Ewing sarcoma in adults

This page explains the symptoms, diagnosis and treatment of Ewing sarcoma in adults. We also have separate information for teenagers and young adults, and for children. 

If you have any questions about Ewing sarcoma or if you need to talk to someone, our Support Line team are here for you.  

What is Ewing sarcoma? 

Ewing sarcoma is a type of cancer that starts in bones (primary bone cancer). It is mostly diagnosed in teenagers and young adults, but it can happen at other ages. It is slightly more common in men than in women.   

Ewing sarcoma most often affects the: 

• pelvis  
• thigh bone (femur) 
• shin bone (tibia) 
• ribs 
• shoulder blades. 

Sometimes Ewing sarcoma can start in the soft tissue near the bone. This is called extraosseous Ewing sarcoma (EES). You may also hear it called soft tissue Ewing sarcoma. Sometimes these cancers are called primitive neuroectodermal tumours (PNETs). 

These are usually treated in the same way as Ewing sarcoma that starts in the bone. 

Symptoms of Ewing sarcoma

The symptoms of Ewing sarcoma depend on which part of the body the tumour starts in.  

People often notice: 

• bone pain that does not go away and may be worse at night 
• swelling or a lump 
• stiffness or problems moving a joint. 

Diagnosing Ewing sarcoma 

If you have symptoms that could be bone cancer, your GP will examine you and may refer you to a specialist team. The specialist team will use different scans and tests to see if you have Ewing sarcoma.  

You might have one or more of these tests:   

• X-ray: uses X-radiation to take images of dense tissues inside the body, such as bones or tumours. 
• MRI scan: uses magnets to create an image of the tissues of the body. 
• core needle biopsy: a small sample of bone taken with a needle. 
• PET-CT scan: combines a CT scan with a positron emission tomography (PET) scan. A small amount of radioactive material is injected into a vein before the scan. It can help show where the cancer is in the body and whether it has spread. 

We have more information about the different types of scans and tests you might have. 

If you’re diagnosed with Ewing sarcoma, a team of experts called a multidisciplinary team (MDT) at a sarcoma specialist centre will look at your results and work with you to plan your treatment. 

After treatment

After your treatment for Ewing sarcoma is finished, you will have follow-up appointments for several years. This is where your doctor can look for signs of sarcoma coming back. 

During follow-up, you will have: 

• a chance to discuss symptoms  
• examinations to look for any signs of sarcoma returning 
• imaging scans such as a CT or MRI 
• chest X-rays to check whether the cancer has spread to the lungs 
• a chance to talk about how you’re feeling and any worries you have. 

We know that some people can feel uncertain and overwhelmed when treatment finishes, and that is completely normal. We have more information about living with and beyond sarcoma. 

Recurrence  

Ewing sarcoma can sometimes come back in the same area after treatment. This is called a local recurrence. 

Sometimes Ewing sarcoma can spread to other parts of the body. This is called metastasis or secondary cancer. The most common areas where it can spread are the lungs, other bones, or soft tissue. Because of this, you may have chest X-rays or other scans during your follow-up appointments. These help your team check for any signs of the cancer returning or spreading.

If the cancer does come back or spread, your specialist team may offer more treatment. This may include chemotherapy, surgery, or radiotherapy. Your team will plan your treatment based on your individual situation. 

It is useful to check for recurrences yourself through self-examination. Your doctor or sarcoma clinical nurse specialist can tell you what to look for.    

It’s normal to feel worried that sarcoma might come back after treatment. Many people feel this way. If you’re feeling anxious, speak to your healthcare team. They can reassure you, answer your questions, and help you find support.    

We have more information about if sarcoma comes back.