Ewing sarcoma is a rare type of cancer that grows in the bones or the soft tissue surrounding them. While it can affect individuals at any age, it is most commonly diagnosed in children and young adults. This cancer often begins in the leg bones or pelvis, but it can occur in any bone in the body and, less frequently, in soft tissues like those in the chest or abdomen.

Signs and Symptoms

Symptoms of Ewing sarcoma often originate in and around the affected bone. It’s important to be aware of both localized and systemic (whole-body) signs.

• Localized Symptoms: These include a noticeable lump in an arm or leg, persistent bone pain, and swelling or tenderness near the affected site. The cancer can also weaken the bone, leading to a break (fracture) from a minor or unknown injury.
• Systemic Symptoms: The cancer can also cause symptoms that affect the whole body, such as fever, unexplained weight loss, and persistent tiredness or fatigue.

Diagnosis: From Imaging to Genetics

A diagnosis typically begins with a physical exam and imaging tests, such as an X-ray, MRI, or CT scan, to get a clear picture of the tumor’s size and location. However, the definitive diagnosis is made through a biopsy, a procedure to remove a small sample of the tumor for lab testing. This test is crucial for two reasons:

• It confirms whether the cells are cancerous.
• It allows doctors to look for a specific DNA change.

The cause of Ewing sarcoma is not fully understood, but it is linked to a mutation in a cell’s DNA, most often involving the EWSR1 gene. Identifying this genetic change helps confirm the diagnosis.

A Combined Treatment Approach

Treatment for Ewing sarcoma is intensive and almost always involves a combination of therapies.

• Chemotherapy: This is a primary treatment using strong medicines to kill cancer cells. It is often given before surgery to shrink the tumor, making it easier to remove safely.
• Surgery: The main goal of surgery is to remove the entire tumor. This may involve removing a portion of the bone, which surgeons carefully plan to minimize the impact on the limb’s function.
• Radiation Therapy: This treatment uses powerful energy beams to kill cancer cells. It is often used after surgery to eliminate any remaining cancer cells, or it may be used instead of surgery if the tumor is in a location that is too dangerous or difficult to operate on.

Outlook and Long-Term Care

Major advances in combination therapy have significantly improved the outlook for patients with Ewing sarcoma. However, the treatments required are very strong and can lead to serious long-term side effects. Because of this, survivors often require long-term monitoring to watch for and manage any late effects from their treatment.