Patient education: Ewing sarcoma (The Basics)

What is a Ewing sarcoma? — 

This is a type of cancer that happens most often in the bone. It happens when normal cells in the bone change into abnormal cells and grow out of control. But in some cases, a Ewing sarcoma starts in tissues outside of the bone.

This cancer happens most often in children and teens ages 10 to 20, but it can also happen in adults. A Ewing sarcoma most often affects bones in the legs, arms, or pelvis.

What are the symptoms of a Ewing sarcoma? — 

A Ewing sarcoma usually causes pain and swelling in the area of the cancer. The pain can come and go, but it usually gets worse over weeks to months. The pain is usually worse at night and with exercise. Some people also see or feel a lump on their bone.

People can have other symptoms, too, depending on where the Ewing sarcoma is. For example, if it is close to a joint, it can cause trouble with moving that joint.

Some people also have a fever or weight loss, or feel more tired than usual.

All these symptoms can also be caused by conditions that are not a Ewing sarcoma. But if you have these symptoms, tell your doctor or nurse.

Is there a test for a Ewing sarcoma? — 

Yes. The doctor or nurse will first order an X-ray of the affected bone.

If the X-ray suggests a Ewing sarcoma, the doctor or nurse will order other tests. These might include:

●Blood tests

●Imaging tests – Imaging tests create pictures of the inside of the body. The doctor or nurse will order imaging tests to look at the area that might have a Ewing sarcoma. These tests can also check for cancer in other parts of the body.

●Biopsy of the Ewing sarcoma – The doctor removes a sample from the area that might have cancer. Then, another doctor looks at the sample under a microscope to check.

●Bone marrow biopsy – Bone marrow is the tissue in the center of certain bones. During a bone marrow biopsy, a doctor takes a very small sample of bone marrow. Then, another doctor looks at the sample under a microscope.

What is cancer staging? — 

This is a way to find out if a cancer has spread past the layer of tissue where it began, and, if so, how far.

The right treatment depends a lot on the stage of the Ewing sarcoma and your (or your child's) other medical problems.

How is a Ewing sarcoma treated? — 

It is usually treated with both surgery and chemotherapy:

●Surgery – The type of surgery depends on where the cancer is and how big it is. For cancer in an arm or leg, doctors usually do "limb-sparing" surgery. This is when they remove the cancer without removing the arm or leg. Depending on the type of surgery, the doctor might need to "rebuild" part of the bone after surgery.

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing. People with a Ewing sarcoma usually have chemotherapy both before and after surgery.

Some people with a Ewing sarcoma might be treated with radiation therapy instead of surgery. This involves getting high doses of X-rays (radiation) aimed at the cancer. Radiation kills cancer cells. Some people might have radiation therapy after surgery, especially if their doctor can't remove all the cancer during surgery.

What happens after treatment? — 

The doctor will check you (or your child) regularly to see if the cancer comes back. Follow-up tests can include exams, blood tests, chest X-rays, and imaging tests.

Watch for the symptoms listed above. Having those symptoms could mean the cancer has come back. Tell the doctor or nurse if you have any symptoms.

What happens if the Ewing sarcoma comes back or spreads? — 

You (or your child) might get more surgery, radiation, or chemotherapy.

What else should I do? — 

Follow all the doctor's instructions about visits and tests. It's also important to talk to the doctor about any side effects or problems you (or your child) have during treatment.

Getting treated for a Ewing sarcoma involves making many choices, such as what treatment to have. Always tell the doctors and nurses how you feel about a treatment. Any time you are offered a treatment, ask:

●What are the benefits of this treatment? Is it likely to help me (or my child) live longer? Will it reduce or prevent symptoms?

●What are the downsides of this treatment?

●Are there other options besides this treatment?

●What happens if I (or my child) do not have this treatment?

More on this topic

Patient education: Bone cancer (The Basics)
Patient education: Bone biopsy (The Basics)
Patient education: Bone marrow aspiration and biopsy (The Basics)
Patient education: Chemotherapy (The Basics)
Patient education: External beam radiation therapy (The Basics)
Patient education: Managing pain when you have cancer (The Basics)
Patient education: When your cancer treatment makes you tired (The Basics)
Patient education: Managing loss of appetite and weight loss with cancer (The Basics)
Patient education: Nausea and vomiting with cancer treatment (The Basics)
Patient education: Hair loss from cancer treatment (The Basics)
Patient education: Medical care during advanced illness (The Basics)