Our Program

The Sarcoma Program at the USC Norris Comprehensive Cancer Center offers access to a diverse, multidisciplinary team of specialists for patients who have known or suspected bone and soft tissue sarcoma cancers. Unique to our multidisciplinary program are our breadth of experience and the high level of expertise we offer in treating these complex and rare tumors.

We treat all subtypes of sarcoma, including osteosarcoma, Ewing sarcoma, chondrosarcoma, malignant fibrous histiocytoma, liposarcoma, leiomyosarcoma, angiosarcoma, fibrosarcoma, embryonal sarcoma, rhabdomyosarcoma and other sarcomas of the bone and soft tissue. Treatment options include surgery, radiation therapy, chemotherapy or a combination of these methods as appropriate to the patient’s sarcoma subtype. With surgery, we strive for limb salvage whenever feasible. We employ the latest techniques for radiation therapy, such as intensity modulated radiation therapy (IMRT). We offer both standard chemotherapy regimens as well as a variety of novel treatments as part of clinical trials.

As a Sarcoma Alliance for Research through Collaboration (SARC)-sanctioned institution focused on achieving breakthroughs in sarcoma treatment, we were the first center to use cryoablation for bone and soft tissue sarcoma. We also have pioneered hip implants for reconstructing the acetabulum (the socket in the hip bone that connects to the thigh bone). For patients who have concerns about blood transfusions, we can offer bloodless sarcoma surgery, a conservative blood management therapy not commonly offered elsewhere.

Our Approach

At the USC Sarcoma Program, treatment is enhanced through our access to a fully integrated multidisciplinary team with strength in both adult and pediatric oncology. We have sarcoma experts in orthopaedic surgery, surgical, radiation and medical oncology, pathology and musculoskeletal radiology. When appropriate, we consult with physicians in urology, thoracic surgery, otolaryngology and neurosurgery. Reconstructive surgeons are also available and frequently involved in soft tissue reconstruction. We offer a variety of ancillary support services including physical therapy and rehabilitation and alternative and complementary medicine.

We are dedicated to ensuring that patients receive appropriate and state-of-the art therapy for their sarcoma. Together, the entire team conducts weekly multidisciplinary conference to evaluate each patient’s medical information and achieve consensus on a comprehensive and personalized treatment plan. Personalized treatment options at the USC Sarcoma Program may also include state-of-the-art surgical techniques, stereotactic radiosurgery, cryoblation and radiofrequency ablation, targeted therapy and immunotherapy.

Conditions

Sarcoma
Sarcoma is a rare malignant tumor that can present in various locations in the body. Sarcoma is the general term for a broad group of cancers that includes tumors that form in the bones and in the soft tissues.

Bone sarcoma
Sarcoma can form in any bone in the body, but most commonly presents in the long bones that make up the arms and legs. There are several types of bone cancer – some occurring primarily in children and others affecting mostly adults. These cancers don’t include cancers that begin elsewhere in the body and spread to the bone. Those cancers are named for where they began, such as breast cancer that has metastasized to the bone.

Chondrosarcoma
Chondrosarcoma is a rare type of cancer that begins in cartilage surrounding the bones. Chondrosarcoma most often affects adults older than 40. Though chondrosarcoma can affect any bone, it most commonly occurs in the bones of the hips and thighs.

Ewing’s sarcoma
Ewing’s sarcoma is a rare type of bone cancer that occurs most often in and around the bones, typically affecting children and young adults. Ewing’s sarcoma can occur in any bone, but most often begins in the bones in the leg, hip, arms, chest, skull and spine. Ewing’s sarcoma rarely occurs in the soft tissues of the arms, legs, abdomen, chest, neck and head. Visit our health library for more detailed information about Ewing’s sarcoma.

Osteosarcoma
Osteosarcoma is a type of bone cancer, often found in the long bones in the arms and legs. This type of cancer usually occurs in children and young adults, but it can also occur in older adults. Visit our health library for more detailed information about osteosarcoma.

Soft tissue sarcoma
Soft tissue sarcoma is a type of cancer that begins in the soft tissues of your body.
Soft tissues include muscle, fat, blood vessels, nerves, tendons and the lining of your joints. Some types of soft tissue sarcoma are more likely to affect children, while others affect mostly adults. Soft tissue sarcoma can occur anywhere in the body, but the most common types occur in the abdomen and in the arms and legs.

Gastrointestinal stromal tumor (GIST)
Gastrointestinal stromal tumors (GISTs) are tumors of the digestive tract. GISTs most often occur in the stomach or upper part of the small intestine and in middle-aged and older adults. GISTs may also be found in the esophagus, large intestine and anus. GISTs start in the cells of your digestive tract that send signals that cause digestive organs to contract to aid in digestion.

Leiomyosarcoma
Leiomyosarcoma is a cancerous tumor that arises from smooth muscle cells. The uterus is the most common location for a leiomyosarcoma. Because smooth muscle is found all over the body, a leiomyosarcoma can form almost anywhere where there are blood vessels — including the heart, liver, pancreas, genitourinary and gastrointestinal tract, the space behind the abdominal cavity (retroperitoneum), uterus and skin.

