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Studying sarcomas with Dr. Schaub

Studying sarcomas with Dr. Schaub

July is Sarcoma Awareness Month, a time to recognize patients with sarcomas and educate people about this rare type of cancer. So, what are sarcomas?

“Sarcomas are tumors of the soft tissue or bone that can arise in patients anytime from infancy to adulthood,” says our sarcoma expert, Dr. Stephanie Schaub. “They are very rare, just one percent of all cancers in the United States, and there are about 150 types, making each even more rare. For that reason, it is important for patients to seek out a sarcoma expert at a center of excellence such as the Fred Hutchinson Cancer Center.”

Each type of sarcoma is different under the microscope; some tend to occur more in children, some respond better to chemotherapy, and some can be surgically removed with or without pre- or post-surgical radiation therapy. For some locally advanced sarcomas that are not surgically resectable, radiation can sometimes be used alone. Planning treatment with an entire team of experts, from surgical oncology to medical oncology and radiation oncology can help with creating a personalized plan for each patient.

“This is why I wanted to study and work at UW Medicine. Not only do they have an excellent team, they also offer all treatment modalities, including proton therapy,” says Dr. Schaub. “However, my personal goals are to improve equitable access to cancer care. A recent UW Medicine paper showed that patient outcomes treated at a sarcoma center of excellence were not impacted by socio-economic status. I want to ensure patients receive high quality care wherever they are by being a resource to the oncology community. And I want to deliver the most thoughtful and advanced treatments, but also minimize long term side effects.”

Dr. Schaub sees definite benefits when it comes to treating several types of sarcomas using proton therapy, largely those concentrated in the trunk of the body.

“Starting low and moving up the body, protons are especially advantageous when treating cancers near the groin in children, adolescents, and young adults because we can better minimize radiation to sensitive reproductive organs such as the testicles, ovaries and uterus.”

The back of the abdomen is also an area she prefers to treat with protons. The liver, bowel and kidneys can all be affected by excess radiation, so the precision of protons helps minimize dose to these organs. Check out this month’s patient story about Jim, who had proton therapy for sarcoma in this area.

Sarcomas in the chest benefit from reduced radiation to the heart, lungs and breast. “Thoracic sarcomas are an area where it makes sense to plan with other experts early. That’s because sometimes surgeons place metal plates or wires where a tumor was removed. These can interfere with proton therapy and making plans early can keep treatment doors open.”

The same can be said for spinal and base-of-scull tumors such as chondrosarcomas, as surgery is often the first step before radiation. In these cases, surgeons also sometimes use metal hardware to stabilize the spine. So planning to use carbon fiber instead retains the option for protons. This is especially important for these types of cancers because proton therapy can deliver the high doses of radiation needed to control the tumor while sparing the sensitive surrounding tissue.

Finally, Dr. Schaub finds that protons can also be a good option for many head and neck sarcomas because they are often located near the brain, eyes and salivary glands.

Proton Therapy radiation may not be an appropriate treatment for your cancer diagnosis, but when it is, Dr. Schaub and the team advocate for the patient when it comes to insurance coverage, travel, and other issues related to treatment. She also shares resources for sarcoma patients, including the NW Sarcoma Foundation, which educates patients on sarcomas, advocates for them, offers emotional support, and can sometimes offer small financial scholarships.