have cancer with radiation treatment.
For sarcoma, that is often used in
combination with surgery or other therapies.
The first step before we can start radiation is to do
a planning session what we call a simulation
because we're often simulating what the treatment is going to be.
What becomes important with
the simulation such an is getting the patient in
the best position possible to be able to
target that tumor but protect everything else around it.
Generally, it takes about one to
two weeks to create that treatment plan,
and then the patient would come back to
begin their daily radiation treatment cores.
Which usually runs for about 5-7 weeks.
We have multiple forms of radiation treatment,
the most common form of radiation is
X-ray radiation or what we call photons.
There's another form of external radiation which is
called proton therapy or particle therapies.
We can strip a proton from the atom and actually
target that particle to the tumor target.
So sarcomas are known to
invade the adjacent areas are the areas around them,
you can think of maybe a tree with roots.
When we give the radiation treatment that's
causing what we call a consolidation bringing in
those roots or those areas that are invading and bringing them
closer to the tumor in creating the shell or what we call a rind.
Radiation is helping us make sure that the
surgeon when he or she is indeed removing the tumor,
they're getting all of that tumor out.
The treatment itself is usually the fastest part,
it maybe five minutes or 10 minutes
depending on how complex the areas we're treating.
You don't feel anything,
you don't see anything, there's no pain,
it doesn't hurt, it doesn't burn,
there's no immediate effect of treatment.
In fact sometimes patients say is anything even happening?
Did anything happened? Or that was it.
The way I think of radiation sometimes is,
we're giving a hit each day a gentle hit each day that's enough
to kill cancer cells but try not to
irritate too much those surrounding tissues,
that's why it takes so long.
We could actually get through the treatment
faster but then you're really giving a harder hit
that could cause more damage
or irritation to the surrounding tissues.
You're going see some skin reaction eventually,
and sometimes it can look like a sunburn.
Usually the first week or two you don't notice much the third
or fourth week you might start to notice
a little bit of that pinkness,
or redness, or tanning coming in
very often just a simple plain lotion will be more than enough.
By the time you get to surgery most of the peak of that redness or
tanning or darkness is generally gone
away you might notice it a little bit like a sunburn,
it takes a little bit of time to fade away.
In the post-operative setting is a little bit
different when we do the radiation after surgery.
You have redness or tanning eventually
sometimes it can be a little bit peeling like a sunburn,
or even blistering, or weeping,
so the main risk is if there are areas
that are opened it could be a risk for infection.
We might use topical cream that might have
antibiotic or even prescribe
an oral antibiotic if were concerned.
Then there can be late side effects things
that can happen months to years down the road.
The main risk are
the areas around there are going to be a little bit weaker,
the muscle, the soft tissue,
the bone, minimizing the long-term effects after surgery and
radiation is to encourage that physical therapy after treatment.
Once the patient's done with treatment,
we definitely want to makes sure that we
are coordinating that follow are what we call
survivorship care now that you're into this period of
survivorship that cancer has been hopefully eliminated.
But we also want to pay attention,
we want to keep close track,
we need to do periodic imaging,
and scans and make sure that cancer has not come back.
We also want to check in on the side effects any of
the late or long-term side effects of treatment,
and what can we do to promote the healing.
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