Liposarcoma
Liposarcoma is a rare type of soft tissue sarcoma forming in the fat cells. It can occur in fat cells in any part of the body, but mostly occurs in the muscles of the limbs or in the abdomen. Liposarcoma occurs most often in older adults.

Malignant peripheral nerve sheath tumor
Malignant peripheral nerve sheath tumors – also called neurofibrosarcomas – occur in the protective lining of the nerves that extend from the spinal cord into the body. These tumors can present anywhere in the body, but most often occur in the deep tissue of the arms, legs and trunk. Symptoms may include pain and weakness in the affected area. The tumors may cause a growing lump or mass.

These tumors occur frequently in patients with neurofibromatosis – an inherited disorder that causes nerve tissue tumors – and in patients who have undergone radiation therapy. However, the majority of patients with this tumor have no risk factors.

Rhabdomyosarcoma
Rhabdomyosarcoma forms in the body’s soft tissues, such as muscle and connective tissue. The cancer cells in this tumor look similar to immature muscle cells. Rhabdomyosarcoma most often affects children and young adults.

Synovial sarcoma
Synovial sarcoma is a rare soft-tissue sarcoma. Only about 1 to 3 individuals in a million people are diagnosed with this disease each year. It occurs most often among teenagers and young adults. Despite its name, synovial sarcoma is not related to the synovial tissues in the joints. The disease starts most commonly in the legs or arms, but it can appear in any part of the body. Synovial sarcoma is when a high-grade tumor spreads to other sites in the body and this offcurs in up to half of the cases. There are no well-established risk factors for synovial sarcoma, but the disease is associated with chromosomal translocation. Because of this translocation, synovial sarcoma cells contain a mutant gene. This mutant gene is thought to contribute to the development of the disease.
Signs of synovial sarcoma may include interference with a bodily function in the area, e.g., trouble breathing or swallowing in the head and neck or pain if nerves are involved.

Other types of soft tissue sarcomas include: alveolar soft part sarcoma, angiosarcoma, clear cell sarcoma, dermatofibrosarcoma protuberans, desmoplastic small round cell tumor, epithelioid hemangioendothelioma, epithelioid sarcoma, extrarenal rhabdoid tumor, fibrosarcoma, hemangiosarcoma, infantile fibrosarcoma, inflammatory myofibroblastic tumor, Kaposi’s sarcoma, lymphangiosarcoma, malignant fibrous histiocytoma, myofibrosarcoma, myxofibrosarcoma and PEComa.

Treatments

The treatment options for sarcomas – both bone and soft-tissue – are based on the type and stage of cancer and the patient’s overall health and preferences. Sarcoma in the bone may be treated with medication, surgery, radiation therapy or a combination of all three.

Chemotherapy
Chemotherapy is a medical treatment used to kill cancer cells. Chemotherapy is most often given through a vein, but may also be administered orally. The chemotherapy medications travel throughout your body. Chemotherapy may also be used in people with bone cancer that has spread beyond the bone to other areas of the body.

Radiation therapy
Radiation therapy uses high-powered beams of energy, such as X-rays, to kill cancer cells. During radiation therapy, a special machine moves around the patient and aims the energy beams at a precise point in the body.

Radiation therapy may be used in people with inoperable cancer, to shrink tumor to make them easier to remove surgically, or after surgery to kill any cancer cells that are left behind. For people with advanced bone cancer, radiation therapy may help control pain and other symptoms.

We offer cutting edge stereotactic radiosurgery options, including the Gamma Knife®, CyberKnife® and TrueBeam™ STx. We offer intensity modulated radiation therapy (IMRT) and were the first center to use cryoablation for bone and soft tissue sarcoma.

Surgery
When performing surgery, the main goal is removal of the entire tumor. In most cases, this involves special techniques to remove the tumor in one single piece, along with a small portion of healthy tissue that surrounds it. We have pioneered hip implants for reconstructing the acetabulum (the socket in the hip bone that connects to the thigh bone). For patients who have concerns about blood transfusions, we can offer bloodless sarcoma surgery, a conservative blood management therapy not commonly offered elsewhere. Our surgeons also offer soft tissue reconstruction.

Resources

Sarcoma Alliance
sarcomaalliance.org

Sarcoma Help Organization
sarcomahelp.org

Our Physicians

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Practicing Locations

USC Healthcare Center 1
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Practicing Locations

Keck Hospital of USC
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Practicing Locations

USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Hospital of USC
LAC+USC Medical Center
USC Healthcare Center 2
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Norris Comprehensive Cancer Center and Hospital

Specializing In

Tumors of the Musculoskeletal System in Adults and Children, Musculoskeletal Infection, Limb Sparing Tumor Surgery

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
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Practicing Locations

Keck Hospital of USC
LAC+USC Medical Center
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Hospital of USC
LAC+USC Medical Center
Other Locations

Specializing In

Lipomatous tumors, Liposarcoma, Melanoma, Sarcoma, Soft tissue sarcoma, Retroperitoneal sarcoma

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Norris Comprehensive Cancer Center and Hospital