Cancer involves abnormal cells growing uncontrollably, invading nearby tissues, and spreading to other parts of the body through metastasis.
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Sarcoma care doesn’t end after surgery or chemotherapy. Ongoing care means regular check-ups, physical rehabilitation, and managing long-term side effects. Because sarcoma can come back even years later, survivors need careful monitoring for a long time. Treatments like limb-salvage surgery and strong chemotherapy can cause lasting changes in the body, so rehab and support are important. Survivorship care focuses on both watching for cancer’s return and helping patients regain strength and movement.
Surveillance protocols are risk-stratified based on the tumor grade and size. High-grade sarcomas have the highest risk of pulmonary metastasis, necessitating chest CT scans and MRI of the primary site every 3 to 4 months for the first two years, then biannually. Low-grade tumors may require less frequent imaging. The goal of this intensive surveillance is to detect recurrences while they are still amenable to surgical rescue. For GIST patients on Imatinib, maintenance therapy may continue for 3 years or even indefinitely for high-risk disease, requiring monitoring for drug-specific side effects like edema and anemia.
Rehabilitation is the cornerstone of quality of life for sarcoma survivors. Patients with limb-salvage endoprostheses require specialized physical therapy to relearn gait patterns and maintain joint range of motion. The interface between the metal implant and the host bone is a dynamic zone; stress shielding (bone loss due to the metal carrying the load) can lead to loosening. Maintenance care involves monitoring for implant wear and potential infection. For patients with soft tissue sarcomas who received radiation, preventing fibrosis and joint contracture through stretching and manual therapy is critical.
The “late effects” of sarcoma treatment can manifest years later. Doxorubicin-induced cardiomyopathy requires lifelong cardiac monitoring with echocardiograms. Ifosfamide can cause chronic renal tubular damage. Radiation to the chest or spine in pediatric patients can lead to secondary malignancies or growth arrest. Maintenance care involves a multidisciplinary team, including cardiologists, nephrologists, and endocrinologists, to manage these systemic risks. In pediatric survivors, monitoring for leg length discrepancy is vital as the child grows, often requiring contralateral epiphysiodesis (slowing the growth of the healthy leg) to maintain symmetry.
Bone health is a priority, especially for patients with osteosarcoma or those treated with methotrexate. Chemotherapy and reduced weight-bearing activity can lead to profound osteopenia and osteoporosis. Maintenance involves aggressive calcium and Vitamin D supplementation, and DEXA scans to monitor bone density. For GIST patients, managing the metabolic side effects of tyrosine kinase inhibitors, such as fluid retention and electrolyte imbalances, is part of the routine care.
The future of sarcoma maintenance lies in molecular surveillance. “Liquid biopsy” technologies detecting circulating tumor DNA (ctDNA) or fusion gene transcripts in the blood are poised to revolutionize follow-up. Detecting a rise in EWS-FLI1 levels in the blood of an Ewing Sarcoma patient could trigger an escalation of therapy months before a tumor is visible on a CT scan (molecular recurrence). This shift from radiological to molecular monitoring promises to enable earlier, more effective interventions for recurrent disease.
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Surveillance typically lasts for at least 10 years, and often for life. The risk of recurrence is highest in the first 2-3 years, so scans are frequent (every 3-4 months). After 5 years, visits become less frequent (annually). However, because late recurrences can occur, especially with specific subtypes, long-term monitoring is essential.
Phantom limb pain is a real sensation of pain coming from a limb that has been amputated. It occurs because the nerves that once supplied the limb are still sending signals to the brain. It is not “in your head.” Treatments include medications (like gabapentin), mirror therapy, and nerve stimulation techniques.
Low-impact activities like swimming, cycling, and walking are highly encouraged and safe. However, high-impact sports (like running, basketball, or contact sports) are generally discouraged because they place excessive stress on the interface between the metal implant and your bone, increasing the risk of loosening or breakage.
The most significant long-term side effect of Doxorubicin (Adriamycin) is damage to the heart muscle (cardiomyopathy), which can lead to heart failure years or decades after treatment. This is why lifelong monitoring of heart function with echocardiograms is required for all patients who received this drug.
Lymphedema is chronic swelling caused by the buildup of lymph fluid. In sarcoma patients, it often happens in an arm or leg after surgery or radiation has damaged the lymph nodes or vessels. It requires lifelong management with compression stockings, massage, and skin care to prevent infection and maintain function.
Nearly 1 in 4 cancer patients will see their cancer spread to other parts of the body. Bone is a common place for this to
Advanced skeletal imaging techniques can show detailed insights into your bone health. They can detect conditions such as fractures, bone metastases, infections, and degenerative bone
A bone cancer bone scan, also known as bone scintigraphy, is a test that uses a radioactive isotope. It finds areas of abnormal bone metabolism.
Inflammatory conditions, like imaging osteomyelitis, are hard to diagnose right. Did you know wrong or late diagnosis can cause a lot of harm? It can
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