Home
PG College
Patient Login
International patients
Contact Us
Emergency
Download Reports
Ewing Sarcoma Care Pune
At Sancheti Hospital, we manage Ewing Sarcoma with multimodal therapy including chemo, surgery, and rehab to enhance recovery and function.
Overview
Ewing sarcoma is a rare but aggressive form of cancer that primarily affects bones and the soft tissues around them. It represents one of the most common bone tumors in children and teenagers, though it accounts for less than 2% of all childhood cancers.
This cancer typically strikes young people between ages 10 and 20, with most cases diagnosed around age 15. While Ewing sarcoma can develop in any bone, it most commonly affects the long bones of the arms and legs, pelvis, chest wall, and spine. The condition belongs to a group called the Ewing sarcoma family of tumors, which includes several related cancers.
The good news is that treatment advances have significantly improved outcomes for patients with Ewing sarcoma. With proper medical care and early detection, many patients can achieve long-term survival and return to normal activities.
Symptoms
Ewing sarcoma symptoms can be subtle at first, often resembling common injuries or growing pains. This similarity to everyday problems sometimes leads to delayed diagnosis, making it important for parents and patients to watch for persistent symptoms.
The most common signs include:
- Pain at the tumor site – This is usually the first symptom, often starting as mild discomfort that gradually worsens. The pain may be worse at night and can interfere with sleep and daily activities.
- Swelling or lumps – A noticeable bump may appear near the affected area, which might feel warm or tender to touch.
- Unexplained fever – Persistent fever without an obvious cause can be a warning sign.
- Fatigue and weight loss – These general symptoms may indicate the cancer is affecting the body’s overall health.
- Bone fractures – The tumor can weaken bones, leading to breaks from minor injuries or even normal activities.
- Difficulty moving or limping – If the tumor affects leg bones, walking may become painful or difficult.
- Numbness or tingling – Tumors near the spine can press on nerves, causing these sensations.
Causes
The exact cause of Ewing sarcoma remains unknown, but researchers have identified specific genetic changes that occur in the cancer cells. Unlike some other cancers, Ewing sarcoma is not linked to lifestyle factors, environmental exposures, or inherited genetic conditions passed down from parents.
The key genetic change involves a process called chromosomal translocation, where pieces of chromosomes break off and attach to different chromosomes. In most Ewing sarcoma cases, this creates an abnormal gene fusion called EWSR1::FLI1, which combines parts of two normally separate genes.
This genetic fusion produces an abnormal protein that disrupts normal cell function, causing cells to grow and divide uncontrollably. This uncontrolled growth eventually forms the tumors characteristic of Ewing sarcoma.
Importantly, these genetic changes happen after birth and are not inherited, meaning parents cannot pass Ewing sarcoma risk to their children through their genes.
Risk Factors
Several factors are associated with higher Ewing sarcoma risk, though most cannot be changed or prevented:
- Age – The cancer predominantly affects children and young adults, with over half of cases occurring between ages 10 and 20. It’s uncommon in children under 5 or adults over 30.
- Sex – Males are slightly more likely to develop Ewing sarcoma than females.
- Race and ethnicity – The condition is much more common in people of European descent and rare in those of African or East Asian heritage. Genetic research suggests certain inherited genetic variations may influence this difference.
- Growth periods – The rapid bone growth during adolescence may play a role in Ewing sarcoma development.
Unlike many other cancers, Ewing sarcoma is not associated with common cancer-causing factors like smoking, radiation exposure, or most inherited cancer syndromes.
Diagnosis
Diagnosing Ewing sarcoma requires a comprehensive evaluation by a team of specialists, including oncologists, surgeons, and pathologists. The process typically involves several steps:
Initial Assessment Doctors begin with a physical examination and detailed medical history, looking for lumps, swelling, or other concerning signs while asking about symptoms and their duration.
Imaging Tests Multiple imaging studies help visualize the tumor and determine its extent:
- X-rays – Often the first test, which may show characteristic bone changes
- MRI scans – Provide detailed images of the tumor within bone and surrounding tissues
- CT scans – Help detect cancer spread to the lungs and other organs
- PET scans – Can identify cancer cells throughout the body based on their metabolic activity
- Bone scans – Check for cancer spread to other bones
Biopsy: A definitive diagnosis requires removing a small piece of the tumor for laboratory analysis. This can be done through a needle biopsy or minor surgical procedure. Pathologists examine the tissue under a microscope and perform specialized tests to confirm the presence of Ewing sarcoma and identify the characteristic genetic changes.
Additional Tests: Blood tests measure various markers that can indicate cancer presence and help guide treatment. Bone marrow examination may also be necessary since Ewing sarcoma can occasionally spread to the bone marrow.
Types
Ewing sarcoma is actually a family of closely related tumors that share similar genetic characteristics. The main types include:
- Classical Ewing sarcoma of bone – The most common form, originating directly in bone tissue
- Extraosseous Ewing tumor – Develops in soft tissues near bones, such as muscles, tendons, or ligaments, accounting for about 20% of cases
- Peripheral primitive neuroectodermal tumor (PNET) – A related tumor that can occur in bone or soft tissue, with slightly different genetic features
All these types are treated similarly due to their shared characteristics and response to therapy.
Stages
Ewing sarcoma staging describes how far the cancer has spread, which is crucial for treatment planning and understanding prognosis. The main stages include:
Localized Disease: The cancer remains confined to its original location in bone or soft tissue, possibly extending to nearby tissues or regional lymph nodes. This stage generally has the best prognosis.
Metastatic Disease: The cancer has spread to distant parts of the body, most commonly the lungs, other bones, or bone marrow. About 25% of patients have metastatic disease at diagnosis, which presents greater treatment challenges.
