What Is Ewing Sarcoma?
Ewing sarcoma is the 2nd most common cancerous bone tumor that affects children, teens, and young adults. It's rare, with only about 250 cases each year in the U.S.
Most often, Ewing sarcoma starts in the bone or soft tissue. It can then spread to other organs, most commonly the lung.
Most Ewing sarcoma tumors occur in teens, but the disease can also happen at a younger age.
What Causes Ewing Sarcoma?
A chromosome rearrangement between chromosomes 11 and 22 causes most Ewing sarcoma cases, often involving the genes EWS and FLI1. This causes a fusion of genes referred to as a fusion transcript.
The fusion transcript changes gene expression and drives the cancer. Detecting this fusion transcript helps us diagnose Ewing sarcoma.
Though there's sometimes trauma or injury when diagnosed, it brings Ewing sarcoma to light rather than causes it.
What Are the Symptoms of Ewing Sarcoma?
While each child's symptoms may differ, the most common symptoms of Ewing sarcoma include:
- Pain around the tumor site.
- Swelling or redness around the tumor site.
- Fever.
- Weight loss and a decreased appetite.
- Fatigue.
- Paralysis or incontinence (if the tumor is in the spinal region).
- Numbness, tingling, and paralysis (if the tumor is pressing on a nerve).
The symptoms of Ewing sarcoma may mimic those of other health issues. Always consult your child's doctor for a diagnosis.
How Do Doctors Diagnose Ewing Sarcoma?
To diagnose your child, the doctor will take a complete health history and do a physical exam.
They'll also order tests and do other techniques, such as:
- Imaging tests, such as X-rays, bone scans, MRIs, CT scans, and PET scans.
- Blood tests.
- A biopsy to remove tissue from the tumor to study under a microscope for cancer and other abnormal cells.
Ewing sarcoma can be tough to tell apart from other tumors like it. Doctors often have to exclude other common solid tumors and use genetic studies.
How Do Doctors Treat Ewing Sarcoma?
Your doctor will base your child's treatment on factors such as:
- Their age, overall health, and health history
- The extent of the disease.
- How well they do with certain drugs or other treatments.
- What doctors expect the course of the disease to be.
- Your input.
Ewing sarcoma treatments
Treatment for Ewing sarcoma may include one or more of the following:
- Surgery.
- Chemotherapy.
- Radiation.
- Rehab, including physical and occupational therapy and psychosocial adaptation.
- Prosthesis fitting and training.
- Care for treatment side effects.
- Drugs to prevent and treat infections.
- Follow-up care, to learn your child's response to treatment, detect recurrent disease, and manage late effects of treatment.
Long-Term Outlook for Children with Ewing Sarcoma
The prognosis for a child with Ewing sarcoma depends on:
- The extent of the disease.
- The size of the tumor and where it is.
- If it has spread.
- How the tumor responds to treatment.
- Your child's age and overall health.
- How your child does with certain medicines and treatment methods.
- Advances in treatment.
As with any cancer, prognosis and long-term survival can vary greatly from child to child. Each child is unique.
We structure our treatment around your child's needs.
Prompt and aggressive care are vital for the best outlook. Follow-up care is also crucial.
Children who survive Ewing sarcoma can have late effects of radiation and chemo. The cancer can also recur.
Experts are always finding new and improved ways to treat Ewing sarcoma and to decrease side effects.
Why Choose UPMC Children's Hospital of Pittsburgh for Ewing Sarcoma Care?
At UPMC Children's Hospital, our advanced training helps us give children and teens with Ewing sarcoma the best care.
Our combined team includes world-renowned experts in:
We also work with other experts, like those in pathology, nursing, physical and occupational therapy, and psychosocial services.
More reasons to choose us for your child's Ewing sarcoma care
At UPMC Children's, we:
- Tailor a unique treatment plan to address your child's needs and health issues.
- Offer a full range of cutting-edge treatments for children with Ewing sarcoma, including minimally invasive techniques, chemo, and radiation therapy.
- Give your child access to cutting-edge research. The focus of the Bailey Lab is to find better ways to target and treat Ewing sarcoma.
We're also a member of the Children's Oncology Group (COG) — the world's largest group devoted to childhood cancer research. This provides access to nearly 100 active clinical trials.
