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Ewing's Sarcoma

Ewing's sarcoma occurs in the bone or close to the bone, most often in adolescents between the age of 10 and 20. It occurs in about one teenager in 50,000 and accounts for about 30 percent of bone cancers in children. This cancer most often is found in the arms and legs, particularly the thigh bone. It also may involve muscle and soft tissues surrounding the tumor. Ewing's sarcoma cells can spread or metastasize to other areas of the body, including bone marrow and the lungs.

Prior to adolescence, the number of boys and girls affected by Ewing's sarcoma is equal. After adolescence, however, the number of men with the disease is slightly higher than women. This may be due to the increased rate of growth among males during adolescence.

The following are the most common symptoms of Ewing's sarcoma. Each child, however, may experience symptoms differently.

  • Pain around the site of the tumor
  • Swelling and redness around the site of the tumor
  • Fever
  • Weight loss and decreased appetite
  • Fatigue
  • Paralysis and incontinence if the tumor is in the spinal region
  • Symptoms related to nerve compression from a tumor such as numbness, tingling and paralysis

In addition to a complete medical history and physical examination of your child, diagnostic procedures for Ewing sarcoma will include an X-ray examination of the painful area. There may be multiple diagnostic tests such as:

  • Bone scans — A nuclear imaging method to detect bone diseases and tumors and determine the cause of bone pain or inflammation.
  • Computed tomography (CT or CAT) scan — With the help of computers, X-rays produce images of thin cross sections of the body to provide more detail than conventional X-rays. CT scans often are used to supplement other diagnostic X-rays. The CT scan of the chest is essential to look for any cancer that may have spread to the lungs.
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A treatment program for Ewing's sarcoma may include several approaches such as surgery, radiation and chemotherapy.

Surgery

Surgery is used to remove a tumor or remove any tumor left after chemotherapy, which typically lasts about nine weeks. Surgery is performed if complete removal of the tumor is possible without damage to vital tissue or organs.

Radiation Therapy

Radiation therapy is a painless procedure similar to X-rays. During therapy, a machine aims beams of high-energy X-rays at the cancer site to kill tumor cells. Some normal cells are damaged as well, but healthy cells have a greater ability to repair damage than do tumor cells. The goal is to damage normal cells as little as possible, while injuring tumor cells so they die or are unable to repair or reproduce themselves. Radiation therapy is used in combination with chemotherapy and sometimes surgery. Radiation for these tumors usually is external radiation from outside the body. Studies are evaluating the effectiveness of radiation implanted in the body during surgery.

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Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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