Ewing Sarcoma: An Aggressive and Long-Term Treatment Challenge

By Dr. Puneet Gupta in

Sep 3, 2020

Ewing Sarcoma is cancer of the bones and soft tissues that mostly affects the children, however, in rare circumstances, adults can also get affected by this condition. We should be aware of this rare disease as it might affect our loved ones or even us. This condition is highly aggressive and if not treated in initial stages it might become incurable with no long term survivors.

Causes of Ewing Sarcoma are not clear, however, it has been found that it begins when cells of bones develop changes in its DNA. These mutations cause rapid multiplication of cells and forming a lump of abnormal cells which start invading the healthy body tissues and disrupting the healthy bodily functions. These cells can also metastasize and spread throughout the body.

Who is at Risk of Ewing Sarcoma?

Now, most people think themselves immune and ignore the symptoms, and delay the treatment. This can lead to the advancement of the disease and reducing the chances of recovery. We should we aware of risk factors associated with the Ewing sarcoma:

• Age.  It usually develops in young children and teenagers. But in some cases, Ewing sarcoma can occur usually in childhood.However no age is a bar.
• Ancestry. Your ancestry can also play a major role in the chances of getting affected. Parents and siblings can suffer from cancer. Blood sample is taken from the family member suffering from cancer so as to know the risk of first degree relatives.

Signs and symptoms of Ewing sarcoma:

Most signs and symptoms of Ewing sarcoma can be mistaken for other conditions.  So, it is advisable if symptoms persist we should consult specialists for detailed diagnosis. Following are the common symptoms of Ewing sarcoma:

• Pain, swelling or tenderness near the affected area
• Pain in Bones
• Inexplicable tiredness
• Inexplicable Fever
• Losing weight

The severity of symptoms depends upon the size and location of the tumor, so even if symptoms are not severe, they should not be ignored and one should immediately consult an oncologist.

When Should one Consult a Doctor?

One should consult a doctor regularly and should go for at least yearly full-body check-ups, even if they do not show any symptoms of any disease. It increases the chances of diagnosing any medical condition that is affecting you or might affect you in the early stages. Giving you enough time to take precautions or treatment.

In the case of Ewing sarcoma,

• If one experience the mentioned signs and symptoms, you should immediately consult a doctor.
• Doctor should be notified of all the medications you have taken or are taking, as they can also cause side effects that might be related to these symptoms. 
• Key personal information regarding lifestyle or stress-related should also be provided for proper diagnosis. 

Diagnosis

Ewing sarcoma is usually diagnosed on the basis of various signs and symptoms child may be experiencing. On the basis of initial finding more tests may be recommended for further investigation. 

To begin with, imaging tests are conducted to identify any tissue lump/tumor. This is also helpful to investigate whether it has spread to other areas.

Imaging tests may include:

• X-ray
• CT SCAN with contrast
• MRI with contrast
• PET SCAN with contrast
• Bone scan

Imaging helps only in the identification of a tumor, now to ascertain whether the tumor is benign or cancerous, the cell needs to be analyzed under a microscope. That entails taking a sample of the tissue and performing a biopsy to analyze the affected cells.

Biopsy- Collecting Samples for Analysis

A biopsy is the process of sample collection from suspicious cells for laboratory testing. After laboratory testing, it can be ascertained whether the cells are cancerous and what type of cancer patients might be suffering from.

Types of biopsy procedures used to diagnose Ewing sarcoma include:

• Needle biopsy.  Needles are inserted through the skin to take bone and tissue cells. This is painless as the area is numbed and high precision instruments are used to safety.
• Surgical biopsy.  This is done in the affected area is either obstructed or unreachable safely using needles. The doctor then makes an incision and if possible removes a portion or entire tumor for biopsy. Usually, cancerous lumps are found while performing operations for other conditions which are then sent for biopsy as part of standard medical practice.

These procedures might sound simple, but extensive preparations need to be made by experts so that it may not affect the future treatment of the patient. One should seek advice from renowned experts in the field with extensive experiences such as the Department of Oncology, Metro Hospitals, who have extensive experience and excellent record in Ewing sarcoma cases.

Ascertaining gene mutations

• As told earlier, gene mutations usually occur in the case of Ewing sarcoma. Typically a gene identified as EWSR1 fuses with a gene called FLI1 and mutates into EWS-FLI1. This causes the cancerous growth of cells. The gene analysis is necessary for the doctors to ascertain the aggressiveness of your disease.
• It is frightening if your loved ones get diagnosed with rare conditions such as Ewing sarcoma, especially if the patient is a child. So, it is necessary to be aware of the disease and uncertainty of the conditions, this helps in coping up with stress.
• Gather information on Ewing sarcoma from reliable sources to make rational decisions: Experts at the metro group of hospitals have a team of experts and cancer boards to assist you in every step and provide all the relevant information necessary to take care of the patient.
• Friends and family can provide emotional comfort: If you or your child get affected by this condition, you should not shutout people from your/their lives, as a positive environment and attitude can do wonder in the treatment.  As these treatments can spread over a course year, the patient requires emotional support when they might feel down.
• Support At Every Step: During and Post Treatment Psycho-Oncology support is provided to the patient by Metro Group of Hospitals as the treatment is physically and emotionally draining. It requires the constant support of psychiatric and behavioral experts along with the emotional support of loved ones.

Department of Oncology, Metro Group of Hospitals is renowned for its quality treatment and affordable care.  Our team has expertise backed by the modern infrastructure to help children and adults with Ewing sarcoma. We have a history of treating people with rare conditions. At Metro, we value all lives and emotions and provide integrated anti-cancer care looking after all needs including physical ,psychological, social,economical and spiritual.