Ewing'S Sarcoma

Ewing's sarcoma is a cancer of the bone that affects children.

It can occur at any time during childhood and young adulthood although it usually occurs during puberty due to the rapid growth of bones during this period. It is more common in Caucasians.

The tumor usually starts in the long bones, chest or pelvis from where it can spread to other parts of the body mostly the lungs and other bones.

Ewing's sarcoma may also occur in the soft tissues of the trunk, abdominal cavity, limbs and head.

The main symptom of Ewing's sarcoma is pain and swelling at the site of the tumor.

The swollen area can become tender to the touch.

Fractures of the affected bones can also occur for no known reason.

Some patients can experience fever.

The exact cause of Ewing's sarcoma is unknown although it may occur due to the rapid growth of bones in children especially teenagers.

This can be due to genetic mutations which cause normal cells to become cancerous.

When a patient is suspected of having Ewing's sarcoma, the following tests can be carried out to make a diagnosis:

• Biopsy of the tumor
• Bone scan
• X-ray imaging
• CT scan and MRI of the tumor

Blood studies can be carried out to measure the levels of certain substances like lactate dehydrogenase (LDH).
If the amounts of these substances exceed the normal levels, it can be seen as a sign of disease.

Treatment for Ewing's sarcoma includes a combination of chemotherapy, radiation therapy and surgery to remove the tumor.

• Chemotherapy is the use of anti-cancer drugs to kill cancerous cells. This treatment can greatly help to improve the results of the surgical treatment. These anti-cancer drugs are usually given before surgery to suppress the growth of cancer cells and after to destroy the remaining cancerous cells.
• Surgery is performed to remove the primary tumor. Depending on the size of the area affected only a part of the limb can be removed or amputation can be permorfed.
• In radiation therapy, high energy waves are used to kill cancerous cells.

Lifestyle modification like joining a support group can ease the stress that patients with Ewing's sarcoma go through.

The complications seen in Ewing's sarcoma are primarily due to the side effects of the treatments.

Side effects include:

• Nausea and vomiting
• Hair loss
• Increased risk of infection
• Bruising and bleeding
• Tiredness
• Sometimes diarrhea

Radiation therapy can cause ulcers on the skin. Some side effects can occur many years later.

These include:

• Reduction of normal bone growth
• Infertility
• Changes in the function of the lungs
• Increased risk of cancer in the future