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Sarcoma

View Sarcoma Treatment in Children

Duke’s sarcoma specialists are nationally recognized for their diagnosis and treatment of sarcomas. The team of medical, pediatric, radiation, surgical oncologists, and others is experienced in treating all types of rare sarcomas and offers the latest treatment options to preserve healthy tissue and bone, including comprehensive limb-sparing surgeries to avoid the need for amputation. We help you improve your chances for a positive outcome.

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About Sarcoma

Sarcomas are rare benign or malignant tumors that affect bone, muscle, fat, and other connective tissues in the body.

The most common sarcomas of bone include osteosarcoma, chondrosarcoma, and Ewing sarcoma.
The most common sarcomas of soft tissue include undifferentiated pleomorphic sarcoma, leiomyosarcoma, and liposarcoma.

While there are many different types of sarcomas, the disease typically appears in two ways: Bone sarcoma typically are painful, soft tissue sarcoma typically present with a growing mass. See your doctor if you find notice a growing, painless lump larger than a golf ball, or have significant bone pain with or without swelling.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Diagnosing Sarcoma

Multiple tests may be performed to determine the type of sarcoma, its location, and stage.

Imaging Tests

An MRI or CT scan produces high-resolution, detailed images that help us pinpoint the location of your tumor. A chest X-ray, CT, or PET scan can help determine if cancer has spread to your lungs or elsewhere in your body.

Biopsy

During a biopsy, a tissue sample from the tumor is removed and examined under a microscope. This may be done in the operating room or outside the operating room, in the clinic with a needle. Needle biopsies may be paired with an ultrasound or CT scan to guide your doctor to the right location in your body.

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Sarcoma Treatments

After sarcoma is diagnosed, it is graded on a scale of one (lowest) to three (highest) based its appearance under a microscope. Our doctors will determine your treatment based on the grade. Many sarcoma treatments include a combination of systemic therapy, radiation therapy, and surgery.

Systemic Therapy

Systemic therapy includes traditional chemotherapy, immunotherapy, and targeted therapies. Chemotherapy kills cancer cells or stops them from growing and is used to treat some types of sarcomas, including most sarcomas of bone. Most soft tissue sarcomas that have not spread to other parts of your body can be treated without chemotherapy. Immunotherapy may be recommended for some soft tissue sarcomas. Our oncologists consider your specific diagnosis, anticipated risks and benefits, and other factors before recommending systemic therapy as part of your personalized treatment plan, and you may be eligible to participate in a cutting-edge clinical trial.

TCR T-Cell Therapy

We are an authorized treatment center for the first FDA-approved TCR T-cell therapy (afamitresgene autoleucel, also known as Tecelra), which uses re-engineered versions of your own cells to find and fight cancer cells. If you have synovial sarcoma, you may be a candidate for this one-time therapy.

TCR therapy may be given in the Duke Blood Cancer Center’s Day Hospital. Open daily, the Day Hospital is staffed by a dedicated team that includes hematologic-oncologists, physician assistants, nurse practitioners, a dedicated pharmacist, and skilled nurses.

Radiation Therapy

Radiation therapy kills or slows the growth of cancer cells by targeting tumors with high-energy radiation beams. It may be recommended before or after surgery to reduce the chances of cancer returning. Your type of sarcoma, its location, and its size indicates whether and what type of radiation therapy may be recommended as part of your treatment plan. Radiation therapy may be performed before or after surgery.

External Beam Radiotherapy
The most common type of radiotherapy, external beam is done in the radiation oncology department over a course that may range from days to weeks.
Intraoperative Radiotherapy
A machine delivers targeted radiation to a surgical site after a tumor is removed. This kind of precision reduces potential damage to surrounding tissue and organs at the former site of the tumor.
Brachytherapy
Using a long, thin, flexible catheter, a "seed" is implanted inside your body to deliver doses of radiation therapy to a targeted area. This form of radiation can prevent tumors from recurring after surgical removal.

Your radiation oncologist will discuss a radiation plan with you if that's best for your condition.

Related Treatments and Services

Wide Local Resection

Surgeons remove cancerous cells and a small section of healthy tissue around the tumor to make sure no sarcoma is left behind. In some cases, additional steps may be needed to reconstruct bone or soft tissue that’s removed to make sure you experience optimal recovery.

Advanced Bone and Joint Reconstruction

Replaces bones damaged by cancer with a customized artificial joint for the hip, knee, shoulder, or elbow. Titanium 3-D printed reconstruction may be recommended as part of your personalized treatment plan.

Vascularized Bone Grafting

Replaces a diseased bone with healthy bone and blood vessels from your own body. A new, healthy bone is typically grafted from a piece taken from your fibula, the smaller of two bones in your calf.

Rotationplasty

Our surgeons can amputate above the knee and re-attach your ankle and foot to your thigh to replace your removed, diseased knee joint. You may work with our physical therapists and prosthetists to learn to use a custom prosthetic leg to restore your ability to walk with the function of a below-knee amputation instead of an above-knee amputation.

Amputation

We will explore all treatment options before recommending amputation, which removes all or part of an arm or leg to make sure your cancer is gone.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025–2026.

Why Choose Duke

The Duke Cancer Institute

The Duke Cancer Institute brings together the extensive resources of Duke University, Duke Health, and the Duke Comprehensive Cancer Center. We are committed to making innovative discoveries, developing new ways to prevent, diagnose, and treat cancer, and delivering those therapies in a patient- and family-centric way.

Experienced Sarcoma Center

As a National Cancer Institute-designated Comprehensive Cancer Center, we offer a level of expertise found only in the top cancer centers across the country. We are also part of the Sarcoma Alliance for Research through Collaboration, a group of leading U.S. sarcoma centers dedicated to improving the care of sarcoma patients through research and clinical trials.

One of the Few Day Hospitals in the Region

The Blood Cancer Center’s Day Hospital is equipped to administer cellular therapy, chemotherapy and other blood products in a safe, outpatient setting. This allows you to receive your treatment without being hospitalized and return home or to a nearby apartment every night during your therapy. The Day Hospital is staffed by a dedicated team that includes hematologic-oncologists, physician assistants, nurse practitioners, a dedicated pharmacist, and skilled nurses who monitor you during your treatment.

Convenient Care from a Team of Specialists

Because sarcoma is a rare and complex disease, the National Comprehensive Cancer Network recommends that you be treated by a team of specialists. Our team includes a radiation oncologist, medical oncologist, and orthopaedic surgeon who will all meet with you on the same day and coordinate your care. You leave your visit with a thorough understanding of your treatment options and with a comprehensive treatment plan in place.

Clinical Trials at Duke

Our active research efforts mean you may be eligible to participate in our clinical trials, which provide access to new therapies and new ways to treat cancer before they are approved.

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Robust Sarcoma Research Program

Sarcoma research at Duke is focuses on earlier diagnosis, novel treatments and better long-term outcomes for patients with sarcoma. For example, based on a large international trial originated and run by Duke sarcoma rearchers, immunotherapy may be recommended for some soft tissue sarcomas.

Support for You and Your Family

Our comprehensive support services range from helping to minimize the side effects of cancer treatment to coping with the emotional and psychological effects of diagnosis and treatment. We collaborate closely with Duke's Teen and Young Adult Oncology Program, which offers age-specific medical care, mental health services, peer connection opportunities, and more. View all of our cancer support groups in our event calendar.

This page was medically reviewed on 05/08/2026 by

Juneko Grilley-Olson, MD | Medical Oncologist