After you get a diagnosis of liposarcoma, a type of cancer that starts in fat cells, your doctor will discuss your treatment options with you. The main choices are surgery, radiation, and sometimes chemotherapy.
Which one of these your doctor suggests depends on things like the type of liposarcoma you have and the size of the tumor. He'll also consider how far and where the cancer has spread.
If you have a fast-growing tumor, you may do better with a combination of two or more treatments.
Talk through all of your choices with your doctor. Ask about the benefits and possible side effects of each one before you make a decision.
Surgery
This is the main treatment for liposarcoma. It could be the only one you need if your cancer is small and hasn't spread to other parts of your body. The goal of surgery is to remove as much of the tumor as possible without damaging your arm or leg, which is where liposarcoma often starts.
Most often, doctors use what they call "limb-sparing" surgery to treat liposarcoma. Your surgeon removes just the tumor along with a ring of healthy tissue around it. Taking out extra cells helps make sure that the cancer won't come back.
Sometimes a tumor is too large to remove or sits next to important parts of your body that surgery could damage. If your doctor can't remove the whole tumor, you'll get chemotherapy or radiation to kill any cancer cells that are left behind.
Rarely, the surgeon will have to remove the whole arm or leg. Your surgeon will only do this if it is the only way to keep you healthy.
Surgery has risks like:
- Heavy bleeding
- Damage to nearby organs
- Infection
- Reactions to anesthesia
- Blood clots
- Problems using your arm or leg
- Swelling
Ask your surgeon which of these problems are most likely to happen from the type of surgery you have.
Radiation Therapy
This treatment uses high-energy rays to kill cancer cells and stop them from multiplying.
Your doctor may suggest you get radiation without any other treatment. They may also recommend you get it before surgery to shrink the tumor and make it easier to remove or after the operation to kill any cancer cells that were left behind.
Radiation can cause side effects like:
- Redness and peeling of skin in the treated area
- Nausea and vomiting
- Diarrhea
- Tiredness
- Swelling, pain, and weakness in your arm or leg
Most of these problems should go away after you finish treatment.
Chemotherapy
This treatment uses strong drugs to kill cancer cells all over your body. You take these medicines by mouth, or a doctor gives them to you through a needle in a vein.
Chemotherapy may be an option if your cancer has spread or there's a high chance that it will come back. Your doctor can also give you chemo after surgery.
Some types of liposarcoma, such as myxoid liposarcoma, respond better to chemotherapy than others.
Chemotherapy for liposarcoma often uses combinations of drugs. Sometimes doctors only put them in the arm or leg that has the tumor, a technique called isolated limb perfusion.
Chemo can also damage healthy cells and cause side effects like:
- Nausea and vomiting
- Hair loss
- Mouth sores
- Tiredness
- Appetite loss
- Low blood cell counts
These symptoms should improve once you stop treatment.
New Treatments
The FDA has approved two new chemotherapy drugs for people whose cancer has spread, have cancer that can't be removed with surgery, or previously had chemotherapy that included the drug anthracycline.
Trabectedin (Yondelis) damages the DNA in cancer cells so they can't grow and multiply. Eribulin (Halaven) stops cancer cells from dividing. You get both drugs with an infusion into a vein.
These medications have side effects similar to other chemo drugs, such as:
- Nausea
- Vomiting
- Tiredness
- Constipation
- Diarrhea
After Treatment
Once your treatment is finished, you'll see your doctor for regular follow-up visits. They'll examine you and do imaging tests like a CT scan or MRI to see if the cancer has come back.
