Bone and Soft Tissue Oncology

Patient and Family Education

Ewing's Family of Tumors

Treatment

There are three primary treatments for patients with one of the EFTs:

surgery
radiation therapy
chemotherapy

For treating the EFTs, surgery or radiation is often used to remove the local tumor and chemotherapy is then given to kill any cancer cells that remain in the body. A less common but very important type of treatment is called myeloablative therapy with stem cell support.

Surgery

Surgery may be used in certain cases to try to remove the cancer and some of the tissue around it. Surgery may also be used to remove any tumor that is left after chemotherapy or radiation therapy.

Side effects of surgery: The side effects of surgery depend on the location of the tumor and the type of operation, among other factors. Although patients are often uncomfortable during the first few days after surgery, this pain can usually be controlled with medicine. The recovery period after an operation varies from patient to patient.

Radiation Therapy

Radiation therapy uses X-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation for the EFTs usually comes from a machine outside the body (external radiation therapy). Clinical trials are evaluating radiation given inside the body during surgery (intraoperative radiation therapy).

Side effects of radiation: The most common side effects of radiation therapy are tiredness, skin reactions in the treated areas (such as a rash or redness) and loss of appetite. Radiation therapy may also cause a decrease in the number of white blood cells that help protect the body against infection. Most of these side effects can be treated or controlled and in most cases they are not permanent.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill or it may be injected into the body through a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the blood stream, travels through the body and can kill cancer cells throughout the body. When more than one drug is given to kill tumor cells, the treatment is called combination chemotherapy.

Side effects of chemotherapy: Chemotherapy drugs generally fight rapidly dividing cells in the body. Cells that divide rapidly include both the targeted cancer cells and healthy cells in the blood, digestive tract and hair follicles. Depending on which anticancer drugs a patient receives, he or she may experience symptoms when healthy cells are damaged along with the cancer cells. If healthy blood cells are destroyed by chemotherapy, the patient may be more susceptible to infections, bruising or bleeding and fatigue. When cells in the hair roots or digestive tract are affected by anticancer drugs, the patient may have hair loss, nausea, vomiting or mouth sores. Not all chemotherapy patients develop all of these side effects, and the symptoms usually go away during the recovery period or after the treatments are done. Doctors can prescribe medicines and other treatments to control most of the symptoms.

Myeloablative Therapy with Stem Cell Support

Myeloablative therapy is a very intense regimen of chemotherapy designed to destroy all cells that divide rapidly. These cells include some blood cells and hair cells, as well as malignant cancer cells.

Stem cells are self-renewing cells that create all of the other types of blood cells. Stem cell support involves enriching the stem cells to increase the number of these important cells circulating in the blood after the chemotherapy has been given to kill the remaining tumor cells.

This page was last updated on: September 21, 2009.