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Ewing's Sarcoma

How Is Ewing's Sarcoma Treated?

For localized Ewing tumor, treatment usually begins with chemotherapy to shrink the tumor before it's treated with surgery or radiation. Chemotherapy uses anticancer drugs that enter the bloodstream and reach all parts of the body. So in addition to shrinking the main tumor, the chemotherapy is intended to kill cancer cells that may have already spread but have not yet been detected.

Between 8 and 12 weeks after chemotherapy starts, imaging tests are used to determine whether the tumor is able to be removed by surgery. If for some reason surgery can't be done or if surgery leaves some cancer cells behind, radiation is used to kill the cells. This course of treatment then is usually followed by several more months of chemotherapy to kill any remaining cells.

Chemotherapy is also the first treatment step for metastatic Ewing sarcoma. The regimen, though, is more intense and continues for several months. Then a series of imaging tests is done to see what effect the chemotherapy has had on the main tumor as well as the cancer that has metastasized. The next step is to remove the primary and all known secondary tumors either by surgery, radiation therapy, or a combination of surgery and radiation. Chemotherapy is then resumed for several more months.

What Happens After Ewing's Sarcoma Is Treated?

When a child is treated for cancer, conditions can develop later in life that stem from that treatment. These "late effects" vary from child to child and depend largely on the kind of treatment received. Radiation and the drugs used in chemotherapy damage normal cells as well as the cancer cells, and over the long term that can have an effect on the brain, which may result in  learning difficulties.  Other late side effects may impair hearing and vision and  growth and development, as well as have an effect on the the heart, respiratory system, and other organs.

Children can also develop second cancers. For example, some chemotherapy drugs can cause leukemia, or a new cancer can develop at the site of radiation therapy. In addition, there is always the possibility of a recurrence of Ewing's sarcoma.

All this means it's important to work closely with your child's health care team and get regular checkups to watch out for possible problems. The American Cancer Society also recommends that you keep accurate records of the treatment your child receives and make sure any doctor your child sees in the future has a copy of those records. At the minimum, those records should include:

  • Copies of any pathology or postoperative reports
  • Copies of any hospital discharge summaries
  • A list of the drugs used for chemotherapy
  • A summary of the radiation type and doses

When your child becomes an adult, he or she should be given a copy of those records.

WebMD Medical Reference

Reviewed by David T. Derrer, MD on May 21, 2014

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