Ewing’s sarcoma is the second most common bone tumor that affects children, teens and sometimes, young adults. It typically begins in developing bone cells and grows uncontrollably to form a mass, called a tumor.
Tumors can form in any bone tissue, however, half of all cases involve flat bones such as the pelvis, and long bones, such as the tibia, fibula and femur in the leg. This type of cancer may also arise in the soft tissues, such as muscle, fat, fibrous tissue, blood vessels, or other supporting tissue.
The cancer is named for James Ewing, the research who first described the tumor in 1921 and accounts for about one percent of all cancers in children and teens, or about 2,400 cases annually.
Ewing's sarcoma occurs most frequently in children ages 11 to 15 years old. Slightly more males than females develop Ewing's sarcomas, and like osteosarcoma, the most common bone cancer found in children. It is also more often diagnosed in taller teens. It is rarely diagnosed in children younger than five or adults older than 30.
Ewing’s sarcoma s primarily affects Caucasians, and is rarely found in African Americans and native Chinese. The cause of the disease is unknown. Ewing's sarcoma is not strongly associated with any heredity cancer syndromes, congenital childhood diseases, or previous radiation exposure, which may be risk factors for other types of bone cancers.
Roughly two-thirds of Ewing's sarcoma patients experience painful swelling and one or more lumps can be felt in the affected bone; the area of swelling may be hot. The symptoms depend on the tumor site and whether it has spread. For example, a tumor on a rib may cause painful breathing, and a tumor on a pelvic bone can cause pressure on the bladder. When Ewing's sarcoma has spread, patients may have other symptoms such as fatigue, weight loss and fever.
Treatment depends on the location of the tumor, its size and grade and the extent of its spread. For most patients, the treatment goal is to remove or control the tumor and stifle the spread of the cancer.
Generally speaking, the tumors are surgically removed to the extent possible to reduce the amount of radiation needed after surgery. After surgery, radiation and chemotherapy are administered to destroy remaining cancer cells.
In cases where patients have widespread metastases— the disease has spread throughout the body— surgical procedures often have little benefit and the doctor may begin radiation and chemotherapy immediately along with a bone marrow transplant.
As with any cancer, early diagnosis means better outcomes and survival rates. Patients with tumors in certain sites, such as pelvic bones and spinal column seem to have poor outlooks because these tumors are typically not easily found early and therefore have spread by the time they are discovered.
The National Cancer Institute (NCI), a part of the National Institutes of Health suggests people with bone cancers consider participating in clinical trials to aid in the development of new treatment and better ways to use current treatment options. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease.
People interested in taking part in a clinical trial should first talk with their doctor. Information about clinical trials is available from the NCI’s Cancer Information Service (CIS) at 1–800–4–CANCER and in the NCI booklet Taking Part in Cancer Treatment Research Studies, found at: http://www.cancer.gov/clinicaltrials/Taking-Part-in-Cancer-Treatment-Research-Studies. This booklet describes how research studies are carried out and explains their possible benefits and risks.
Further information about clinical trials is available at http://www.cancer.gov/clinicaltrials on the NCI’s Web site. The Web site offers detailed information about specific ongoing studies by linking to PDQ®, the NCI’s comprehensive cancer information database at http://www.cancer.gov/cancertopics/pdq.
Internet Resources for Ewing’s Sarcoma:
MEDLINEplus National Library of Medicine
National Childhood Cancer Foundation Children's Oncology
National Cancer Institute (en Español)
American Cancer Society
Lynette Summerill, is an award-winning journalist who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.