Ewing sarcoma of the bone is the second most common form of bone cancer in children.
The most commonly affected areas are the pelvis, thigh bone and shin bone.
In rare cases, Ewing sarcoma can also develop in the soft tissues around the bone. This is known as extraosseus Ewing sarcoma.
Please note that this information is specific to Ewing sarcoma that occurs in children.
Signs and symptoms
Symptoms of ewing sarcoma of the bone can vary depending on the size and location of your child’s tumour.
- Bone pain, particularly occurring at night
- A mass or swelling
- Restricted movement in a joint
Symptoms can sometimes be confused with more common problems such as a sports injury or growing pains.
Diagnosis
Your GP will examine your child and may arrange tests or X-rays. If your GP suspects that your child may have a bone tumour, they should refer your child to a specialist centre or hospital for further tests.
Your child will have a physical examination at the specialist centre or hospital. They may also be given a blood test to check their general health.
The doctor may conduct an X-ray of the bone that is in pain, which is often used to diagnose a bone tumour.
Your child may also have a number of tests, including a chest X-ray, a biopsy, an MRI or a CT scan. You can read more about scans and tests here.
Treatment
Surgery
During surgery, the surgeon will remove the tumour and will aim to take out an area of normal tissue around it too. This is known as taking a margin. To achieve this margin of normal tissue, your child may receive limb-sparing surgery. The aim of this surgery is to preserve the limb where the tumour is rather than amputating it.
Limb-sparing surgery involves taking out the affected bone and replacing it with a bone graft (bone taken from another part of the body). Unfortunately, it’s not always possible to use limb-sparing surgery. Sometimes the cancer may spread from the bone to the nerves and blood vessels around it. If this happens the only way to treat the cancer may be to remove part of the limb known as a partial amputation. Your child may need to have all of their limb removed. This is called a full amputation.
Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. It is sometimes used before surgery to reduce the size of the tumour so it can be operated on and removed. This can be useful to treat large tumours and can prevent the need to have the limb either partially or fully amputated.
Chemotherapy is also sometimes used after surgery. In this case, the aim is to kill off any local cancer cells which remain in the area of the tumour.
Radiotherapy
Radiotherapy uses high-energy radiation beams to destroy cancer cells. If your child’s cancer is in the bones and it’s impossible to remove the tumour surgically, then radiotherapy can be used. It’s often used after chemotherapy and before or after surgery. Ewing sarcoma tends to respond well to radiotherapy.
After treatment
Many children with Ewing sarcoma are cured. Regular check-ups and X-rays are needed. Your child will have follow-up appointments every few months for the first 3 years after treatment and then every 6 months for another 2 years.
