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Ewing sarcoma is a rare bone and soft tissues cancer that usually affect children and adolescents. Ewing’s sarcoma typically develops in puberty when young people’s bones are rapidly expanding. Ewing sarcoma affects young men more often than young women. The DNA of cells can change, resulting in abnormal cells that assault healthy tissue and cause Ewing sarcoma.
Ewing sarcoma can develop in any bone, however it typically starts in the pelvic and leg bones. It is less common for this to be found in the limbs, abdomen, chest, or other soft tissues.
The prognosis for those who have Ewing sarcoma has been significantly improved as a result of significant developments in its management. It is advised to continue monitoring for the rest of one’s life to look for any residual effects of aggressive chemotherapy and radiation.
Symptoms
Before the disease to becoming constant, Ewing’s sarcoma symptoms first come and go. When patient have Ewing sarcoma, over 85% of kids and teenagers experience pain. Other symptoms include:
- Tenderness, swelling, or stiffness in the bone or in the tissue around the bone.
- Lumps that may feel warm and soft to the touch near the skin’s surface.
- Bone pain
- Unexplained tiredness
- Unexplained fever
- Sudden weight loss
- Bones that break without injury
If there are any concerning signs and symptoms that the child is experiencing that is persistent and concerning, then seek medical attention.
Causes
The exact cause of Ewing sarcoma is unknown. Doctors are aware that when a cell experiences DNA alterations, Ewing sarcoma starts to form. The instructions that inform a cell what to do are encoded in its DNA. When healthy cells typically die, the alterations instruct the cell to quickly reproduce and remain alive. As a result, abnormal cells accumulate into a mass (tumor), which can penetrate and damage healthy human tissue. The abnormal cells can splinter off and spread (metastasize) throughout the body.
The EWSR1 gene is most frequently affected by DNA alterations in Ewing sarcoma. The cancer cells may be examined for mutations in this gene if the doctor suspects that you have Ewing sarcoma.
Risk factors
The following factor increases the risk factors for Ewing sarcoma:
- Age: Ewing sarcoma can affect any age, but adolescents and teenagers have a higher risk of developing it.
- Hereditary: People with European heritage have a higher incidence of Ewing sarcoma. People with African and East Asian ancestry are substantially less likely to experience it.
Diagnosis
A physical examination is typically the first step in diagnosing Ewing sarcoma to understand better any symptoms the patient may be exhibiting. Based on the results, more tests and procedures can be suggested.
- Imaging tests: Imaging tests assist the healthcare provider in examining the bone problems, detecting malignancy, and identifying indicators of cancer spread. Imaging test may include x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, or bone scan.
- Biopsy: A sample of uncertain cells is obtained by a biopsy and tested in a laboratory. Tests can determine the type of cancer you currently have as well as if the cells are malignant.
Biopsy techniques used to identify Ewing sarcoma include:
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- Needle biopsy: A tiny needle is inserted into the tumor by the healthcare specialist through the patient’s skin. Small bits of tissue are taken out of the tumor with the needle.
- Surgical biopsy: Skin incision is created and either completely removes the tumor (excisional biopsy) or only a piece of the tumor is removed (incisional biopsy).
The biopsy must be carried out by the medical professionals without obstructing upcoming cancer removal procedure. As a result, before the biopsy, request from your doctor a recommendation to a group of specialists with knowledge in the treatment of Ewing sarcoma.
- Laboratory test: This test uses blood samples to examine the function of the child’s kidneys, liver, and other organs. An excessive level of a material in their blood may indicate a sickness or be a side effect of therapy.
- Testing the cancer cells for gene mutations: The EWSR1 gene is typically altered in Ewing sarcoma cells. The EWS-FLI1 gene is most frequently formed by the fusion of the EWSR1 gene with the FLI1 gene. A test to check for these gene alterations in cancer cells can support the diagnosis and provide the healthcare provider with information about how aggressive the disease.
Treatment
Chemotherapy is typically used to treat Ewing sarcoma. Usually, the malignancy is removed surgically. In some cases, other therapies, like radiation therapy, may be used.
- Surgery: The purpose of operation is to eliminate all cancer cells. A little bone fragment or an entire limb may be removed during surgery for Ewing sarcoma. The size, location, and response to chemotherapy of the tumor will all affect whether surgeons can completely remove the disease without amputating the limb.
- Chemotherapy: Chemotherapy is frequently used to start the treatment of Ewing sarcoma. The medications may cause the tumor to shrink, which will make it easier to operate on the cancer and administer radiation therapy to the affected areas. Chemotherapy kills cancer cells by using medications. The typical chemotherapy regimen consists of two or more medications that may be taken orally, intravenously (IV), or both ways. Chemotherapy may help reduce pain and decrease the growth of advanced cancer that has spread to other parts of the body. Chemotherapy treatments may be continued to eliminate any residual cancer cells following surgery or radiation therapy.
- Radiation therapy: High-energy beams, including X-rays and protons, are used in radiation therapy to kill cancer cells. The energy beams used in radiation therapy are given via a machine that moves all around. To lessen the chance of harming surrounding healthy cells, the beams are precisely focused on the location of the Ewing sarcoma.
To kill any cancer cells that may have survived surgery, radiation therapy may be advised. If the Ewing sarcoma is located in an area of the body where surgery is either not possible or would have unfavorable functional consequences, it can potentially be employed as an alternative to surgery.
Radiation therapy can help reduce pain and limit the growth of advanced Ewing sarcomas.
