Ewing Sarcoma Family of Tumors Treatment
General Information About Ewing Sarcoma Family of Tumors
Key Points for this Section
Ewing sarcoma family of tumors is a group of cancers of the bone and of soft tissue.
Ewing sarcoma family of tumors is a group of tumors that form from a certain kind of cell in bone or soft tissue. This family of tumors includes the following:
Ewing tumor of bone. This type of tumor is found in the bones of the legs, arms, chest, trunk, back, or head. There are three types of Ewing tumor of bone:
- Extraosseous Ewing sarcoma (tumor growing in tissue other than bone). This type of soft tissue tumor is found in the trunk, arms, legs, head, and neck.
In some patients, the tumor may have spread by the time it is diagnosed.
Ewing tumors usually occur in teenagers and are more common in boys and Caucasians.
Possible signs of Ewing sarcoma family of tumors include swelling and pain near the tumor.
These and other symptoms may be caused by Ewing sarcoma family of tumors. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
- Pain and/or swelling, most commonly in the arms, legs, chest, back, or pelvis (area between the hips).
- A lump (which may feel warm) in the arms, legs, chest, or pelvis.
- Fever for no known reason.
- A bone that breaks for no known reason.
Tests that examine the bone and soft tissue are used to diagnose and stage Ewing sarcoma family of tumors.
The following tests and procedures may be used to diagnose or stage Ewing sarcoma family of tumors:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as lactate dehydrogenase (LDH), released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
- Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.
- X-ray: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone. Samples are removed from both hipbones. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
- Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
A biopsy is done to diagnose Ewing sarcoma family of tumors.
Cells and tissues are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for signs of cancer. The specialists (pathologist, radiation oncologist, and surgeon) who will treat the patient usually work together to plan
the biopsy. This is done so that the biopsy incision doesn't affect later treatment with surgery to remove the tumor and radiation therapy. It is helpful if the biopsy is done at the same center where treatment will be given.
The following tests may be done on the tissue that is removed:
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) depends on certain factors before and after treatment.
Before treatment, prognosis depends on:
- Whether the tumor has spread to distant parts of the body.
- Where in the body the tumor started.
- How large the tumor is at diagnosis.
- Whether the tumor has certain genetic changes.
- The patient's age. Infants and patients aged younger than 15 years have a better prognosis than adolescents aged 15 years and older, young adults, or adults.
- The patient's gender. Girls have a better prognosis than boys.
- Whether the tumor has just been diagnosed or has recurred (come back).
After treatment, prognosis is affected by:
- Whether the tumor was completely removed by surgery.
- Whether the cancer came back more than two years after the initial treatment.
Treatment options depend on the following:
- Where the tumor is found in the body and how large the tumor is.
- The patient's age and general health.
- The effect the treatment will have on the patient's appearance and important body functions.
- Whether the cancer has just been diagnosed or has recurred (come back).
Decisions about surgery may depend on how well the initial treatment with chemotherapy or radiation therapy works.