What is Ewing’s Sarcoma?
Ewing’s sarcoma is a very rare cancer that can occur in bones or in the soft tissues that surround your bones, like nerves and the cartilage. It mostly affects young people whose age is between 10-20. It is highly curable at the same time.
In developed countries like the USA, it affects about 200 young adults and children every year. Also, males have a higher chance of developing this than females.
Adults can also get Ewing’s sarcoma but are very uncommon. It rarely affects Asian Americans or African Americans, but is very common in white people.
Exactly, it is not clear what leads to Ewing’s sarcoma. But one develops this cancer when changes occur in the DNA of a cell. The DNA has instructions for every function. Due to changes in it, the DNA leads to abnormal changes, like multiplying quickly and evading apoptosis.
It results in the formation of an abnormal cell mass that can invade and destroy healthy cells. These abnormal cells can metastasize to other body parts.
However, changes in the EWSR1 gene most often lead to Ewing’s sarcoma. Thus, your doctor will look for changes in this gene to detect the presence of Ewing’s sarcoma.
There are several possible symptoms that you can feel upon having Ewing’s sarcoma. You may develop pain, stiffness, or swelling at the site of the tumor. Thus, this may persist for weeks or months in areas of tumor-like legs, arms, back, chest, or pelvis. One can easily mistake it for a bruise or a bump. One might even mistake it for sports injuries in children.
- A warm and soft lump near the skin.
- Low fever that is constant.
- Limping because of pain in the legs.
- Pain in the bones that gets worse during the night or when you exercise.
- Bones break without any
- Loss in weight
- Paralysisif the tumor is present near the spine.
- No control over the bladder.
- You need to contact your doctor upon seeing such symptoms. A timely diagnosis will help you detect and heal your tumor in an efficient way.
Diagnosis and Tests
Whether you have Ewing’s sarcoma, your doctor will perform several tests to detect your tumor. In case you have a tumor, then your doctor will try to find out if the tumor has spread to other parts and to what extent has it spread. This is called staging.
Physical exam: This is the first thing that your doctor will do. He/she will look for the signs such as lumps, redness, and swelling around the painful areas.
X-rays: After a physical examination, your doctor will order you an x-ray. This takes an image of the affected area of your body. If anything suspicious is found in the x-ray, then your doctor will order other tests.
Bone scan: A bone scan helps to detect if the cancerous cells are present in bones. Your doctor will inject a small amount of radioactive dye into your veins and will aggregate in the areas having tumors.
Upon lying beneath a bone scanner, your doctor will be able to detect to find if the radioactive dye has gathered at a certain place or not.
Magnetic resonance imaging (MRI): An MRI is done when you lie still and flat on a plain surface. Then, this surface will take you inside an MRI machine that has a tube shape. To create a detailed, 3-D image inside your body, it uses radio waves and a magnetic field.
Computed tomography scan (CAT/CT scan): Similar to the MRI, your doctor may also perform a CT scan. It connects with a computer and takes pictures.
Positron emission tomography scan (PET scan): I this test, a technician will inject a small amount of radioactive sugar into your vein and place you inside a scanner. As the tumor cells use more sugar, they will brighten up in the scan.
Blood test: A blood test doesn’t confirm Ewing’s sarcoma. But a CBC checks how many WBCs, RBCs, and Hb you have in your blood.
Biopsy: In this method, using a needle or during surgery, your doctor will remove a piece of your tissue. To detect cancer, the sample is viewed under a microscope. This will help confirm Ewing’s sarcoma.
Bone marrow biopsy: Your doctor will numb an area of your body, generally the hips. Your doctor will take a small piece of bone marrow by inserting a needle into your bone and examine the tissue under a microscope.
The cancer treatment usually begins with chemotherapy, and then your doctor may perform surgery to remove the tumor. In certain situations, your doctor may also perform other treatments like radiation therapy.
This method uses drugs that can kill cancer cells. Usually, a doctor administrates a combination of two or more drugs in pill form, by infusion into a vein (IV) or through both ways.
Usually, your doctor will begin the treatment with chemotherapy. These drugs make it easier for the doctor to remove a tumor by shrinking it. A doctor may use surgery or radiation therapy to eliminate the tumor.
The treatment with chemotherapy may continue after surgery or radiation therapy to kill the remaining cancer cells.
However, if cancer has spread to other parts of the body, then chemotherapy only helps relieve the pain and slow the tumor growth.
The motive of surgery is to remove all the tumor cells. But you should take into consideration what effects it might have on your daily life. For Ewing sarcoma, the extent of surgery depends on various factors like the location of the tumor and its size.
To kill cancer cells, a doctor uses radiation therapy, which uses high-energy beams, like protons and X-rays. In case a surgery is not successful or possible for a surgeon to remove all, then radiation therapy is useful.
A machine delivers beams of energy during radiation therapy while you lie on a table. Thus, to reduce the risk of damage to surrounding healthy cells, a specialist directs the beams to the area of the Ewing’s sarcoma.
Your doctor may recommend this after surgery to kill the remaining cancer cells. Radiation therapy can slow the growth of cancer for advanced Ewing sarcomas and relieve the pain.
Coping and support
When you get diagnosed with Ewing sarcoma, it could be frightening for you as well as your family. You may learn to cope with the uncertainty and distress related to cancer with time. You need to follow these instructions until then;
Call on for medical support: Various things are going to help you. The knowledge and understanding of a medical social worker, or any other mental health professional will help you in understanding your cancer.
If your child or other family member suffers from cancer, you need to ask health care professionals for advice. They will provide you with options for medical health support as well as emotional and social support.
In addition to this, you can check various online services that will provide you support to combat cancer.
- Gain more knowledge about Ewing sarcoma to make decisionsabout control and care:
Ask your doctor about various treatment options related to Ewing sarcoma. Little knowledge is dangerous. Therefore, more confidence in understanding and making decisions about treatment options will be there with you. So you should always learn more about the disease.
Ask the health care team for guidance if your child has cancer. Get more and more information for appropriately caring for the patient.
Be close to your friends and family: A close and strong relationship with your family and friends will help you deal with Ewing sarcoma.
You need practical support, moral support from your friends and relatives. Someone should be there for you to look after the family. Emotional support from them is going to matter most. A healthy and happy person will ultimately efficiently fight the disease.
Prepare for your appointment
You are likely to start making an appointment with your primary care doctor if some signs and symptoms worry you. Ask for a referral to an experienced specialist if your doctor suspects Ewing’s sarcoma.
A team of specialists typically can treat Ewing’s sarcoma. For instance;
Orthopedic surgeons or orthopedic oncologists who have specialization in operating bone cancers.
Doctors who have a specialization in treating cancers with systemic medications or chemotherapy.
Pathologists diagnose the specific type of cancer by analyzing a tissue.
Rehabilitation specialists who after surgery help in the recovery of a tumor.
What you should expect from your doctor:
You will face several questions from your doctor. You should be ready to answer to give more time to your doctor to address them. Your doctor may ask;
What signs and symptoms concern you more?
Have your symptoms been occasional or continuous?
When did you start to notice the symptoms?
The severity of your symptoms?
Is there anything that improves your symptoms?
Is there anything that worsens your symptoms?
Do you have any family or personal history of cancer?