肉瘤

簡介

我和病患、護理人員、醫師、和支援照護團體的成員建立了關係。 這樣的關係支持我撐過治療、讓我有勇氣持續奮鬥。」 Hannah Komai,骨癌倖存者

如果您診斷發現罹患肉瘤或骨肉癌,請與我們討論治療的選擇。 這類癌症相當少見而且每種情況都不一樣,需要專家來檢測、治療和復健,來得到成功的治療。

City of Hope 的醫療團隊以病患為中心,來診斷和治療肉療,包括以下腫瘤和癌症:骨、軟骨、肌肉、脂肪、神經、血管和淋巴管、深部皮膚組織、關節組織。

預約諮詢

如果您已被確診患有肉瘤或是罹患肉瘤的高危險群,或希望為您的治療尋找第二意見的諮詢服務,您可以上網預約或聯絡我們,電話是 800-826-4673 (HOPE)。 請前往第一次預約頁面瞭解更多資訊。 

City of Hope is a nationally recognized leader in the research and treatment of sarcomas. We are one of the few facilities designated a comprehensive cancer center by the National Cancer Institute, and for over a decade, U.S. News & World Report has named City of Hope one of the top cancer hospitals in America.

Our physicians have been consistently named "America's Top Doctors" by Castle Connolly and are active participants in the National Comprehensive Cancer Network, which sets evidence-based best practices for detecting, evaluating and treating sarcomas nationwide.

Our multidisciplinary staff pursues an integrated approach to treating sarcomas by combining the latest research findings with outstanding patient care. This includes using advanced technologies and specialized techniques such as:

  • Minimally invasive surgical approaches that reduce discomfort, blood loss and recovery time
  • Innovative limb-sparing surgeries that can preserve patients’ range of motion and quality of life
  • Expandable limb implants that can “grow” with the patient, eliminating the need for additional surgeries
  • Highly precise radiation delivery that uses advanced imaging technology to guide radiation dose and focus, increasing its cancer-fighting effectiveness while minimizing exposure in normal tissues
  • Individually customized chemotherapy and targeted therapy regimens, including isolated-limb delivery that may be more effective against the cancer and less toxic to the patient
  • Comprehensive rehabilitation program to help restore motion and function after treatment
  • An adolescent and young adults program to address the concerns of sarcoma patients, who are typically diagnosed at a younger age

Additionally, City of Hope patients have access to our extensive team of supportive care experts, who will help you and your caregivers achieve and maintain a better quality of life during and after your cancer treatment.

What are sarcomas?

Sarcomas are uncommon cancers that develop in your body’s connective tissues, including bone, cartilage, fat, muscle, nerves, blood vessels and lymph vessels.

Sarcomas are typically divided into two main types, bone cancer (osteosarcoma) and soft tissue sarcoma, the latter of which has over 50 classifications, depending on tissue type affected, such as:

  • Chondrosarcoma (cartilage)
  • Liposarcoma (fat)
  • Angiosarcoma (blood vessels)
  • Rhabdomyosarcoma (skeletal muscles)
  • Leiomyosarcoma (smooth muscles)
  • Synovial sarcoma (tissue surrounding joints)
  • Fibrosarcomas (fibrous connective tissue)
  • Schwannoma and neurosarcoma (peripheral nerve cells)
  • Kaposi’s sarcoma (under skin or mucus tissue in nose, mouth or anus)

What risk factors are linked to sarcomas?

Factors that can elevate sarcoma risk include:

  • Family history
  • Previous cancer radiation or chemotherapy
  • Exposure to radiation
  • Rare genetic disorders such as Li-Fraumeni syndrome, Rothmund-Thomsund syndrome and retinoblastoma
  • Paget disease: a precancerous condition involving abnormal bone formation, typically found in people over the age of 50
  • Prolonged arm or leg swelling (lymphedema)

What are the symptoms of sarcomas?

Sarcoma symptoms vary depending on the area and tissue type affected, and may include:

  • Swelling or a lump, particularly one that grows over a short period of time (a few weeks or months)
  • Pain, especially with movement
  • Bone fractures
  • Numbness or weakness in a limb
  • Abdominal discomfort
  • Bloody or black stools

Although these symptoms can be caused by other conditions, you should check with your doctor to get a definitive diagnosis.

Sources: National Cancer Institute and American Cancer Society

Diagnosing sarcomas

Precise sarcoma tests are crucial for treatment planning, and City of Hope is equipped with state-of-the-art technologies and specialized staff to ensure an accurate, comprehensive diagnosis of these cancers.

Highlights of our screening and diagnosis services include:

  • Advanced imaging technology to better locate tumors and determine treatment response
  • Genomic and molecular profiling of the cancer, which can lead to more effective, less toxic treatments

How are sarcomas detected?

