Anyone with a suspected sarcoma should be referred to a specialist sarcoma team for confirmation of diagnosis and for treatment of this form of cancer.
This is a team of experts from a wide range of healthcare professions called a multidisciplinary team (MDT).
A sarcoma MDT will be based at a sarcoma specialist centre. Your MDT will discuss your case and your sarcoma specialist or sarcoma clinical nurse specialist will talk you through your options so you are included in deciding what treatment is best for you.
All sarcoma MDTs in the UK treat soft tissue sarcoma; however, there are only five designated MDTs that treat both bone sarcoma and soft tissue sarcoma. If you have a soft tissue sarcoma, it is likely that you will have your case seen by the MDT closest to where you live. If you have a bone sarcoma you will be referred to the nearest sarcoma MDT that treats both bone and soft tissue. This may mean travelling some distance from your home to receive treatment.
Core members of your MDT
Each MDT must have certain members with specialist expertise to ensure the team works effectively. These are called core members. The core members of a sarcoma MDT are defined in the National Cancer Peer Review Manual for cancer services: sarcoma measures and the NICE quality standard for sarcoma.
Key worker/Clinical Nurse Specialist
Offers support and advice, and acts as an important point of contact for patients when they have a concern.
Treats cancer through the removal of tumours - your surgeon will have special expertise in sarcoma.
A doctor who specialises in cancer treatment other than surgery, for example, chemotherapy or radiotherapy.
A doctor who specialises in diagnosing medical conditions through images, for example, x-rays.
A doctor who identifies disease by studying a tissue sample.
Extended team members
Sarcoma MDTs may also have extended team members who work as part of the core team and attend sarcoma MDT meetings where appropriate. They may not always be based at the same hospital site as the core MDT.
Extended team members include:
Sarcoma specialist physiotherapist
Advises on exercises to help with rehabilitation before, during and after treatment with surgery, radiotherapy and chemotherapy.
Advises on activities of daily life and equipment to assist recovery and independent living. Also works with local services to ensure patients are properly supported once they leave hospital.
Provides care for anyone who requires an artificial replacement for a lost limb called a prosthesis. They design and select the best possible prosthesis for the patient and make adjustments to maximise its performance during the fitting.
Provides care for anyone who requires an orthosis, a device to support or control part of the body such as splints, braces and special footwear. Orthoses aid movement and relieve discomfort.
Advises people on what to eat in order to lead a healthy lifestyle. They may be involved in the rehabilitation of those who have had surgery to the gastrointestinal tract.
Provides advice and support to people who are going through difficult times. They may help you access services in your local community and help people find solutions to their problems.
Counsellor or psychologist
Offers emotional and psychological support to people.
Some types of sarcoma are treated in MDTs that do not treat sarcoma specifically but have expertise in treating the part of the body that is affected. There should be clear pathways between the site-specific MDT and the sarcoma MDT to ensure there is sufficient sarcoma specialist input into the treatment plan.
Members of site-specific MDTs who are not specialists in sarcoma, may also liaise with the sarcoma MDT to offer their expertise in treating sarcoma patients depending on what part of the body is affected.
These could include:
Specialises in surgery of the bones, joints and other structures involved in making the body move.
Specialises in surgery of the organs in the chest including the heart, lungs and oesophagus.
Specialises in reconstruction. They may be involved in the treatment of skin sarcomas or in reconstruction following surgery, for example, if you need a skin graft.
Head and neck surgeon
Specialises in surgery of the head and neck including the ears, nose and throat as well as skull-based surgery.
Specialises in treatment other than surgery of cancer of the female reproductive system, for example, chemotherapy and radiotherapy.
Specialises in surgery of the female reproductive organs.
Specialises in surgery of the GI tract – a long tube running through the body from the oesophagus (gullet) to the anus (back passage)
Specialises in surgery of the vascular system – the arteries and veins.
A surgeon who specialises in the treatment of disorders of the central nervous system (brain and spinal cord) and the peripheral nervous system (the nerves outside of the brain and spinal cord). They may be involved in the treatment of patients with sarcomas affecting the spine, such as chordoma.
Questions to consider
You may find it useful to ask the following questions to find out more about your MDT:
- Has my case been discussed by a sarcoma MDT?
- What was their decision?
- Where is my MDT based?
- Who is in my MDT?
- Who is my key worker?