• Although mainly found to start in the bones, it can sometimes start in the soft tissue. 

• This is called an extra osseous Ewing’s sarcoma.

• Ewing’s sarcoma most commonly occurs in teenagers.

What causes Ewing's sarcoma?

The causes of Ewing’s sarcoma is unknown, however it is suggested that it could be caused by rapid bone growth. This may be why it is often found in teenagers.

What are the symptoms?

• Pain is the most common symptom of Ewing’s sarcoma. This depends on where the cancer is located. 

• There may be some swelling over the site, or it may be sore to touch. 

• Sometimes because the bone is weakened from the cancer, it can break easily. This is sometimes how people find out about their cancer. 

TIP: If you have any of these symptoms you should have them checked by your doctor - but remember, they are common to many illnesses.

How is it diagnosed?

After visiting a GP a referral with most probably be made to a hospital for some tests. These may include:

• X-rays

• Bone scan

• Blood test

• Bone marrow aspirate

• MRI

• CT scan

If the results of the test show Ewing’s sarcoma, another referral will be made to a doctor who specialises in the treatment of bones (called an orthopaedic doctor).

Some of the tests they undergo will be done by a specialist bone surgeon.

How is it treated?

A team of doctors and other staff at the hospital will plan the treatment. It will depend on the size of the tumour and where it is.

Treatment may be coordinated by an oncologist (a doctor who specialises in treating cancer with chemotherapy) an orthopaedic surgeon (a surgeon who specialises in bones) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve:

• Chemotherapy

• Radiotherapy

• Surgery

Most people have chemotherapy to shrink to size of the tumour and to get rid of any cancer cells around the body. This is usually followed with surgery to remove the tumour. More chemotherapy and radiotherapy usually follows.

Chemotherapy for Ewing’s Sarcoma

• This treatment is often given to people with Ewing’s sarcoma to shrink the tumour prior to surgery. This means that the surgery will be less invasive. Often chemo starts again after surgery to kill any remaining cancer cells and stop them from spreading. This is called adjunct chemotherapy.

For more information about chemotherapy, go to our chemotherapy fact sheet.

Surgery for Ewing’s Sarcoma

• The aim of surgery is to remove the tumour. Because of the type of tumour (being in the bone) it can often be difficult to remove. Sometimes some of the bone will be removed, and either a prosthesis (a metal replacement bone), or a bone graft (bone taken from another part of the body) will be inserted. This is known as limb-sparing surgery.

• Unfortunately because of the location of the tumour, sometimes limb-sparing surgery doesn’t work and a limb might have to be amputated. It only ever happens if it is completely unavoidable. This is because the cancer has spread from the bone and into the nearby blood vessels. 

For more information about surgery, go to our surgery fact sheet.

Radiotherapy for Ewing’s Sarcoma

• Radiotherapy is often given to people with Ewing’s sarcoma before and/or after surgery. This is to shrink and destroy the tumour. For people with a tumour on the spine, it may be used instead of surgery.

For more information about radiotherapy, go to our radiotherapy fact sheet.

Side Effects

There are some side effects of the treatments for Ewing’s sarcoma which can be found in our side effects fact sheets.

More information

You may want to check out the fact sheets on the left hand side for more information on related topics.

Check out our community pages to chat with other young people about Ewing’s sarcoma, its treatment….or anything really.