Sarcoma Awareness Month: The Critical Role of Multidisciplinary Nursing

July marks Sarcoma Awareness Month, a vital period for the oncology community to focus on a group of rare malignancies that account for less than 1% of all adult cancers. Despite their rarity, sarcomas represent a significant clinical challenge due to the existence of more than 70 distinct subtypes affecting bone and soft tissue.

At NYU Langone’s Perlmutter Cancer Center, experts emphasize that managing these masters of disguise requires highly specialized, multidisciplinary coordination and a dedicated nursing staff.

The challenge of early detection

One of the primary obstacles in sarcoma care is late diagnosis. Lily Walsh, PA, an outpatient physician assistant in orthopedic oncology at Perlmutter Cancer Center, notes that sarcomas often present as "painless lumps or bumps" that are easily dismissed.

"Sarcoma is not caused by trauma, but often patients kind of can associate it with... you do run into things and you bump and you get these bumps," Walsh explained. She urges clinicians to maintain a high index of suspicion, even for incidental findings: "It’s not always just a lipoma or a hematoma or something benign."

A hub for multidisciplinary care

Treatment for sarcoma often involves a complex combination of chemotherapy, radiation, and limb-sparing surgery. To navigate this, Perlmutter utilizes the Bone Extremity and Spinal Tumors (BEST) clinic, where patients can see multiple specialists in a single visit. Walsh highlights the role of nursing and advanced practice providers as the "center point of contact" for these patients.

This coordination extends to multidisciplinary tumor boards, where clinical insights from the bedside are vital. Walsh noted that PAs often bring personal patient preferences to the table: "I think we play a big role in kind of explaining to the others too maybe how the patient's feeling... [saying] ‘this is really what the patient wants."

Addressing psychosocial and functional needs

Ashley Feldman, NP, an adult nurse practitioner with 13 years of experience in orthopedic oncology, highlights the profound emotional and physical toll of these diagnoses. Beyond clinical toxicities, Feldman identifies body dysmorphia and activity changes as major hurdles. "I think patients sometimes struggle with that more than their nausea or pain ... not being able to live the life that they were used to living," Feldman observed.

To combat these declines, NYU integrates nutrition, social work, and "regimented rehab programs" early in the treatment timeline to optimize recovery. Feldman sees her role as providing a necessary perspective during a frightening time.

"We can see the light through the tunnel where they might not be able to right now," she said.

The road to survivorship

The journey does not end with a clean pathology report. Feldman emphasizes the importance of long-term surveillance to monitor for local recurrence or late-onset side effects. A comprehensive survivorship plan involves a partnership with primary care physicians to ensure ongoing health maintenance.

For nurses looking to specialize, Feldman suggests that hands-on experience is "unmatched" by textbooks. "You’re going to learn it from seeing and doing and being hands-on," she said, encouraging nurses to be active participants in tumor boards and to learn from the entire multidisciplinary team.