Ewing Sarcoma

Ewing Sarcoma

Ewing Sarcoma is a type of cancerous tumor that grows in the bones or the soft tissue around your bones, such as your nerves or cartilage. It is rare, and mostly affects people between the ages of 10 to 20. It also has a high rate of being cured.

It mostly affects people of white ethnicity. In the US, around 200 children and young adults every year are affected by Ewing Sarcoma. Adults can get Ewing sarcoma as well, but it is generally uncommon.


Signs and symptoms of Ewing’s sarcoma generally include the following:

  • Pain, swelling or tenderness near the affected area
  • Unexplained tiredness
  • Fever with unknown cause
  • Bone pain
  • Unexpected weight loss


If you or your child, experiences any such persistent symptoms, then you might consider making an appointment with your doctor.


The exact causes of Ewing sarcoma are still unknown. It is however known to doctors that Ewing sarcoma begins when a cell develops changes in its DNA. The DNA of a cell contains the instructions telling it what to do. These changes instruct the cell to multiply quickly and go on living, whereas healthy cells would die normally. This leads to a mass of abnormal cells which can invade and destroy any healthy body tissue.

In Ewing sarcoma, the DNA changes generally affect a gene known as EWSR1. If your doctor suspects that you might be having Ewing sarcoma, your cancer cells might be tested to look for any changes in this gene.

Few factors that can increase the risk of Ewing sarcoma include:

  • Your age- Though Ewing sarcoma occurs at any age, it is much more likely to occur in children, teenagers, and young adults.
  • Ancestry- This condition is also known to be more common in people of European Ancestry. In people of African or East Asian ancestry, it is rarer.


Your doctor might recommend a number of tests to see if you have Ewing’s sarcoma. If you do, they will also try to find out if the tumor has spread and to what extent.

Physical Exam

Physical exam involves your doctor checking around the painful areas for redness, swelling, or lumps.

Bone scan

This method helps in finding out whether cancer cells are in your bones. First, a small amount of radioactive dye is going to be injected into one of your veins. The dye will then collect in the bones having any tumors. When you lie beneath the bone scanner, your doctor is able to detect where the radioactive dye has gathered.


This method is able to take an image of a certain area of your body where the tumor is suspected. If the X-rays show any problems, your doctor can order other imaging tests.

Blood test

Though blood tests cannot confirm Ewing’s sarcoma, a complete blood count, or CBC, can check how many red blood cells, white blood cells, and how much hemoglobin you are having.

Magnetic resonance imaging (MRI)

For this test, you will need to lie flat and still on a surface that will slide you inside the tube-shaped MRI machine. The machine uses a magnetic field and radio waves for creating detailed, 3-D images of inside your body.

Computed tomography scan (CAT/CT scan)

Similar to an MRI, you lie flat inside a CT scanner, which takes X-ray pictures while it is linked to a computer. Generally, the MRI is preferred over the CT scan.

Positron emission tomography scan (PET scan)

First you will lie inside the PET scanner while a technician will inject a small amount of radioactive sugar into your vein. The cancer cells are going to show up brighter in the scan since they use more sugar than healthy cells.


Biopsy involves your doctor removing a piece of your tissue with either a needle or during surgery. This sample is then viewed under a microscope to see if it is cancerous. This helps to confirm Ewing’s sarcoma.

Bone marrow aspiration and biopsy

This method involves your doctor numbing an area of your body, usually in the hips, after which they insert a needle and takes a small piece of bone marrow and bone, which they will examine under a microscope.


For Ewing sarcoma, there are various types of treatment that your doctor can consider.


Chemotherapy is the most common form of cancer treatment, which involves using powerful drugs to kill cancer cells. Generally, chemotherapy treatment combines two or more drugs which can be administered as an infusion into a vein, in pill form, or in some cases, through both methods.

The drugs can help in shrinking the tumor and make it easier to remove cancer with surgery or radiation therapy if needed.


Surgery is performed with the objective to remove all of the cancer cells. But before you plan, you will need to consider how it will affect your ability to go about your daily life.

Surgery for this condition may involve removing a small portion of the bone or in some cases, removal of the entire limb. Whether surgeons are able to remove all of cancer without removing the entire limb depends on several factors, such as the location and size of the tumor and whether it shrinks after chemotherapy treatment.

Radiation therapy

This method uses high-energy beams like protons and X-rays, to kill the cancer cells. During radiation therapy, the beams of energy are going to be delivered from a machine that revolves around you as you will lie on a table. To reduce the risk of damage to healthy tissues, the beams are carefully directed to the area.

Sometimes radiation therapy might also be recommended after surgery in order to kill any cancer cells that remain.

If your Ewing sarcoma is advanced, then radiation therapy helps to slow its growth, as well as help in relieving any pain.


Ewing sarcoma and its treatment can lead to multiple side effects which include:

  • Cancer that spreads (metastasizes)- Ewing sarcoma can spread from where its starting area, which makes treatment and recovery harder. Ewing sarcoma generally spreads to the lungs and to the other bones.


  • Long-term side effects of treatment- The aggressive treatments needed for controlling Ewing sarcoma can lead to substantial side effects, both in the short term as well as long term. Your healthcare team might help you manage the side effects that happen during treatment. They are also likely going to provide you with a list of side effects that you need to watch for, in the upcoming years after treatment.

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