Summary about Disease
Ewing sarcoma is a rare type of cancer that occurs most often in bones, but can also occur in soft tissue. It most commonly affects children and young adults, but can occur at any age. The "Ewing sarcoma family of tumors" (ESFT) encompasses several closely related cancers that share similar genetic changes and cellular origins. These include Ewing sarcoma of bone, extraosseous Ewing sarcoma (occurring in soft tissues), and primitive neuroectodermal tumor (PNET). ESFT is characterized by the fusion of the EWSR1 gene with another gene, most commonly *FLI1*.
Symptoms
Symptoms of Ewing sarcoma can vary depending on the location and size of the tumor. Common symptoms include:
Pain and swelling at the tumor site.
Bone pain that worsens at night or with activity.
A palpable mass or lump.
Fatigue.
Fever (less common).
Unexplained fractures.
Numbness, tingling, or weakness if the tumor presses on nerves.
Bowel or bladder problems if the tumor is near the spine.
Causes
The exact cause of Ewing sarcoma is unknown. It is not linked to lifestyle factors or environmental exposures. It is believed to arise from a genetic mutation that occurs spontaneously, usually involving a translocation between chromosomes, most often chromosomes 11 and 22. This translocation results in the fusion of the EWSR1 gene with another gene, often *FLI1*. This abnormal fusion gene produces a protein that promotes uncontrolled cell growth. It is generally not considered to be inherited.
Medicine Used
Treatment for Ewing sarcoma typically involves a combination of:
Chemotherapy: This is the main systemic treatment used to kill cancer cells throughout the body. Common chemotherapy drugs include:
Vincristine
Doxorubicin
Cyclophosphamide
Ifosfamide
Etoposide
Surgery: Used to remove the tumor whenever possible. Limb-sparing surgery is often preferred to amputation.
Radiation Therapy: Used to kill remaining cancer cells after surgery or to treat tumors in locations where surgery is not feasible. Other medications may be used to manage side effects of chemotherapy or radiation. Targeted therapies and immunotherapies are under investigation for ESFT but are not yet standard treatments.
Is Communicable
No, Ewing sarcoma is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Because Ewing sarcoma is not communicable, there are no specific precautions to prevent its spread. However, general health precautions are always advisable, such as:
Maintaining a healthy lifestyle with a balanced diet and regular exercise.
Avoiding tobacco and excessive alcohol consumption.
Getting regular medical checkups.
Early detection is key if symptoms emerge, consult with a medical professional.
How long does an outbreak last?
Ewing sarcoma is not an infectious disease and does not occur in "outbreaks." It is a cancer that develops in an individual. The duration of treatment can vary significantly depending on the stage of the cancer, the individual's response to treatment, and the specific treatment plan. Treatment can take several months to over a year.
How is it diagnosed?
Diagnosis of Ewing sarcoma typically involves the following:
Physical Exam and Medical History: The doctor will assess the patient's symptoms and medical history.
Imaging Tests:
X-rays: To visualize bone abnormalities.
MRI (Magnetic Resonance Imaging): To provide detailed images of the tumor and surrounding tissues.
CT (Computed Tomography) Scan: To check for spread to other organs, particularly the lungs.
Bone Scan or PET Scan: To identify areas of increased bone activity, which may indicate cancer spread.
Biopsy: A sample of tissue from the tumor is taken and examined under a microscope to confirm the diagnosis and determine the specific type of cancer. Molecular testing is done to identify the characteristic EWSR1 fusion gene.
Timeline of Symptoms
The timeline of symptoms can vary greatly. Some individuals may experience symptoms for weeks or months before seeking medical attention, while others may have a more rapid onset of symptoms.
Early stages: Pain and swelling may be mild and intermittent, often mistaken for a sports injury.
Progression: Pain becomes more persistent and severe. A palpable mass may develop. Systemic symptoms like fatigue and fever may appear.
Advanced stages: Symptoms related to metastasis (spread to other organs) may develop, such as shortness of breath (if the cancer has spread to the lungs) or neurological problems (if it has spread to the brain or spinal cord).
Important Considerations
Early Diagnosis is Crucial: The earlier Ewing sarcoma is diagnosed, the better the chances of successful treatment.
Multidisciplinary Approach: Treatment requires a team of specialists, including oncologists, surgeons, radiation oncologists, and supportive care professionals.
Long-Term Follow-Up: Because of the potential for late effects from treatment and recurrence, long-term follow-up is essential. This includes regular imaging and monitoring for secondary cancers.
Fertility Preservation: Treatment can affect fertility. Consider fertility preservation options before starting treatment, especially for adolescents and young adults.
Clinical Trials: Patients may consider participating in clinical trials to access new and potentially more effective treatments.