Childhood Bone Cancer
About 1% of all children who have cancer have Ewing's sarcoma.  Named after Dr. James Ewing who first described it in the 1920s, Ewing's sarcoma is the second most common form of bone cancer (after osteosarcoma).  Although it is considered a bone cancer, Ewing's sarcoma is actually a family of tumors that can also affect soft tissue.  Most Ewing's tumors are found in the distal and proximal ends of long bones.  The most common sites of origin are:

• Distal extremities - 27%
• Proximal extremities - 25%
• Pelvis - 20%
• Chest - 20%
• Spine/Skull - 9%

Most people who are diagnosed with Ewing's sarcoma are children or adolescents between the ages of 10 and 20.  Adults can also get it, but this cancer is rarely found in people older than 30.  Boys are slightly more likely to develop this cancer than girls, and it is most often found in Caucasians.

Like osteosarcoma, symptoms of Ewing's sarcoma vary from person to person.  The most common symptoms are pain, swelling, and tenderness of the affected area.  If the tumor is in the ribs, the child may have difficulty breathing.  If it is a large tumor in the bone, the child may also suffer a bone fracture while performing even an ordinary movement.  Other common symptoms include fatigue, fever, weight loss, and anemia.

Parents who suspect that their child has a tumor should take him or her to the physician immediately.  Diagnosing cancer will involve more than one doctor visit, more than one medical professional, and several tests that may include:

• Imaging tests (x-rays, MRIs, or CT Scans) to help determine if cancer is present and if it has spread.
• Blood test to determine the presence of cancer.
• Bone test to determine if cancer has spread.
• Biopsy to determine the type of cancer.  Most biopsies are performed under general anesthesia, especially when children are involved.

Ewing's sarcoma looks similar to other bone cancers, so a positive diagnosis is made only after several tests have been performed and only after several medical professionals have reviewed the results.  If Ewing's sarcoma is present, the child's treatment may consist of chemotherapy, surgery, radiation, or any combination of the three.  Based on the stage and location of the tumor and the general physical condition of the child, the physician will recommend which course of treatment is best.

Fortunately, Ewing's sarcoma is a rare cancer.  Only 150 new cases are diagnosed in the US each year.  Unfortunately, nearly all of these are children.  About 64% of patients are between the ages of 10 and 20; 27% are children less than 10.  If the tumor has not spread, the child has a 50-60% chance of surviving at least five years.  This chance increases to 80% if the tumor is found below the elbow or midcalf. 

Sources: 
"Ewing's Family of Tumors."  (2003, August 21.)  Retrieved November 7, 2003, from the National Cancer Institute:  http://www.cancer.gov/cancerinfo/pdq/treatment/ewings/healthprofessional/ 

"Ewing's Sarcoma."  (2001, August 7.)  Retrieved November 7, 2003, from AETNA InteliHealth: http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/24565.html

"Ewing Sarcoma Family Tumor." (2003, August.)  Retrieved November 7, 2003, from St. Jude Children's Research Hospital: http://www.stjude.org/disease-summaries/0,2557,449_2167_2956,00.html

"Ewing's Sarcoma FAQ."  (2003, May 17.)  Retrieved November 7, 2003, from the Cancer Index: http://www.cancerindex.org/ccw/faq/ewings.htm 

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