Ewings sarcoma

Ewing’s sarcoma is a malignant tumour that develops from the stromal cells of the bone marrow. The bones are the primary target of the tumour. Illness has a negative prognosis as tumour grows fast and metastasizes early. In general, Ewing’s sarcoma is not a widespread condition. Though, this disease is the second most frequent malignant oncological pathology among all the paediatric tumours. 

Ewing's sarcoma – Diagnostics

Following visualization methods will help to identify the pathological changes of the bones, tumor and its metastases:

• Radiography
• Computed tomography
• Magnetic resonance imaging
• Positron-emission tomography

A biopsy with the following examination of the tumor tissue is required for confirming the diagnosis:

• Immunohistochemistry
• Cytogenetic examination
• Using a PCR (polymerase chain reaction)

Biopsy can be excisional or incisional. Excisional biopsy is rarely applied as it requires removal of the whole tumor. It’s possible at the beginning stage of Ewing’s sarcoma, when malformation has a small size and is located in the convenient for surgical intervention place.

Incisional biopsy means taking tumor fragment for analysis. The procedure is held by one of the following ways:

• Closed – with the help of needle
• Opened – through the incision (surgical intervention)

In some cases, bone marrow biopsy is needed, as Ewing’s sarcoma often gives metastases over there. 

Other examination methods that can be used for the diagnostics are:

• Bone scan (for detecting bone metastases)
• Angiography
• Ultrasound examination

Best clinics for the Ewing's sarcoma diagnostics in Germany:

University Hospital Oldenburg

7788

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HELIOS Clinic Krefeld

7443.86

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Helios Hospital Berlin-Buch

7893.82

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Ewing's sarcoma – Treatment

Basic methods for Ewing’s sarcoma treatment are:

• Chemotherapy
• Radiation therapy
• Surgical intervention

Surgeries can be different depending on the location of the tumour. If tumour is extensive, then surgery is not performed. Instead, doctors prescribe only chemotherapy and radiation therapy. 

Surgeons remove a bone and replace it with a prosthesis when sarcoma is located on the limbs. The prosthesis in children have to be replaced after several years due to the ongoing growth of the skeleton. There are high-tech prostheses that can change their size without any surgery. A limb is rarely amputated if sarcoma is present in the bones. 

If the tumour is located in the chest, surgeons remove the tumour and nearby ribs. Often, Ewing’s sarcoma spreads into the lungs and thus the surgery expands to those areas as well. 

Tumours of the pelvic cavity require the removal of bone fragments. Regardless of tumour location, doctors remove soft tissues together with the bone. Meanwhile, the surgeon tries to preserve nerves and tendons as much as possible to ensure the mobility of the operated body part.

Best clinics for the Ewing's sarcoma treatment in Germany:

Vitos Orthopedic Clinic Kassel

Surgical treatment for Ewing sarcoma

19938.82

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Gamma Knife and Radiotherapy Center Krefeld

Chemotherapy and radiation therapy for Ewing sarcoma

35162.18

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Catholic Clinic Koblenz-Montabaur

Surgical treatment for Ewing sarcoma

19783.26

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Ewing's sarcoma – Rehabilitation

Most patients require rehabilitation after the treatment of complex oncological diseases. It includes the following aspects:

• Prevention of complications that may occur as a result of treatment. It can be pneumonia, lymphostasis, thromboembolic or infectious complications.
• Restoration of general health. The elimination of the consequences after surgeries and chemotherapy is carried out. The functions of internal organs are restored with the help of various medical and rehabilitation measures.
• Restoration of occupation. A person must not just stay alive. He must have physical and intellectual capabilities, which are sufficient for employment. 
• Psychological support. First of all, it is required for patients, whose occupational performance was harmed because of the disease. Patients with deterioration of appearance also will benefit from psychological help.
• Restoration of appearance. If necessary, you can use surgical and other methods in Germany to restore appearance defects caused by cancer. For example, to carry out the reconstruction of the breast.

In German clinics, rehabilitation is carried out in a comprehensive manner. The patients are provided with qualitative care here. Doctors' monitoring and conservative treatment allow to avoid complications, which usually happen after treatment of oncological diseases. Psychotherapy, physiotherapy and physical therapy are actively used in Germany.

Specialists in different medical spheres take part in the rehabilitation process. These are massage therapists, speech therapists, specialists in physiotherapy exercises, physiotherapists. Social and occupational therapy is carried out, as well. If necessary, people are taught how to eat properly, take care of the postoperative scar, etc.

In Germany, rehabilitation is carried out with the maximum level of comfort for the patient. A person feels the results quite quickly and it improves his motivation and promotes further recovery.

Authors:

The article was edited by medical expert, board certified Dr. Nadezhda Ivanisova. For the treatment of the conditions referred to in the article you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Center for Biotechnology

American Cancer Society

Cancer Support Community