How Synovial Sarcoma Is Treated

Table of Contents
View All
Table of Contents

Synovial sarcoma is a type of soft tissue cancer that often affects the arms and legs. However, it can also grow in other areas with soft tissue, such as internal organs. Treatment of synovial sarcoma includes surgery to remove the tumor, and often chemotherapy and/or radiation to treat remaining cancer cells.

Doctors performing surgery

FG Trade / Getty Images

Surgery

The primary treatment for synovial sarcoma is surgery to remove the tumor. The type of surgery performed depends on the location and size of the tumor. The goal of surgery is to have “negative margins,” meaning there are no remaining cancer cells at the edge of the tissue that has been removed.

Surgery is also performed with the goal of keeping as much of the affected limb as possible using a procedure called limb-sparing surgery. However, in more severe cases, removal of the tumor requires amputation of part or all of the limb. If cancer has spread to other parts of the body, additional surgeries might also be needed.

While surgery can get rid of your cancer and preserve your affected limb, it can also lead to wound-related complications. In some cases, these complications might require additional surgery.

Potential Complications of Surgery

  • Infection
  • Re-opening of the wound, called dehiscence
  • Tissue death
  • Significant bruising
  • Buildup of fluid under the skin

To reduce your risk of wound-related complications, follow your doctor’s instructions after surgery and immediately report any issues (for example, excess bleeding or drainage) that might arise. Maintaining a healthy body weight and avoiding harmful behaviors such as smoking can also help promote wound healing.

Lymphedema

Surgical removal of synovial sarcoma can further lead to a lifelong condition called lymphedema. This condition most often occurs after surgery on the arms or legs, especially if blood vessels, lymphatic vessels, or lymph nodes were damaged during surgery.

Lymphedema causes excess swelling in the affected area. Skin often feels tight, and you might have a tingling sensation if nerves are compressed.

Unfortunately, there is no cure for lymphedema, but treatments can help manage your symptoms. These include:

  • Exercise
  • Compression wrapping or compression garments
  • Physical or massage therapy
  • Use of a compression pump
  • Surgery (for severe cases)

Lymphedema is more common in patients with previous heart disease and people who have had radiation therapy.

Chemotherapy

Chemotherapy is sometimes used in the treatment of synovial sarcoma. Compared with other soft tissue cancers, synovial sarcoma is considered to be more chemosensitive—meaning, these tumors tend to respond better to the effects of cancer-killing drugs. However, chemotherapy is not used for all patients with this condition, particularly if the tumor was completely removed during surgery.

Chemotherapy is most often used in children and young adults with large tumors that were not able to be completely removed by surgery. The most common drug combination used in chemotherapy for synovial sarcoma is ifosfamide and doxorubicin.

Doxorubicin is also used to help prolong a person’s life when synovial sarcoma has spread to other areas of the body and cannot be removed. This type of treatment, called palliative care, focuses on reducing pain and other negative side effects of serious illness. According to a research review, the average length of survival after beginning this treatment is 18 months.

Side Effects of Chemotherapy

Chemotherapy cannot tell the difference between healthy cells and cancer cells, and this type of treatment has a host of potential side effects. These can include:

  • Hair loss
  • Fatigue
  • Changes in appetite
  • Diarrhea or constipation
  • Weight changes
  • Difficulty with concentration
  • Mood shifts
  • Low red blood cell counts
  • Infection

Other Drug Therapies

Other types of drugs can be used to treat synovial sarcoma if chemotherapy is not successful. A drug called pazopanib has been used to treat patients with advanced soft tissue sarcoma, including synovial sarcoma. Pazopanib works by blocking tumor growth and the growth of blood vessels within the tumor.

Immunotherapy with engineered T-cells is another area being researched for the treatment of synovial sarcoma. This type of treatment teaches a person’s immune system how to recognize and attack cancer cells while also boosting immune cells.

Treatment for cancer can leave you with fatigue, weakness, and decreased range of motion. These side effects can make everyday tasks more difficult. A physical or occupational therapist can address these symptoms and teach you different ways to make daily activities easier.

Radiation

Radiation therapy kills cancer cells using high-energy beams targeted at the affected area. This type of radiation is called external beam radiation therapy. Patients with synovial sarcoma might have radiation before surgery to shrink the tumor and reduce the amount of tissue that has to be removed, or after surgery to kill remaining cancer cells.

Radiation is not without side effects. Patients who receive radiation before surgery are more likely to have wound-related complications afterward, while radiation after surgery can lead to increased joint stiffness. Radiation can damage healthy cells near the affected area, and most people who have this type of treatment experience fatigue as a side effect.

A Word From Verywell

Undergoing treatment for cancer can be overwhelming. Be sure to talk to your doctor about your options and what to expect during your treatment. Consider joining a support group and talking with other patients who are fighting cancer.

Was this page helpful?
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Cancer Institute, Center for Cancer Research. Synovial sarcoma. Updated February 27, 2019.

  2. Gazendam AM, Popovic S, Munir S, Parasu N, Wilson D, Ghert M. Synovial sarcoma: a clinical reviewCurr Oncol. 2021;28(3):1909-1920. doi:10.3390/curroncol28030177

  3. Kennedy S, Mayo Z, Gao Y, Miller BJ. What are the results of surgical treatment of postoperative wound complications in soft tissue sarcoma? A retrospective, multi-center case seriesIowa Orthop J. 2018;38:131-136.

  4. Wu P, Elswick SM, Arkhavan A, et al. Risk factors for lymphedema after thigh sarcoma resection and reconstructionPlast Reconstr Surg Glob Open. 2020;8(7):e2912. doi:10.1097/GOX.0000000000002912

  5. Centers for Disease Control and Prevention. Lymphedema. Updated May 12, 2021.

  6. Desar IME, Fleuren EDG, van der Graaf WTA. Systemic treatment for adults with synovial sarcomaCurr Treat Options Oncol. 2018;19(2):13. doi:10.1007/s11864-018-0525-1

  7. American Cancer Society. Chemotherapy side effects. Updated May 1, 2020.

  8. Cancer Research Institute. What is immunotherapy? Updated October 2020.

  9. American Cancer Society. How radiation therapy is used to treat cancer. Updated December 27, 2019.