Ewing's Sarcoma- An Overview

Introduction

Ewing's sarcoma is a cancerous condition affecting young children's and adults' bones and soft tissues. This condition usually occurs during puberty when the bones develop rapidly. Ewing's sarcoma usually occurs in the legs, pelvis, and arms. This condition's usual symptoms are bone pain, swelling, and fever. The advanced treatment of Ewing's sarcoma has enhanced the outlook of the condition. Read the article to know more.

What Is Meant by Ewing's Sarcoma?

Ewing's sarcoma is a group of rare forms of cancer that usually affect the soft tissues and bones of children and teenagers. The new treatment modalities and searches help people affected by this condition to lead a longer, cancer-free life. Ewing sarcoma is a very rare condition, and people affected by this condition will have tumors in the arms, legs, pelvis, or spine. It usually occurs during the puberty phase, when the person’s bone develops. This condition usually affects males more than females.

What Are the Different Types of Ewing's Sarcoma?

The types of this condition are

• Bone Tumor: This is the most common type of Ewing sarcoma, where the tumor will be formed in the bone, usually the pelvis, ribs, or arms. 87 percent of the Ewings tumors are of this form. But the tumor can develop in any bone.

• Soft Tissue Tumor: In this type, the tumor develops in the soft tissue present around the bone or the cartilage.

• Peripheral Primitive Neuroectodermal Tumor: This type of tumor is present in the nerves and can develop in different parts of the body.

• Askin Tumor: This is a form of peripheral primitive neuroectodermal tumor that is seen in the chest wall.

What Are the Signs and Symptoms Related to Ewing's Sarcoma?

Ewing's sarcoma usually seen as bumps, lumps, or bruises on the affected area. Usually, parents mistake the presence of Ewing's sarcoma for some sports injury. Some common symptoms related to this condition are

• Bone pain is on and off and can get worse in the night.

• Swelling in the soft tissues around the bones and cartilage. This may cause stiffness and pain.

• Lumps present close to the skin surface can feel warm on touch.

• Fever that does not subside.

• The bone breaks without any injury.

• In the case of metastatic Ewing's sarcoma, fatigue and unexpected weight loss will be seen.

What Are the Causative Factors of Ewing's Sarcoma?

There is no clear answer for the cause of Ewing's sarcoma but studies have proven that some genetic mutation or some alteration changes the normal cells into Ewing's sarcoma cells. These cells multiply and form cancerous tumors in the bones and soft tissues. No one knows the cause of this mutation, but they are aware of the changes that occur after birth due to this mutation. The biological parents do not cause these mutations.

How Is Ewing's Sarcoma Diagnosed?

The doctor will initially hear out the signs and symptoms experienced by the affected person, and a physical examination will be conducted. The doctor will recommend several tests to diagnose this condition; some are

1. Imaging Test:

Imaging tests help the doctor rule out the presence of tumors in any part of the body and help the doctor see the development of the bones. Some imaging tests recommended are

• X-ray uses electromagnetic waves to produce images of the soft tissues and structures within the body.

• MRI (magnetic resonance imaging)uses magnetic and radio waves to produce images of the structures present within the body.

• CT (computed tomography) scan uses a group of X-rays to produce images of the structure present within the body.

• PET (positron emission tomography) uses radioactive drugs to show typical and atypical activities.

• Bone scan is a radiographic method used to examine different bones and skeletons.

2. Biopsy:

Doctors recommend a biopsy to get tissue samples that are examined by the pathologist. Biopsy procedures may include

• Needle biopsy, where a thin needle is used to get the fluid and tissue samples from the lump.

• Bone marrow aspiration is done to see for the presence of cancerous cells in the liquid from the spongy material present within the bone marrow.

3. Blood Test:

A blood test is recommended to see whether the cancer has spread to other parts. These tests include

• Complete Blood Count (CBC): Reduced blood count and platelet count are the signs of cancer.

• Comprehensive Metabolic Panel: This test is done to measure the levels of enzymes present in the body.

• Lactate Dehydrogenase: Higher levels of lactate dehydrogenase indicate the presence of cancer.

How Is Ewing's Sarcoma Managed?

Chemotherapy is the common and the initial treatment. Even if the diagnostic tests do not show any spread of the condition, the doctor will plan the treatment method, keeping in mind that there would have been a minimal spread. Along with chemotherapy, other treatment methods include

• Radiation therapy.

• Surgery.

These three treatment methods are used in different combinations. For eliminating primary tumors, surgery, and radiation is the best option. In the majority of cases, doctors perform surgery to excise tumors, and radiation is used only when surgery cannot remove the tumor completely.

Some side effects of treatment of Ewing's sarcoma are

• Nausea.

• Diarrhea.

• Fatigue.

People under this treatment can go for palliative care, which can help to ease the symptoms and side effects.

What Are the Risk Factors Related to Ewing's Sarcoma?

Some common risk factors are

• Age: This condition can affect people of any age, but it is more commonly seen in children and young adults.

• Sex: The prevalence of this condition is higher in boys than in girls.

• Race: People who are white are at higher risk than black people.

What Are the Complications Related to Ewing's Sarcoma?

Some complications are the following.

• Metastatic cancer, where cancer will spread.

• Recurrent cancer is where the cancer recurs after the treatment.

• Late effects are those effects of treatment that occur after many years.

Some complications are caused by treatment.

• Problem with organs and tissues.

• Issues in growth and development.

• Mood swings and mental health issues.

• Difficult to think, learn, and remember.

• Issues in having children.

The survival rate of the affected person depends on the age and the spread of cancerous tumors. 78 percent of the children and 15 to 68 percent of the teenagers will survive for about five years after diagnosis.

Conclusion

Ewing's sarcoma is a cancerous condition that affects the bone and the soft tissue present around the bone or cartilage. It usually affects children and young adults. The causative factor is unknown, but this condition can be treated through chemotherapy, radiation therapy, and surgery. The prognosis of the condition depends on various factors.