Originally published in December 2003 icon
Signs and Symptoms Latest Research
About 30 children a year, in the UK, are diagnosed with Ewing’s sarcoma (150 In the US), It usually develops during teenage years, but the good news is that most of those diagnosed can be cured.
Most of those diagnosed can be
cured
Even if the tumour comes back, further treatment can be given successfully. Surgery and radiotherapy can stop bones growing, and make muscles and tendons shorter -which may mean further operations - but most children who are successfully treated grow up with little disability.
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The condition is named after Dr James Ewing, who discovered that unlike the common bone tumour, osteosarcoma, this one could be treated with radiation. At first Ewing’s sarcoma was only seen in bones, but soon it was found in the soft tissues and named extraosseous (not in bone), Ewing’s (EOE). Now it is known as a cancer which can develop anywhere in the body.
Nobody knows what causes it, but researchers have found that Ewing’s sarcoma, EOE and PNET (another rare cancer found in bone and soft tissue) cells have similar abnormalities in their DNA. These cells contain similar proteins rarely found in other types of cancers.
Signs and symptoms
The most common symptom is pain in the bone where the tumour is located, or in the affected soft tissue area. It can start as a persistent ache, which will not go away, and may feel worse at night when the muscles are relaxed. Sometimes the pain is first noticed after a knock or injury, which draws attention to the cancer (but does not cause it). Eventually there may be some swelling in the area, and it may become tender to touch,
In children this symptom may be mistaken for a sprain or "growing pains". Other general symptoms may include tiredness, weight loss and, occasionally, the child develops a fever. Bone cancer is sometimes discovered when a bone, that has been weakened by cancer, breaks after the person has had a minor fall or accident. See your GP if you suffer any persistent bone pain.
The most common symptom is pain in the bone or the affected soft tissue area where the tumour is located An X-ray of the painful part of the bone is usually able to identify a tumour, although sometimes it can be difficult to see. Other tests may be carried out to see whether the cancer has spread. Chemotherapy is given before and/or after the tumour is removed. Radiotherapy can be used to shrink a tumour if it is in a part of the body difficult to operate on, for example the pelvis. It may also be used after surgery to help lower the risk of recurrence.
Often surgery can remove the tumour without causing too much damage. However, if the tumour is in one of the main bones of the arm or leg, it may be necessary to amputate the whole limb, or part of the affected bone, which is then replaced by some form of false limb
Regular check-ups after treatment will include chest X~rays, because Ewing’s sarcoma can spread to the lungs. You will also have CT and MRI scans, but not at every visit.
Latest research
Cancer Research UK reports that clinical trials are looking at the use of high dose chemotherapy and stem cell transplants for Ewing’s sarcoma. High doses are sometimes given to try to improve the chance of completely eradicating the cancer.A current study is comparing: vincristine, actinornycin and ifosfamide: vincristine, actinomycin D and cyclophosphamide:high dose busulphan, melphalan and stem cell rescue.
A big surgical advance was reported in the Lancet at the beginning of the year. Italian surgeon Dr Marco Manfrini,and his colleagues from the Bologna’s Rizzoli Orthopaedic Institute, reconstructed a young cancer patient’s hip by using a combination of her thighbone and a donor bone graft.The new joint is still doing well more than four years later. Dr Herman Kattlove, oncologist and medical editor for the American Cancer Society, commented, "It’s a remarkabletreatment. What they did is almost miraculous. They had to keep the blood supply intact. The surgeons must be very skilled. It’s a remarkable treatment."
For information on your Cancer Drugs and chemotherapy click here and more in formation about Ewing’s sarcoma and other bone cancers is available from CancerBACUP and Cancer Research UK.