Rohit Sharma, M.D. Answers Questions On: Soft-Tissue Sarcoma and Melanoma

I think the advantage is that my entire focus is on managing a select number of diseases, so I can bring a different level of expertise to the table in managing those types of cancers.

A surgical oncologist focused on soft-tissue sarcomas and melanomas will be better up-to-date on the latest technologies, treatment options, and medications, versus a generalist who is more of a jack-of-all-trades.

When you focus on one area, I think that brings a very different understanding of the disease process. I think the opportunity for a better outcome is greater.

We offer a wide range of surgical options for management of soft-tissue tumors and skin cancers such as melanoma. This can range from local excisions of the lesions – removing the cancer at its site of origin – to a higher level of complexity. That could mean widely excising the tumor and involving other surgeons – for example, plastic surgeons to help with complex wound reconstruction.

The operations that I perform can extend to evaluation of the regional lymph nodes for cancer related to the specific malignancy an individual has. It can involve extensive lymph node dissection procedures to address cancer that is known to exist in those lymph nodes. And it can also involve procedures to remove areas of metastases when appropriate.

With regard to the sarcomas, we perform when appropriate what are called radical resections of those tumors – removing the tumor as well as contiguous organs – to most aggressively remove the disease in hopes of curing that individual.

We often use a multidisciplinary approach for soft-tissue sarcomas. At times we mate surgical treatment with radiation treatment administered prior to the operation, or after the patient is healed from the surgery. For example, with help from our radiation oncologists we can treat soft-tissue sarcomas with combined brachytherapy, which is the use of catheters in these operative wounds to more precisely deliver radiation treatment to these areas from which the tumor was removed.

One of the challenges that we have with soft-tissue sarcomas and melanomas is that chemotherapies have only had a modest benefit. We’ve had to rely on early detection and aggressive surgical intervention to try to control these diseases before they spread, or before they get large, in the case of soft-tissue sarcomas.

After decades of having only a couple of options in managing melanomas with chemotherapy, we now have several new drugs that really are changing the way we manage the disease. And probably in the next decade, we’ll see the greatest evolution in how we manage melanoma as we better understand these new treatments and gain better insight into the biology of skin cancers.

Similarly, for sarcomas, we have some clinical trials investigating new treatments, which will hopefully result in new therapies.