Chemotherapy is the use of medicines to kill or reduce the spread of cancer cells. Chemotherapy is given as cycles and may be given once a day, once a week or even once a month. This depends on the type of cancer and the best regimen (course) as determined by research. Chemotherapy, unlike radiation (which treats only the part of the body exposed to the radiation), treats the entire body. As a result, any cells that may have escaped from where the cancer originated are treated.

A doctor who prescribes chemotherapy is known as a medical oncologist.

Depending on what type of cancer you have and whether it has spread, your doctor may use chemotherapy to:

• Eliminate all cancer cells in your body, even when cancer is widespread
• Prolong your life by controlling cancer growth and spread or
• Relieve symptoms and improve your quality of life.

Most chemotherapy drugs are given in one of the following ways:

• You might take a tablet or medicine orally (swallow)
• It may be given intravenously as an injection over a short period of time or as an infusion over a longer period of time. For these treatments you come into the Department usually for part of the day.

Side effects

Some people have no side effects at all from chemotherapy. Sometimes, however, chemotherapy will make you feel sick. As each type of chemotherapy has different side effects they will be discussed with you prior to starting any treatment so you know what to expect. Chemotherapy targets cells that are quickly dividing, whether it's a cancer cell or not. Therefore, some non-cancer cells that divide quickly are also damaged. The following is a list of some normal cells that divide quickly in the body and may be susceptible to the effects of chemotherapy:

• Cells in your hair (can cause hair loss)
• Cells of the skin and mouth (can cause sores in your mouth and dry skin)
• Cells in your stomach and intestines (can cause you to feel sick, vomit or have diarrhoea)
• Cells in your bone marrow. This is where your red and white blood cells are made. White blood cells fight infections, so temporarily you are very prone to these and they can become serious. Loss of red blood cells can make you anaemic and tired.

There are many medicines you can take to reduce or lessen these unwanted effects of chemotherapy.

In some cases, chemotherapy may be the only treatment you need. More often, it's used in conjunction with other treatments, such as surgery or radiation, to improve results. For example, you may receive:

• Neoadjuvant chemotherapy. The goal of neoadjuvant therapy is to reduce the size of a tumour with chemotherapy before surgery or radiation therapy.
• Adjuvant chemotherapy. Given after surgery or radiation, the goal of adjuvant chemotherapy is to eliminate any cancer cells that might linger in your body following earlier treatments.

Radiation therapy uses special equipment to deliver high doses of radiation (beam of x-rays) to cancerous tumours, to kill or damage them so they cannot grow or spread. Normal cells may be affected by radiation, but most appear to recover fully from the effects of the treatment. Radiation therapy affects only the tumour and the surrounding area. Some cancers are very sensitive to radiation but not all.

Radiotherapy is usually given in small doses over a period of time; this is known as a course. A doctor who manages your radiotherapy is called a radiation oncologist.

Some common side effects of radiation treatment include:

• Fatigue or tiredness
• During the first 2 weeks of treatment, a faint and short lasting redness may occur on your skin. Dryness and peeling of the skin may occur in 3 to 4 weeks. The skin over the treatment area may become darker.
• Mucositis (inflammation of the lining of the mouth) is a temporary side effect that may happen when radiation is given to the head and neck area.
• Radiation to the head and neck area can increase your chances of getting cavities. Before starting radiation therapy, notify your dentist and plan for a complete check-up.
• When radiation treatments include the chest area, the lungs can be affected and you may experience shortness of breath or cough.
• Radiation to the abdomen may result in swelling and inflammation of the intestines, causing nausea, vomiting, or diarrhoea.

Service types: Cancer diagnosis process.

Accurate diagnosis is essential in sarcoma care. The following biopsy types are performed:

• Core needle biopsy
• Open/incisional biopsy
• Image‑guided biopsy (CT or ultrasound‑guided)

All suspected sarcomas should be discussed at the Sarcoma MDM before biopsy to ensure the correct approach and avoid compromising future surgery.

Pre‑Hab (Pre‑habilitation) Clinics

Pre‑habilitation is an important part of the sarcoma pathway. The Northern Regional Sarcoma Service offers Pre‑Hab Clinics to help patients prepare physically, mentally, and practically for major surgery or treatment.

Pre‑Hab may include:

• Physiotherapy and mobility optimisation
• Nutrition support
• Psychological and emotional preparation
• Smoking cessation support
• Pre‑operative education
• Planning for recovery and rehabilitation

The goal is to improve surgical outcomes, reduce complications, and support patients and whānau through treatment.

Post‑Operative Support

Following surgery, patients receive coordinated support from the Sarcoma team, including:

• Education and ongoing support from Sarcoma Nurse Specialists
• Wound care guidance
• Physiotherapy and rehabilitation planning
• Pain management support
• Follow‑up appointments for surveillance and recovery

These minimally invasive treatments may be used for selected metastatic or recurrent sarcoma lesions, particularly in the lung, liver, or bone, depending on tumour type and location:

• Thermal Ablation Uses heat (radiofrequency or microwave energy) to destroy tumour tissue.
• Cryotherapy (Cryoablation) Uses extreme cold to freeze and destroy cancer cells. Often used for bone lesions or small soft‑tissue metastases.

Ablation and cryotherapy are performed in collaboration with Interventional Radiology and are considered on a case‑by‑case basis following MDM review.