Recurrent Disease: Cancer that returns after initial treatment, either at the original site or in new locations. Recurrentb is typically more difficult to treat successfully.
Treatment
Ewing sarcoma treatment requires a coordinated approach involving multiple specialists and typically follows a specific sequence over many months.
Chemotherapy: Treatment almost always begins with chemotherapy to shrink the tumor and eliminate cancer cells that may have spread. The standard regimen alternates between two drug combinations: VDC (vincristine, doxorubicin, and cyclophosphamide) and IE (ifosfamide and etoposide). This chemotherapy phase typically lasts 6-12 months.
Local Tumor Control: After initial chemotherapy, doctors focus on eliminating the primary tumor through:
- Surgery – The preferred option when possible, involving complete tumor removal with wide margins of healthy tissue. In rare cases, amputation may be necessary.
- Radiation therapy – Used when surgery isn’t feasible or when cancer cells remain after surgery. Ewing sarcoma is highly sensitive to radiation.
- Combined approach – Sometimes both surgery and radiation therapy are used together.
Consolidative Chemotherapy: Additional chemotherapy follows local treatment to eliminate any remaining cancer cells and reduce recurrence risk.
Advanced Treatments: For metastatic or recurrent disease, doctors may consider:
- High-dose chemotherapy with stem cell transplantation
- Targeted therapies that attack specific cancer pathways
- Immunotherapy approaches currently being studied in clinical trials
Rehabilitation
Rehabilitation plays a vital role in helping patients recover function and adapt to changes from cancer treatment. The rehabilitation team includes physical therapists, occupational therapists, and other specialists who work to:
- Restore strength and mobility in affected limbs
- Improve daily living activities
- Address long-term physical effects of treatment
- Provide emotional support for coping with physical changes
Rehabilitation begins early in treatment and continues as needed throughout recovery, helping patients return to school, work, and recreational activities.
Complications
While Ewing sarcoma treatment has greatly improved outcomes, the disease and its intensive therapies can cause various complications:
Disease-Related Complications
- Metastatic spread to lungs, other bones, or bone marrow
- Recurrence of cancer, often within the first 2-5 years after treatment
- Bone fractures due to tumor weakening of bone structure
Treatment-Related Complications: The intensive nature of Ewing sarcoma treatment can lead to late effects that appear months or years after therapy ends:
- Heart and lung problems from chemotherapy and radiation therapy
- Growth and development issues in children
- Cognitive and emotional difficulties
- Second cancers due to treatment exposure
- Infertility affecting future family planning
- Bone and joint problems in treated areas
Regular follow-up care is essential to monitor for and manage these potential complications.
Prevention
Currently, there is no known way to prevent Ewing sarcoma. Since the genetic changes that cause the cancer occur randomly after birth and are not linked to environmental factors or lifestyle choices, prevention strategies don’t exist.
However, early detection and prompt treatment significantly improve outcomes. Parents and teenagers should be aware of the warning signs and seek medical evaluation for persistent bone pain, swelling, or other concerning symptoms.
Living With Ewing Sarcoma
Living with Ewing sarcoma involves adapting to ongoing medical care, monitoring for potential complications, and maintaining quality of life during and after treatment.
Follow-up Care Regular medical appointments are crucial for monitoring recovery and detecting any recurrence early. This typically includes:
- X-rays of the original tumor site
- CT scans of the lungs to check for metastasis
- Bone scans to monitor for cancer spread
- Blood tests to assess overall health
- Long-term monitoring for treatment-related complications
Lifestyle Considerations: Maintaining a healthy lifestyle supports overall well-being and recovery:
- Balanced nutrition to support healing and energy
- Regular exercise as tolerated and recommended by the medical team
- Avoiding tobacco and other cancer-causing substances
- Staying up-to-date with vaccinations and preventive care
Key Takeaways
- Ewing sarcoma is a rare but treatable bone cancer that primarily affects children and young adults
- Early detection and prompt treatment significantly improve outcomes
- Treatment requires a comprehensive approach combining chemotherapy, surgery, and/or radiation therapy
- Localized disease has much better prognosis than metastatic disease
- Long-term follow-up is essential to monitor for recurrence and late effects
- Emotional support and rehabilitation services are important components of comprehensive care
- Clinical trials may offer access to promising new treatments
- Prevention is not currently possible, but awareness of symptoms enables early detection
At Sancheti Hospital, we understand the challenges that patients and families face when dealing with Ewing sarcoma. Our comprehensive cancer care team includes experienced oncologists, orthopedic specialists, and support staff who work together to provide personalized treatment plans for each patient.
We offer advanced diagnostic imaging, modern chemotherapy protocols, precise surgical techniques, and state-of-the-art radiation therapy facilities. Our multidisciplinary approach ensures that patients receive not only the latest medical treatments but also the emotional support and rehabilitation services needed for the best possible outcomes.
We are committed to supporting patients and families throughout their journey, from initial diagnosis through long-term follow-up care, helping them navigate this challenging time with expertise, compassion, and hope.
Meet Our Ortho Onco Specialist
Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Will my child be able to play sports again after Ewing sarcoma treatment?
Many children return to sports and physical activities, though this depends on the tumor location and treatment type. Your doctor will assess each case individually, and some may need to avoid high-impact activities to protect treated bones.
Are there any dietary restrictions during Ewing sarcoma treatment?
Chemotherapy can lower immunity, so doctors often recommend avoiding raw foods, unwashed fruits, and restaurant meals. Your medical team will provide specific dietary guidelines based on your treatment plan and blood counts.
Can siblings or family members catch Ewing sarcoma from the patient?
No, Ewing sarcoma is not contagious and cannot spread from person to person. Family members cannot catch it through contact, sharing meals, or living in the same house with the patient.
