Doctors treating Ewing’s Sarcoma can use a range of treatments to achieve a positive outcome, although regrettably this is not possible all of the time.
The options available to healthcare professionals include chemotherapy, radiotherapy and surgery. Wherever possible, surgery will be used to remove the tumour, because this is currently considered the best hope for the cure.
Chemotherapy is the use of drugs to treat cancer. Cancer cells reproduce rapidly, so the treatments used are designed to kill cells that grow rapidly. This is why people being treated often lose their hair.
Ewing’s Sarcoma is usually treated using a number of different drugs.
One drug commonly used is Vincristin. This is a clear, colourless drug given through a syringe into a PICC line or directly into a vein. This is given once per treatment.
Another drug used is Ifosfamide, another clear, colourless drug that is given through a drip. This is given three or four times per treatment.
A third drug is Doxorubicin. This is a red drug given through a drip. This is also given three or four times per treatment.
Another drug used is Etoposide, another clear and colourless drug given through a drip. This is given three or four times per treatment.
These drugs are normally given before surgery, and are commonly known as VIDE. The idea of these drugs is to kill as much of the tumour as possible.
Chemotherapy is also often given after surgery. This is to ensure if there were any other cancerous cells in the body, they are killed.
Doxorubicin and Etoposide are often stopped for post-operative treatment. Actinomycin is often given alongside Vincristin and Ifosfamide.
Normally patients will have more post-operative chemotherapy than pre-operative treatment. This is perfectly normal and reflects the desire of the doctors to remove the tumour.
Surgery is used to remove the tumour. This is the most favourable option, because it allows doctors to remove the cells from a patients’ body.
There are various different options available when it comes to surgery. Ewing’s often develops in the long bones in the arms or legs. Depending on the location, limb-salvage surgery may be an option. This involves removing the diseased bone and inserting a metal prosthesis. As many Ewing’s patients are still growing, this often needs lengthening.
However, sometimes it is not possible to save a limb. Doctors don’t like doing it, but sometimes amputation is the only way to maximise a patients’ survival chances.
If doctors recommend amputation, it is for one of two reasons; either because there isn’t a large enough margin around the tumour to guarantee all of the tumour is removed, or because what is left would result in virtually no function in the limb.
With the advancements being made in prosthetic technology, often greater mobility can be secured by using a prosthesis.
Radiotherapy involves firing high energy rays at the tumour to kill the cells, whilst doing as little damage to normal cells as possible. Radiotherapy can be used before surgery, or even as part of surgery. It has been known for patients to have a bone removed, irradiated, then re-inserted, although this is not common.
Radiotherapy is also used when surgery is not an option. For some locations, such as the pelvis or spine, it is very difficult to operate without causing significant damage, or risking damaging the tumour and allowing cancer cells to escape and travel around the body. In this case, radiotherapy will be used alongside chemotherapy to treat the tumour.
These treatments can cause a range of side effects. The most common side effects of chemotherapy and radiotherapy are nausea and vomiting. This can often be controlled through the use of anti-sickness drugs.
Other side effects of chemotherapy include hair loss, lowered immunity and increased risk of infection, tiredness and diarrhoea.