Ewing sarcoma

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:

• • 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.