<b>Cure</b>
The best chance for a cure is an isolated LMS tumor that was surgically excised with wide, clear margins, while it was small. Even some of these patients have recurrences or metastases, though the 'still clear' rate may be as high as 80 or 90% at 5 years.
A larger, high grade tumor is much more likely to recur or metastasize. The rate of recurrence or metastasis may be as high as 80% or more for these tumors.

<b>Local Recurrences</b> 
With a local recurrence, if you can have it surgically excised with wide, clear margins, you may again have a chance for cure. The oncologists often use radiation in the area as well, adjuvantly, in this situation. If you have a c-kit positive GIST , and if you respond to STI-571...it is possible that you might instead choose this option.

<b>Recurrent Local Recurrence</b> 
is again treated surgically if possible, and/or radiation or chemotherapy as the oncologist and the patient decide.

<b>Metastases</b> 
With a metastasis, if you can have it surgically excised with wide, clear margins, you may again have a chance for a cure. However, you are likely to get more metastases. If you are c-kit positive, if you respond to STI-571...it is possible that you might instead choose this option.
Once the metastases present are either inoperable, or too numerous to operate upon, you will probably choose chemotherapy.

<b>Chemotherapy</b> 
Doxorubicin, the chemotoxic agent that is most successful against LMS so far, is not that successful. About 30% of the patients will experience a partial success rate. A very, very few may go into what looks like complete remission. The rest will not respond to Doxorubicin. And the response does not last that long [months]. Doxorubicin is also very toxic to heart, bone marrow, and liver. Its cardiotoxicity is so powerful, that there is a lifetime dosage of doxorubicin that must not be exceeded. 

Presently, in the literature, chemotherapy regimens containing Doxorubicin are the chemotherapeutic choices with the highest response rates. There are, however, other choices of agents, and many clinical trials of other treatments going on.

<b>Why Clinical Trials?</b>

When there are no GOOD treatments for a condition, there are often MANY treatments offered. There are other chemotherapy agents, and other treatment options...THAT is why the clinical trials sections of all the sites are so important for people with LMS. 

<b>Why bother?</b>

<b>BECAUSE</b> you cannot depend solely upon your doctor, even if the doctor is a sarcoma oncologist. You must find out about these possibilities yourself.

<b>BECAUSE</b>, essentially, you are choosing to continue living, taking chemo trials as appropriate, until either you are very lucky and go into complete remission, or the tumors grow despite all chemo- or other therapy, or your bone marrow succumbs to myelodysplasia [effect of recurrent chemo and/or radiation on bone marrow]. 

<b>BECAUSE</b> the era of designer drugs is upon us. Those LMS patients who have GIST, have a drug which is a specific poison for their tumor. There are enzyme systems in LMS that are vulnerable to development of other, similar designer drugs. The idea is to stay alive until the drug is developed to which the majority of LMS tumors will respond. 