Your doctor may use the following tests to look for sarcomas:

  • Physical exam
  • Blood test
  • Bone scan X-ray
  • Biopsy: Examination of suspicious tissue — depending on its location, this may using a fine needle to extract a sample or surgically removing a small piece of the tissue.
  • CT or CAT (computed tomography) scan: This test involves taking a series of X-ray images to form a computer-generated image, which determines tumor size, location and spread. Special dyes may be used to enhance this scan.
  • MRI (magnetic resonance imaging) scan: This procedure uses radio waves and strong magnets to produce detailed images of the body’s tissues, including tumor size and location.
  • PET (positron emission tomography) scan: For this test, a small amount of radioactive sugar is injected into the bloodstream, followed by a radioactivity scan to detect cancer cells (which takes up sugar at a faster rate than normal cells.)
  • FISH (fluorescence in situ hybridization): A laboratory test that looks for genetic or chromosomal changes in the biopsied cells, which can be used to guide treatment.
  • Immunohistochemistry: A test that looks for antigens in biopsied tissue sample to help determine cancer type.

Based on the results of these tests, the cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs. Generally, cancer caught in earlier stages will have better outcomes than those caught in advanced or metastasized stages.

What are the current screening guidelines for sarcomas?

There are currently no screening guidelines for sarcomas, since no screenings have been shown to lower risk of dying for people of average risk. However, your physician may recommend more vigorous monitoring if you are at a high risk of developing this disease, which includes:

  • Previous cancer therapy
  • Genetic conditions that elevate sarcoma risk
  • Family history of sarcoma

肉瘤治療選擇

不是只有病人而已, 他們還有兄弟姊妹、 父母、阿姨、叔叔,他們都要確保這個孩子得到最好的照護。 這是我們最大的挑戰之一,也是我們最大的回報。」 Judith K. Sato,醫學博士,骨肉癌部門主任

因為肉瘤獨特的類型和生長的部位,需要個人化的治療計劃,才能達到最佳的臨床治療效果和生活品質。 在 City of Hope,我們的跨領域醫療團隊有各領域的專家-包括外科手術、放射腫瘤科、腫瘤內科、病理、復健和支援醫療-他們會一起檢閱您的病例來決定最好的治療方式。

我們的醫生是許多組織和合作組織和團體的積極成員,如西部肉瘤團體 (WEST)和兒童腫瘤團體。 我們的團隊參與了許多關於檢測、治療和預防肉瘤的臨床試驗。 我們在研究上的積極努力代表病患能夠獲得最有前景和最新的癌症療法。

進一步了解下列的肉瘤治療選擇:

外科手術

我有許多病患是青少年...看到他們能長大、從高中畢業去念大學並擁有自己的家庭是非常令人欣慰滿足的。」 Dominic Femino,醫學博士,整型外科主任

對早期或局部惡化的肉瘤,以手術切除癌組織是主要的治療方式。 手術依癌症的類型、大小和部位而定。

City of Hope 提供最新最先進的肉瘤治療手術,讓您能獲得在其他地方無法達到的療效。 這包括外科醫師創新的癌症切除手術,致力保存正常組織以及在義肢選擇上的專長,讓您能保持或恢復生活品質。

儘可能使用低侵入性-比傳統開放性手術切口較小-的手術。 這能夠在維持最佳治療效果的情況,讓不適、失血、住院和恢復的時間大幅淢低。

我們的肉瘤手術重點包括:

  • 肢體保留手術:在可能的情況下,我們的外科醫師會以移除癌症而不截肢為目標,以保留行動能力和生活品質。 包括:
    • 將正常組織的切除降到最低
    • 在手術切除部位以移植或填充物替代,如骨水泥
    • 用天然或合成材料進行骨骼和關節重建
  • 旋轉成型術:對肉瘤長在膝蓋或膝蓋附近的病患,旋轉成型術一種改良的截肢手術,以腳踝和足部(見右圖)取代膝關節,使其與小腿義肢相容。 這能在肉瘤手術後大大提高身體平衡、協調和動作的範圍。
  • 可擴展的假體骨使用特別的磁鐵幫助假體延伸,以配合病患的生長,不需透過其他的手術來以手動廣展(或取代)傳統的假體骨。
  • 擁有以手術治療複雜肉瘤病例的經驗,包括:
    • 局部晚期癌症
    • 大型或變型的腫瘤
    • 接近或位於重要器官或結構的腫瘤
    • 對兒童或年青成人患者進行手術,他們的骨骼和與其連結的組織仍在生長
    • 其他可能讓手術更為複雜的健康狀況

