Catholic University Catholic Hematology Hospital

Overview

Ewing's sarcoma is a type of cancer that primarily affects the bones, similar to osteosarcoma, which also occurs in the bones. However, Ewing's sarcoma differs in that it can also develop in the soft tissues of the body, not just the bones. Osteosarcoma tends to happen more often in the long bones of the arms and legs, whereas Ewing's sarcoma doesn't play favorites with location—it can appear in the central bones of the body, like the pelvis or the chest wall, as well as in the limbs.

Causes and Symptoms

Certain cancers, like Ewing's sarcoma, don't have a known cause, but sometimes, genetic factors or exposure to radiation might play a role. In some patients with Ewing's sarcoma, a specific change can be seen in their DNA, where parts of chromosomes 11 and 22 have swapped places. This is something that genetic tests can pick up.

The symptoms of Ewing's sarcoma can vary depending on where the tumor is growing. But generally, people might notice pain or a lump where the tumor is, fevers, and sometimes even fractures that happen without a clear reason. The pain can come and go, and because it often shows up during the teenage years, it's sometimes brushed off as just normal growing pains, which unfortunately can mean the cancer isn't caught as early as we'd like. Ewing's sarcoma tends to develop in certain areas of the body more than others – the pelvis, thigh bone (femur), the long bones in the arms, and the chest wall are the usual spots.

Treatment

The battle against Ewing's sarcoma involves a combination of treatments: surgery, radiation therapy, and chemotherapy. Before we move in with surgery or radiation, we start with what's called neoadjuvant chemotherapy. This is a preemptive strike to shrink the main tumor and tackle any potential spread of the cancer (metastases).

Drugs like Vincristine, Doxorubicin, and Cyclophosphamide are the usual suspects in this regimen. Lately, we've also been using Ifosfamide and Etoposide, which have been game-changers in improving the odds of beating this disease. Ewing's sarcoma is more receptive to radiation therapy compared to osteosarcoma, which makes it a strong ally in our local treatment arsenal. But since radiation can interfere with bone growth, especially in younger patients, we often pair it with surgery to get the best results while minimizing long-term side effects.