Ewing's Sarcoma: Treatment Options

How is it treated?

• Chemotherapy: Chemotherapy is the use of drugs to kill cancer cells. These drugs can be delivered either orally, in the form of pills, or intravenously, directly into the blood stream through a needle placed into a blood vessel. In chemotherapy, combinations of drugs tend to be more effective than just one type of drug by itself.
  
  Chemotherapy drugs can usually be taken in a doctor's office or hospital, or even at home in some cases. Usually, the patient will go to see the doctor every day for a few weeks to receive the treatment. The patient will then have some time off from the medicine in order to build up strength and allow his or her immune system to recover. This cycle can continue until the doctor determines the cancer has stopped spreading or is beginning to go away.
  
  The dose, or amount of chemotherapy you receive, depends on several factors, including your medical history, age, and severity of cancer. Studies have found that younger patients are better able to handle the side effects of higher doses of these drugs. Patients who have experienced chemotherapy in the past, or those whose bodies are no longer responding to the treatment, may not feel the benefits as strongly as others.
  
  
• Radiation Therapy: In this form of treatment, high-energy rays are targets at the tumor area. A doctor can apply radiation locally to the tumor site in an attempt to reduce the size of the tumor and prevent any further growth. The patient usually needs to go to a radiation oncology department five days a week for several weeks in order to have this procedure done.
  
  In the case of Ewing's sarcoma, radiation and/or chemotherapy can be used to minimize the tumor independently, or it can be used to shrink a tumor prior to scheduled surgery.
  
  
• Surgery: Sometimes, depending on size and location, tumors can be surgically removed. During surgery, an orthopedist, or bone specialist, remove the tumor and any affected tissue surrounding it. Occasionally, a tumor in the arm or leg may cause the entire limb to be amputated. If the tumor is interfering with the function of the surrounding blood vessels or nerves, all or part of the bone may need to be taken out. When a patient needs to have a full or partial amputation, their limb can be fitted with a prosthesis, or an artificial limb. In most cases, patients are able to return to a fairly normal activity level once the body has adjusted to the amputation and prosthesis fitting.
  
  
• Bone Marrow Transplantation: Strong doses of chemotherapy tend to destroy the bone marrow cells. In cases where a doctor thinks that the patient will benefit greatly from a higher dose of chemotherapy, a bone marrow transplant may be necessary to prevent some of the side effects of weakened bone marrow. When dealing with Ewing's sarcoma, the best way to do this is through an autologuous transplant.
  
  • Autologous Transplants: In an autologous transplant, the patient's own bone marrow is extracted prior to the high dose chemotherapy treatment. It is then preserved, usually by freezing, and placed back into the body after the treatment is complete.
    

Clinical trials

In some case, your doctor may recommend or you may wish to consider participating in a clinical trial. Clinical Trials are carefully monitored research studies that provide patients with the opportunity to receive the most up-to-date, state-of-the-art care. In a clinical trial, new advancements in cancer treatment are compared to the current, most effective existing treatment. All participants are either treated with an existing and effective method, or with a new, innovative method. Patients in clinical trails have access to the newest drugs, procedures, and treatments. While the side effects of clinical trials depend on the exact treatment used, patients who have participated in clinical trials in the past have found their experience to be valuable. Clinical trials are being conducted in cities and towns across the country, and oftentimes, the clinical trial covers many of the costs. If you are interested, your doctor or health care provider can give you more information on clinical trials in your area. You may also call the Rhode Island Cancer Council who can help you to find a clinical trial in your area.

Possible side effects from treatment

When deciding on a course of treatment, it is important to weigh the benefits of the treatments against the side effects. The side effects described below are some of the most common; however, everyone reacts differently to these treatments. Your doctor will be able to help you decide which of the options is best for you. Throughout y our treatment, it is important to keep the rest of your body healthy by eating a balanced diet and to avoid crowds and people who are sick in order to decrease your exposure to infection. Patients are encouraged to get plenty of rest so that their bodies can heal, but also to remain as active as possible in their everyday lives.

• Chemotherapy: The medicine used in chemotherapy targets and kills the cancer cells in the body. Cancer cells are identified by the medicine as those cells that divide rapidly. Many times, chemotherapy not only kills these cancer cells, but it can damage or even reduce the number of normal, healthy cells in the body, in particular, those healthy cells which divide rapidly. These cells include:
  
  • The lining of the digestive tract, including the inside of the mouth and the cells in the intestines.
    
  • The immune cells located in the bone marrow.
    
  • The cells responsible for hair growth on various parts of the body (hair follicles).
    
  As a result, a chemotherapy patient may experience some side effects such as sores inside the mouth, digestive problems such as loss of appetite or nausea and vomiting. Patients also tend to experience hair loss as a result of chemotherapy. The immune system also suffers because the body is less able to fight off infection and produce blood cells. A lack of red blood cells may also result in fatigue and a decrease in platelets may result in bruising easily and prolonged bleeding. These side effects are, for the most part, temporary and will go away when the chemotherapy is stopped. Some of the permanent side effects include early menopause in women and infertility in both men and women.
  
  
• Radiation Therapy: Patients undergoing radiation therapy often complain of feeling tired. The radiation exposure can also cause a patient's skin to become red or dry, especially in areas that are exposed to the cold air or sun, or where clothing may rub. You should avoid using any creams or lotions unless your doctor prescribes them. Wearing loose, soft, comfortable clothing and avoiding extreme hot or cold temperatures can help with this. Also, the radiation can affect various parts of the body, depending on the location of the tumor. For instance, if the digestive system is exposed to radiation because the tumor is located in the lower back, the patient may experience some digestive problems.
  
  
• Surgery: Immediately following surgery, you may experience pain or swelling at the site of the incision. After an amputation, many patients experience pain in the nerve endings that had been connected to the limb. Most of these symptoms lessen and disappear in time.
  
  It is recommended that patients using prosthesis avoid sports and activities that require physical contact. Most patients living with prosthesis have regained much of their original motility and do participate in sports such as skiing.
  

Follow up

Throughout your treatment process, and even afterwards, it is important to keep your doctor up to date on how you are doing. If your doctors suggest follow-up visits, be sure to go to the appointments. If further tests are ordered, it is important that you have them done. Even though you may be feeling better, you want to make sure that you are able to stay healthy over time. Your doctor is there to help you, and he or she is one of your best resources for information and support throughout this process.

If you found this information helpful, please consider making a donation to the Rhode Island Cancer Council so we may continue adding content to our website and providing valuable services to Rhode Island residents. Please click the Donate icon to the left to make a donation via credit card or your PayPal account.

See also: