Consultants Responsible for the Program
Prof. Mohamed Mahmoud AbdElhakim
What is Ewing sarcoma?
Ewing sarcoma is a type of cancer that grows in bones or in the soft tissue around bones. It often occurs in the leg, pelvis, ribs, or arm.
Ewing sarcoma is the second most common type of pediatric bone tumor. But it is rare. Only about 200 children and young adults are diagnosed with Ewing sarcoma in the United States each year.
Ewing sarcoma is more common in older children and teens.
If the cancer is caught before it spreads, the chance of long-term survival is about 70%. If the cancer has already spread, the chance of a cure is about 30%.
Ewing sarcoma is usually treated with chemotherapy, surgery and/or radiation. Patients can have treatment that has already been studied in clinical trials. Or they may get treatment that is being studied at the time of diagnosis.
Ewing sarcoma symptoms
Symptoms of Ewing sarcoma depend on where the tumor is located. Symptoms might include:
Sarcomas are cancer found in the bone and soft tissue of the body. Watch this video to learn about sarcoma symptoms, diagnosis, and treatment in children.
Pain can get worse over weeks or months. It may even cause your child to wake up at night.
The signs and symptoms of Ewing sarcoma often start out like normal childhood aches and pains. This means that it can take a while before Ewing sarcoma is diagnosed.
Ewing sarcoma risk factors
We do not know why children and young adults develop Ewing sarcoma. But certain factors can increase the risk. These factors include:
Ewing sarcoma does not seem to be passed down in families.
Ewing sarcoma diagnosis
Doctors use several procedures and tests to diagnose Ewing sarcoma. These include:
Ewing sarcoma staging
Although other cancers are classified as stages 1–4, Ewing sarcoma is classified as either localized or metastatic.
Localized means there is a tumor in only 1 place in the body.
Metastatic means the cancer has spread to 1 or more places. These might include:
About 25% of patients have metastatic disease when they are diagnosed. In about half of those patients, the disease has spread to the lungs.
Ewing sarcoma treatment
Ewing sarcoma is usually treated with chemotherapy followed by surgery and more chemotherapy. Radiation therapy may be used in place of surgery or added to the treatment.
Your child may be treated with 3–4 months of chemotherapy before having surgery, radiation or both. Your child may need more chemotherapy after surgery or radiation therapy. The typical length of treatment for Ewing sarcoma is about 8–9 months
Ewing sarcoma prognosis
Survival of Ewing sarcoma depends on several factors:
Patients who have chemotherapy and a single, localized Ewing sarcoma tumor that can be completely removed with surgery have a 70% chance of long-term cure in the United States.
Patients who have cancer that has spread to distant parts of the body at diagnosis have a 15–30% chance of survival, depending on where the cancer has spread.
The prognosis for patients with recurrent Ewing sarcoma is poor. The chance of cure after the cancer has returned (relapsed) is around 10–15% in the U.S.
Patients with recurrent Ewing sarcoma often develop new tumors within the first 2 years of diagnosis. This most often occurs as new growths in the lungs.
Patients who have early recurrence (their Ewing sarcoma comes back within 2 years of diagnosis) are much harder to cure than those who have later recurrence.
Balancing quality of life with cancer-directed therapy is important. Talk to your care team about problems to expect and how to help manage them. Palliative care can help families manage symptoms, promote quality of life, and make informed decisions.
Life after Ewing sarcoma
Monitoring for Ewing sarcoma recurrence
Ewing sarcoma can come back years into survivorship. But it is most common within the first 2 years after treatment ends. The tumor can come back in the same place or in another part of the body.
Your child will need follow-up care to screen for recurrence for a long time after treatment ends. The care team will suggest types of tests and how often they should be done. Imaging tests usually include:
If your child has had Ewing sarcoma in the bone marrow, the care team may also suggest bone marrow tests.
Diagnostics of Ewing Sarcoma
The program includes:
Required documents
Type of program : Outpatient
Expected duration of the program: 15 days
Chemotherapy of Ewing sarcoma
The program includes:
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including laboratory assessment of liver and kidney function, ultrasound scan. Based on the received results, the doctor will elaborate the chemotherapy regimen. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).
Chemotherapy is carried out as the inpatient procedure, with mandatory admission to the hospital. After the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.
After the course of chemotherapy, you will stay under medical supervision in the ward for a few more hours. After the completion of the chemotherapy course you will receive the medical report with detailed recommendations regarding further treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of chemotherapy, if necessary.
Required documents
Type of program : Inpatient
Duration: 7 days
Surgical intervention (Limb salvage surgery)
The program includes:
Required documents
Type of program : Inpatient
Expected duration of the program: 10 days
Radiotherapy of Ewing Sarcoma
The program includes:
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will conduct radiotherapy planning with the help of CT or MRI, make the permanent tattoo marks on the skin and conduct CT simulation in order to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).
Radiation therapy is carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded radiation therapy room, on a special table.
Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.
After the completion of the radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.
Required documents
Type of program : Outpatient
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