We treat patients from Victoria, regional New South Wales, Tasmania, Canberra and South Australia. Like all our tumour streams, the Sarcoma Service is a collaboration with clinical partners, providing coordinated and comprehensive cancer care.
Our history
The Victorian Bone and Soft Tissue (Sarcoma) Tumour Service was originally established in 1996 as a collaborative service between Peter Mac and St Vincent’s Hospital Melbourne. Since this time, it has built a national and international reputation as a tertiary referral service that provides comprehensive multidisciplinary sarcoma care.
Sarcoma referrals
Please refer to us any patients with a lump that you suspect may be a tumour as soon as you can. Any lump 5cm (five centimetres - about half the length of the long edge of a credit card) or greater, or deep to the deep fascia, should be considered a sarcoma until proven otherwise.
Do not:
- Biopsy the lump before referral
- Organise for the lump to be excised before referral
- Base your decision about the diagnosis of the lump on an ultrasound
Contact the Sarcoma Nurse Consultant for assistance in organising an appointment for your patient.
Visit the Sarcoma Referral Guidelines and referrals page for further information.
Clinics
We run the following clinics:
- Peter Mac – Wednesday 9:30 to 12:30
- St Vincent’s Hospital – Monday 9:30 to 12:30
Sarcoma patient pathway
Patients with sarcoma present to their general practitioners either with unremitting pain (bone) or a painless growing lump (soft tissue).
1. Referral
Patients with sarcoma present to their general practitioners either with unremitting pain (bone) or a painless growing lump (soft tissue).
After preliminary investigations to confirm a lump or bone abnormality, general practitioners often refer patients to an orthopaedic surgeon, a general surgeon, or a specialist bone and soft tissue sarcoma expert.
The appropriate management from this point is referral to a tumour centre or bone and soft tissue sarcoma expert for investigation, biopsy and treatment if required.
2. Diagnosis
Diagnosis is made after obtaining a history, performing a physical examination and obtaining investigations including a biopsy.
Investigations are best performed prior to biopsy to avoid biopsy artefacts from confounding the results of anatomic imaging.
Appropriate imaging delineates the local tumour manifestation and any systemic spread.
Relevant imaging includes plain radiographs of the affected limb or body part, MRI scan of the body part, CT chest and nuclear scans.
3. Pathology
Biopsy for histologic examination is best performed after anatomic imaging of the tumour.
The safest form of biopsy is an image-guided biopsy to target the most metabolically active area of the tumour and to avoid areas of necrosis. Pre-biopsy MRI or CT scan is very useful to plan biopsy.
Biopsy should be performed in line with the operative incision to allow excision of the biopsy track.
Discussion of the position of the biopsy track with a bone and soft tissue sarcoma surgeon is strongly recommended to avoid complications and to allow optimal positioning of the biopsy site. This is best undertaken under the supervision of or after consultation with a bone and soft tissue tumour surgeon.
4. Determination of treatment (achieving multidisciplinary care)
The results of the imaging and biopsy are discussed in a multidisciplinary setting where expert opinions related to the diagnosis and subsequent treatment can be offered.
Isolated Limb Perfusion (ILP)
Isolated Limb Perfusion (ILP) is a surgical procedure where we deliver chemotherapy into a limb (arm or leg) affected by a tumour. This is a type of “regional chemotherapy,” where we can administer very high doses of chemotherapy directly to the tumour. By isolating the limb from the rest of your body’s blood supply we can distribute the drugs just to the limb. This means that ILP treats the tumour and avoids many of the toxic side effects of chemotherapy.
If you are a clinician with a patient for whom ILP may be suitable or interested in enquiring about ILP, we would be delighted to be contacted for advice or an opinion.
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Pages related to sarcoma
Go back to the Oncology information for health professionals page