Private Care Magazine, Issue 4 - The Royal Marsden

Sarcoma Q&AQ&ASOFT-TISSUESARCOMASDr Aisha Miah, ConsultantClinical Oncologist,discusses the latest researchinto sarcoma treatmentsAfter completing her oncologytraining at The Royal Marsden,Dr Aisha Miah undertook aPhD in advanced radiotherapytechnology and gained furtherexperience in the USA and theNetherlands. Now back withThe Royal Marsden, she offerschemotherapy and radiotherapyfor the treatment of soft-tissuesarcomas and is developing newradiotherapy techniques for limband retroperitoneal sarcomas.“The Sarcoma Unit at TheRoyal Marsden is fantastic,”says Dr Miah. “We have anexcellent clinical and researchteam – everyone has the sameethos in improving patient careand the standards of treatmentand facilities, and is given thesupport to undertake researchand implement new treatments.”What is a sarcoma?It is a cancerous tumour ofthe connective tissue – bone,muscle, nerves, fatty tissue andcartilage – that can occur in anypart of the body. There are morethan 50 types of soft-tissuesarcoma and they are extremelyrare, accounting for about oneper cent of all cancer diagnoses.The causes are mostly unknown.Who do they affect?Sarcomas can affect both sexes.Particular types of soft-tissuesarcoma arise in young patients,but the majority – about two thirds– of those diagnosed are over 50.Dr Aisha Miah,Consultant ClinicalOncologist, speaksto a patientHow are they treated?Surgery is the main treatmentfor most types of soft-tissuesarcoma – often in conjunctionwith radiotherapy. Some typeswill be treated with chemotherapybefore or after surgery. Doctorstake into account the type ofsarcoma, how far it has grownor spread, as well as the generalhealth, fitness and age of thepatient. We believe the outcomeis improved by treatment inspecialist cancer centres suchas our Sarcoma Unit.What are the symptoms?The main symptom is a lumpthat is painless at first, butbecomes painful or sore as itgrows and presses againstnerves and muscles. A lumpcan be anywhere in the body –interestingly, the most commonplaces for a sarcoma to presentare on the buttocks or thighs.What research are youcurrently conducting?We’re taking part in a nationalstudy called VORTEX, lookingat the role of post-operativeradiotherapy in limb sarcomasand whether we can reduce theincidence of long-termcomplications. Internationally,we’re part of the EuropeanOrganisation for the Researchand Treatment of Cancer,and have recently opened theSTRASS trial, looking at the roleof pre-operative radiotherapy inthe treatment of retroperitonealsarcomas. Working closely withmy medical oncology colleagues,we have a number of clinicaltrials for the treatment ofmetastatic soft-tissue sarcoma.I’m also interested indeveloping radiotherapytechniques that improveoutcomes without increasinglong-term toxicity for the patient.This will primarily involveintensity-modulated radiotherapy(IMRT) studies in the use ofpre-operative radiotherapy forlimb sarcomas. Advancedimaging technology anddiagnostic pathology offerthe potential for personalisedtreatments, dose escalationradiotherapy and integratedchemotherapy or biologicalagents with radiotherapy.We hope to improve diseasecontrol while minimising therisk of long-term toxicities forthe patient so that they maintainan excellent quality of life.Soft-tissuesarcomas1%of all cancersare soft-tissuesarcomas,making themvery rare3,000people a yearare diagnosedwith soft-tissuesarcomasin the UK50+types of softtissuesarcoma8 The Royal Marsden Private Care