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Ewing’s Sarcoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Sep 15, 2023

Ewing’s Sarcoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

An uncommon form of cancer known as Ewing sarcoma develops in the soft tissue surrounding the bones or in the bones themselves.

Ewing sarcoma usually starts in the pelvic and leg bones, though it can occur in any bone. Less frequently, it starts in the limbs, abdomen, chest, or other soft tissues.

Ewing sarcoma is most usually detected in adolescents and teenagers, while it can occur at any age.

Significant advancements in the treatment of Ewing sarcoma have improved the prognosis for people who have it.

It is advised to continue monitoring for the rest of one's life to look for any potential long-term effects of aggressive chemotherapy and radiation.

Causes Of Ewing’s Sarcoma

Ewing’s sarcoma has an unknown origin.

Doctors are aware that when a cell experiences DNA alterations, Ewing sarcoma first manifests. DNA contains the instructions that control a cell's behavior. The changes tell the cell to fast replicate and survive when normally healthy cells would die. The result is a collection of abnormal cells that can invade and harm good bodily tissue, known as a tumor. The abnormal cells might split apart and disperse (metastasize) throughout the body.

Most typically, DNA mutations in Ewing sarcoma impact the EWSR1 gene. If your doctor believes you have Ewing sarcoma, your tumor cells may be tested for mutations in this gene.

Symptoms Of Ewing’s Sarcoma

Ewing sarcoma symptoms include the following:

  • Near the affected area, there may be pain, swelling, or discomfort.
  • Joint discomfort
  • Tiredness without cause
  • Unidentified reason for fever
  • Without attempting, losing weight

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Risk Factors Of Ewing’s Sarcoma

Risk factors for Ewing sarcoma include the following:

  • Your age. Although Ewing sarcoma can affect people of any age, children and teenagers are more likely to contract it.
  • Your family history. People with African and East Asian ancestry tend to have it significantly less frequently while Europeans are more prone to it

Diagnosis Of Ewing’s Sarcoma

A physical examination is typically the first step in the diagnosis of Ewing sarcoma in order to better understand any symptoms you or your kid may be experiencing. Other tests and procedures might be suggested in light of those results.

Imaging examinations

Imaging tests help your doctor analyze your bone problems, check for cancer, and look for indicators that the cancer has spread.

The following imaging tests are possible:

  • X-ray
  • CT scans
  • magnetic resonance imaging.
  • PET (positron emission tomography)
  • X-ray of the Bones
  • Biopsy

To get a sample of suspect cells for laboratory analysis, a biopsy process is used. Tests can reveal the sort of cancer you have and whether you have malignant cells.

The following categories of biopsy procedures are used to identify Ewing sarcoma:

  • The biopsy is done using a needle. A tiny needle is inserted into the tumor by the physician through the patient's skin. Small bits of tissue are taken out of the tumor using the needle.
  • Biopsy performed during surgery. Through a skin incision, the physician removes either the complete tumor (excisional biopsy) or a section of the tumor (incisional biopsy).

The medical team must carefully plan the sort of biopsy that is required as well as the specifics of how it should be carried out. The biopsy must be carried out by medical professionals without interfering with upcoming cancer removal procedures. For this reason, before the biopsy, request from your doctor a recommendation to a group of specialists with a great deal of experience treating Ewing sarcoma.

Screening for gene alterations in cancer cells

We'll run a lab test on a sample of your cancer cells to identify the DNA alterations that are present. Usually, the EWSR1 gene is altered in Ewing sarcoma cells. 

A new gene termed EWS-FLI1 is most frequently created when the EWSR1 gene fuses with the FLI1 gene. An accurate diagnosis can be made and information about the severity of your illness can be obtained by checking the cancer cells for these gene changes.

Treatment Of Ewing’s Sarcoma

The first line of treatment for Ewing sarcoma is often chemotherapy. The cancer is typically surgically removed. Other treatments, like radiation therapy, may be employed in some cases.


Chemotherapy uses powerful drugs to attack cancer cells. A typical chemotherapy treatment plan includes two or more drugs that can be administered intravenously (IV), orally, or both ways.

The first line of treatment for Ewing sarcoma is often chemotherapy. 

The medications may cause the tumor to shrink, making it simpler to operate on or use radiation therapy to treat the malignancy.

Chemotherapy treatments may be continued to eradicate any residual cancer cells following surgery or radiation therapy.

Chemotherapy may ease pain and symptoms of advanced cancer that has spread to other parts of the body.


Surgery is used to completely eliminate all cancer cells. However, it's equally crucial to consider how the surgery will affect your daily life when planning the procedure.

Surgery for Ewing sarcoma may involve the removal of a single bone fragment or an entire limb.

The size, location, and response to chemotherapy of the tumor will all affect whether surgeons can completely remove the disease without amputating the leg.

Radiation therapy

Radiation therapy employs high-energy beams, such as protons and X-rays, to destroy cancer cells.

A device that moves around you is giving radiation therapy while you are lying on a table receiving treatment.

To lessen the possibility of harming nearby healthy cells, the beams are carefully pointed toward the Ewing’s sarcoma.

After surgery, radiation therapy could be advised to eradicate any cancer cells that survived. If the Ewing sarcoma is found in an area of the body where surgery is either not possible or would have unfavorable functional effects (such as the loss of bowel or bladder function), it may also be utilized as a substitute for surgery.

Radiation therapy can help reduce pain and limit the growth of advanced Ewing sarcomas.

Complications Of Ewing's Sarcoma

Ewing sarcoma and its treatment-related complications include:

  • Cancer that metastasizes (spreads). Since it may impact areas other than the original site, the spread of Ewing sarcoma can make treatment and recovery more challenging. The most typical sites for Ewing sarcoma metastasis are the lungs and other bones.
  • Long-term negative effects of therapy. Ewing sarcoma must be treated aggressively, which can have detrimental short- and long-term implications. In addition to offering you a list of side effects to watch out for in the years after treatment, your medical team can help you manage any side effects that develop during therapy.

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