在癌症手術後,我們也提供了各式的復健服務,結合了物理、職業和娛樂治療方式,幫助恢復動作和行動能力。

放射線治療

放射線治療使用高能量的 X 光或其他形式的放射線來殺死癌細胞。 作法是直接對腫瘤做集中放射線照射,或在腫瘤內或附近放置能釋放輻射的物質。

放射線可用來治療無法透過手術切術的腫瘤(有時縮小腫瘤到可以開刀的程度),並用來減輕疼痛和其他癌症相關症狀。 也可以在手術後殺死在腫瘤區任何殘留的癌細胞,以減少復發的可能性。

City of Hope 是圖像引導放射線治療計劃的權威,我們使用先進的造影技術-如電腦斷層掃描、磁造影和正電子發射計算機斷層掃描-來瞭解腫瘤的大小和位置,來「雕塑」輻射在癌症區的照射。 這將確保輻射能精準照射在腫瘤區,同時盡量減少對週圍正常組織的影響。

藥物治療

藥物治療幫助病患對抗肉瘤的方式是以藥物來殺死癌細胞或停止其成長和擴散。 這些藥物包括:

  • 化學治療,以快速分裂的細胞為目標,包含癌症細胞。
  • 標靶治療,按照癌症細胞特徵來辨認並攻擊癌細胞。
  • 免疫療法,刺激病患自己的免疫系統來辨識和攻擊癌細胞

藥物或聯合藥物治療要視肉瘤的類型和期數、過去使用的療法,以及病患的健康和整體治療目標而定。 個人化醫療照護會做進一步做您癌症的分子和基因測試,能幫助找出更有效的治療方法和/或更少的毒性。

除了傳統的藥物治療方法,City of Hope 的肉瘤病患也可接受孤立肢體輸注治療,能將對抗癌症的藥物直接注射到罹癌症影響的手或腿。 這是透過以止血帶綁在有癌細胞的肢體,並將其主動脈和靜脈連接到藥物遞送的機制來完成。 這讓我們可以使用更高劑量的藥物,同時減少系統副作用的發生率和嚴重程度,如噁心和疲倦。

City of Hope 的病患也可以方過我們的臨床試驗計劃來獲得最新且前景看好的藥物治療計劃。

我們的醫療照護由一群跨領域的團隊提供,其中包括外科腫瘤科,腫瘤內科醫師、放射腫瘤科醫師;他們與病理科醫師、放射科醫師、復健專家等人員密切合作,致力於為患者獲得最好的治療結果。

Orthopaedic Surgery

Dominic Femino, M.D.

臨床專業領域

  • Orthopaedic Surgery

Pediatric Hematology/Oncology

Judith K. Sato, M.D.

臨床專業領域

  • Pediatric Hematology/Oncology

Sarcoma research and clinical trials

At City of Hope, sarcoma clinicians and researchers collaborate extensively to develop and evaluate new therapies for better survival and quality-of-life outcomes. Our patients have access to a wide variety of clinical trials including new chemotherapy and targeted therapies, novel surgical techniques, innovative radiation approaches and new prevention strategies.

These trials give current patients access to promising, leading-edge therapies and improve overall care for future patients worldwide. Visit our clinical trials page to learn more about current studies and their eligibility criteria.

Our current sarcoma research projects include:

  • Identifying biomarkers for sarcoma recurrence, which can help predict and detect cancer relapse for earlier, more effective treatment
  • New targeted therapies for advanced or recurrent sarcomas that do not respond to standard treatment
  • Using high-dose chemotherapy with stem cell transplantation to improve outcomes
  • Building a tissue bank of sarcoma cells to better understand its biology, variation and development
  • Ongoing survivorship studies to improve the health and quality of life for sarcoma survivors, who are typically younger than other cancer patients

LEARN MORE

與肉瘤共存

無論如何,這將會是一條艱難的路。 但態度非常重要。 努力讓自己專注在最後的治療結果。 保持樂觀的態度。」 Trevor Hoffman,肌肉癌倖存者

在成為 City of Hope 的病患後,您立即享有優質的援助服務,讓您和您所愛的人在肉瘤治療期間及之後無後顧之憂。

我們能幫您解決以下和其他問題:

拜訪我們的與癌症共存支援照護醫療網站來進一步瞭解這些資源。

進一步瞭解更多我們提供的支援照護計劃,請聯絡Sheri & Les Biller Patient and Family Resource Center,電話是626-218-2273 (CARE)。

進一步瞭解

Hannah Komai Success Story Image
Hannah,骨癌倖存者

現已脫離癌症的 Hannah 從City of Hope的照護獲得啟發,現在在大學主修護理學位。

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