Will my child need surgery?
Ewing sarcoma treatment often includes surgery for the initial biopsy and removal of the primary tumor that is visible. When the tumor occurs in a bone, this is usually done with bone grafts, limb-sparing procedures and reconstruction. In cases where the primary tumor cannot be completely removed, radiation therapy is often used with, or in place of, surgery. Because radiation treatment is very effective, amputation is rarely necessary for Ewing sarcoma.
Will my child need chemotherapy? If so, how is it given?
Chemotherapy, before and after surgery, is a critical part of the comprehensive and multidimensional treatment of Ewing sarcoma. It is sometimes given before surgery in order to shrink the tumor, which can make surgical removal easier to accomplish. Chemotherapy is also given after surgery, even if there is no other evidence of tumor left behind. This is done because we know that microscope amounts of Ewing sarcoma remain after surgery. Chemotherapy is used to eradicate these cells to minimize the chance that the cancer will come back at other sites. Chemotherapy for Ewing sarcoma is nearly always given intravenously (IV) through a catheter — called a "central line." Chemotherapy is usually given over a period of two to five days in the hospital. Each of these cycles of chemotherapy is given every two to three weeks. Usually, about 14 cycles of chemotherapy are used.
Will my child need radiation treatment?
Radiation is often given to sites where the Ewing sarcoma is visible. In situations where surgery cannot be used, radiation treatments can effectively control the tumor and prevent the cancer from growing. In some cases, radiation therapy is used after a primary tumor is removed in an effort to get rid of any cancer cells that might have been on the margin or edge of the tumor removal site.
How long will treatment take? How long will my child be in the hospital?
Chemotherapy for Ewing sarcoma is usually given in cycles, with each cycle covering a period of two to five days in the hospital. A new cycle is given every two to three weeks. Usually, about 14 cycles of chemotherapy are needed. The total duration can be from 30 to 45 weeks. At some stage during the treatment, surgery is often performed to remove the visible tumor. The recovery period in the hospital varies from patient to patient, lasting from several days to one to two weeks. Radiation therapy, if needed, is given five days per week for four to six weeks. It is administered in the outpatient treatment center. Chemotherapy is often modified or delayed during surgery or radiation therapy.
What are the side effects of treatment?
Chemotherapy drugs not only attack the cancer cells, they can injure normal tissue and blood-forming cells. For this reason, your child may experience some of the common side effects of chemotherapy including low blood counts (causing anemia), nausea, vomiting, hair loss, mouth sores, irregular periods (girls) and inability to produce sperm (boys). Radiation therapy may put children at a risk of developing a second malignant tumor later in life. Your treatment team will do everything they can to reduce or prevent side effects of treatment.
Does treatment cause infertility?
Patients and their parents should talk to their doctor about the reproductive risks associated with cancer treatment. In certain situations, there are options available to try to preserve fertility, such as with sperm banking. These programs are available at Comer Children’s.