Ewing Sarcoma

Ewing sarcoma is a type of cancer that primarily affects the bones. It is the second most frequently occurring bone cancer after osteosarcoma. Children and adolescents are affected most often. In the United States, the incidence is 1 per million individuals.

What are its main signs and symptoms?

Pain and fluid accumulation are the chief symptoms. There is a risk of bone fracture as well. Other symptoms include:

• Raised body temperature without a known reason
• Feeling tired
• Nodules or lump under the skin, especially in the armpits, limbs, chest, or the pelvic region

What are the main causes?

The actual cause is not known; however, it is transmitted genetically. It is an acquired genetic defect. The two genes that are involved include:

• EWSR1 on number 22 chromosome
• FLI1 on number 11 chromosome

How is it diagnosed and treated?

The diagnostic methodology mainly includes:

• Examining the patient thoroughly and taking medical history
• Imaging:
  • MRI scan
  • CT scan
• Positron emission tomography (PET) scan
• Bone marrow:
  • Aspiration
  • Biopsy
• Blood tests like C- reactive protein, erythrocyte sedimentation rate

Treatment includes:

• Chemotherapy
• Radiation therapy
• Surgery

If cancer recurs too often, the use of stem cell therapy may be preferred. Other therapies may include:

• Involvement of monoclonal antibodies
• Antigen-targeting immunotherapy

The survival rates depend on the stage of cancer and other factors like the size of the tumour, lactate dehydrogenase (LDH) levels, tolerance to the treatment, and individuals being under 10 years of age.

It is best to have follow-up schedules to manage treatment progress. All the tests may be ordered again usually 2-3 months from the treatment to assess the initial phase of the treatment. These tumours tend to recur even after many years.

It is important to provide emotional support to the patient.

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2. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Ewing Sarcoma Treatment
3. Genetic home reference. Ewing sarcoma. USA.gov U.S. Department of Health & Human Services. [internet].
4. Science Direct (Elsevier) [Internet]; Trends in incidence of Ewing sarcoma of bone in India – Evidence from the National Cancer Registry Programme (1982–2011)
5. Ramaswamy A, Rekhi B, Bakhshi S, Hingmire S, Agarwal M. Indian data on bone and soft tissue sarcomas: A summary of published study results. South Asian J Cancer. 2016 Jul-Sep;5(3):138-45. PMID: 27606300
6. American Cancer Society [internet]. Atlanta (GA), USA; Living as a Ewing Tumor Survivor