Ewing’s Sarcoma

Treatment

The treatment of Ewing sarcoma is done through the following interventions:

• Chemotherapy: Chemotherapy involves drugs that destroy rapidly dividing cells, such as cancer cells. It is usually the initial treatment for Ewing sarcoma. With the advancements of new chemotherapy drugs, the survival rates and favorable outcomes in patients with Ewing sarcoma are significantly increased. Chemotherapy drugs shrink the tumor and are combined with radiation therapy or surgery. Chemotherapy may also be used after radiation therapy or surgery to kill the remaining cancer cells.
• Surgery: Surgery is a treatment option for Ewing sarcoma to remove the primary tumor. It may be one of the preferred treatment options if the tumor is limited to the bones or surrounding tissues. Surgery may also be an option in combination with chemotherapy or radiation therapy if the tumor has spread to other organs. During surgery, the oncosurgeon removes the tumor along with some of the surrounding healthy tissues. It reduces the risk of cancer recurrence. Surgery also involves the reconstruction of the joints, bones, or soft tissues after the tumor has been removed. The reconstruction surgery aims to restore the anatomy and functional characteristics as optimally as possible. The outcomes of reconstructive surgery depend upon the severity and extensiveness of the tumor and the number of tissues removed during the tumor removal surgery.
• Radiation therapy: Radiation therapy involves use of high-energy radiations to kill cancerous cells. The technique is usually combined with chemotherapy (chemoradiation therapy) and surgery to make the treatment more effective. Radiation therapy also reduces the risk of cancer recurrence. Radiation therapy is also indicated in patients who are not eligible for surgical interventions.
• High-dose chemotherapy: High-dose chemotherapy may also be used in patients with advanced Ewing sarcoma. However, stem cell rescue procedure is also performed prior to high-dose chemotherapy. The blood-forming cells are destroyed during high-dose chemotherapy, therefore, before starting the high-dose chemotherapy, the stem cells are extracted from the bone marrow of blood and are preserved. The preserved stem cells are infused into the patients after completing high-dose chemotherapy.
• Immunotherapy: Immune system identifies and kills the abnormal cells, such as cancer cells, in the body. However, cancer cells develop certain processes that help them evade the immune system and allow them to grow in the body. Immunotherapy drugs interfere with this process and make the cancer cells more vulnerable to immune system attack.
• Targeted therapy: Several chemicals in the cancer cells, such as proteins and enzymes, are essential for their growth, development, division, and spread. Targeted therapy inhibits the action of these chemicals and kills cancer cells.