What is Ewing Sarcoma?

Ewing sarcoma is a type of bone cancer that most often affects children and teens. It originates in the cells inside or on the exterior of the bone, in muscle, fat, fibrous tissue or blood vessels. These tumors most often form along the backbone, the pelvis, arms and legs.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of Ewing sarcoma. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Ewing sarcoma symptoms can include:

• Pain, tenderness, stiffness or swelling in the leg, chest, back or pelvis that does not lessen over time
• Swelling and limited range of motion in a joint
• A bump for no known reason that doesn’t go away
• Fever for no known reason
• A broken bone that happens without injury

Diagnosis

We use advanced diagnostic procedures and technology to effectively diagnose, stage, inform treatment and carefully monitor bone cancer. Common diagnostic procedures can include:

Biopsy: During this test, a sample is removed from the tissue or tumor for laboratory testing. Testing can tell the physician whether the tissue is cancerous and, if so, what type of cancer is present. Testing will also reveal the cancer’s grade and its potential to become aggressive. The biopsy can be performed with a needle or through a surgical procedure.

Bone scan: This test can identify bone damage, detect cancer in the bones and monitor problems such as infection and trauma to the bones. A bone scan can often find problems days to months earlier than a regular X-ray. A small amount of radioactive material is injected into a blood vessel, travels through the bloodstream, collects in the bones and is detected by a scanner.

Computed tomography (CT) scan: A series of detailed pictures, taken from different angles, are created by a computer linked to an X-ray machine.

Magnetic resonance imaging (MRI): This test uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body without using X-rays.

Positron emission tomography (PET) scan: This imaging test uses a radioactive substance called a tracer to look for disease in the body.

X-ray: This test can show the location, size and shape of a bone tumor. If X-rays suggest that an abnormal area may be cancer, the physician is likely to recommend other imaging tests.

Causes

Bone cancers like Ewing sarcoma arise from an error in a cell’s DNA, which causes uncontrolled cell growth. Behaviors and lifestyle factors do not contribute to the development of Ewing sarcoma.

Risk Factors

Risk factors that can contribute to Ewing sarcoma include:

Age: Ewing sarcoma typically affects children, adolescents and young adults.

Genetic syndromes: Certain rare syndromes passed through families increase the risk of bone cancer, including Li-Fraumeni syndrome and hereditary retinoblastoma.

Paget’s disease of bone: In older adults, Paget’s disease of bone – a chronic disorder that can cause enlarged and misshapen bones – may increase the risk of Ewing sarcoma development.

Race: Ewing sarcoma is found more often in Caucasian people.

Radiation therapy for other cancer: Exposure to large doses of radiation increases the risk of developing bone cancer.

Prevention      

No known lifestyle changes can prevent Ewing sarcoma.

Prognosis

Prognosis for Ewing sarcoma depends on whether the cancer has spread. When found early, Ewing sarcoma can be highly treatable.

Treatment and Recovery

Ewing sarcoma treatment depends on a person’s age and overall health, and whether the cancer has spread to other parts of the body. Sometimes, multiple types of treatments are necessary, including:

Chemotherapy

Special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. Chemotherapy is usually given before and after surgical treatment.

Surgery

In many cases, a surgeon can safely remove a tumor and leave the limb intact. A metal implant or bone graft, or combination of both, may be needed to help healthy tissue grow in the affected area of the bone. In some cases, the size or location of a tumor may require amputation of the limb as the best option to help the patient return to a functional life.

Radiation Therapy

High-energy radiation is administered to the affected bone in order to kill cancer cells. Most often, radiation treatments are given five days a week for several weeks.

Complications

Complications of Ewing sarcoma can include:

Anemia: This condition, which develops when blood lacks enough healthy red blood cells or hemoglobin, can be a complication of chemotherapy.

Fractures: Cancerous bones become progressively weaker and may break easily under stress.

Increased blood calcium: As cancer attacks the bone, more calcium may be released into the bloodstream, which may lead to dizziness, trouble thinking, cramping, constipation and/or kidney stones.

Increased bruising or bleeding: This is a common side effect of chemotherapy and related anemia.

Pain: This often stems from the tumor site and can get worse as cancer progresses.

Metastasis: Ewing sarcoma cells can spread through the bloodstream or lymphatic system to other areas of the body.

Osteomyelitis: Patients undergoing treatment for bone cancer may be at an increased risk for this bone infection.