Ewing Sarcoma

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Norton Children’s Cancer Institute

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Ewing sarcoma gets its name from the physician who first described it in the 1920s. It is a type of bone cancer and the second most common type of malignant bone tumor that affects children and young adults between ages 10 to 20.

Ewing sarcoma is most common in the pelvis, accounting for approximately 25% of cases, but also can be found in long bones such as the femur, tibia and humerus. It occurs more often in males than in females and comes back after treatment in about one-third of cases.

Ewing sarcoma metastasizes, or spreads to other places in the body, in about 25% of cases. Metastatic Ewing sarcoma also is called Stage 4 Ewing sarcoma.

The exact cause of Ewing sarcoma is unknown. However, most patients with it have a genetic change that occurs randomly after birth. The abnormal gene can be found through genetic testing, providing an opportunity to address the cancer before symptoms arise.

The overall five-year survival rate for Ewing sarcoma is 62%, with better outcomes in children under age 10. In cases where the cancer has not spread, the cure rate is 82%. In Stage 4 Ewing sarcoma, the cure rate is 39%. By their nature, long-term survival rates don’t reflect the latest advancements in treatment and may underestimate current survival chances.

Treating Ewing sarcoma requires experienced and skilled oncologists. Ewing sarcoma has the best chance of being cured when it’s treated by pediatric cancer specialists. Young adults may benefit from treatment at a children’s hospital instead of an adult-service hospital because of the care team’s expertise specifically in childhood diseases.

The board-certified and fellowship-trained oncologists at Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine, come together at regular conferences to share viewpoints from various perspectives that help determine the best course of treatment. It’s like getting second, third and fourth opinions all at once.

By staying at the forefront of research, our physicians are experienced with newly approved therapies for Ewing sarcoma and can provide access to clinical trials of experimental treatments.

Ewing Sarcoma Symptoms

  • A lump in the bone of an arm or leg
  • Pain in a bone that gets worse with time
  • Stiffness, tenderness or swelling in an affected bone
  • Pain that can wake a child up from sleep
  • Bone fracture not caused by injury
  • Feeling tired often (fatigue)
  • Fever
  • Unexplained weight loss
  • Anemia (low red blood cell count)
  • Back pain if the tumor is located near the spinal cord

Diagnosing and Treating Ewing Sarcoma

Like many childhood and adolescent cancers, Ewing sarcoma can have vague symptoms that can be easily overlooked or attributed to other causes. Consulting with a pediatric cancer specialist offers the best opportunity for early diagnosis and successful treatment.

Ewing sarcoma can be diagnosed through tests such as:

  • Biopsy (taking a sample of a tumor)
  • Bone scan
  • MRI
  • X-rays
  • Bone marrow aspiration and biopsy

Additional testing will be done to make sure major organs, such as the heart, liver and kidneys, are functioning well enough to tolerate certain treatments.

Treatment for Ewing sarcoma will depend on whether the tumor has spread to other locations. Treatment will include chemotherapy, surgery and/or radiation, and in some rare cases, bone marrow transplant.

The Norton Children’s Difference

Norton Children’s Hospital’s cancer care program is one of the oldest oncology programs in the U.S. that has been continuously accredited by the American College of Surgeons’ Commission on Cancer. Backed by nearly 60 years of pediatric expertise, we have a proven cancer care team of more than 200 leading cancer specialists, including oncologists, surgeons, nurses, social workers, chaplains, behaviorists, therapists and pharmacists. This skilled, multidisciplinary team is entirely focused on the needs of your child and family.

In addition, we are home to:

  • Kentucky’s leading multidisciplinary pediatric brain tumor program
  • Kentucky’s only pediatric apheresis and pediatric photopheresis programs
  • An immunotherapy program
  • One of the country’s largest sickle cell anemia treatment programs
  • Kentucky’s leading Adolescent and Young Adult Program and Transition Clinic
  • Kentucky’s only CAR-T cell therapy treatment for pediatric patients
  • Life after cancer survivorship program
  • Pediatric bleeding and clotting program (hemostasis and thrombosis)

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