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If you have questions or need additional information, we invite you to contact NCI's LiveHelp instant messaging service at https://livehelp.cancer.gov, or call the NCI's Contact Center 1-800-4-CANCER (1-800-422-6237) (toll-free from the United States)."> <svg xmlns="http://www.w3.org/2000/svg" height="24" viewBox="0 0 24 24" width="24" class="usa-icon" role="img" aria-hidden="true" focusable="false"> <path d="M0 0h24v24H0z" fill="none"/> <path d="M20 4H4c-1.1 0-1.99.9-1.99 2L2 18c0 1.1.9 2 2 2h16c1.1 0 2-.9 2-2V6c0-1.1-.9-2-2-2zm0 14H4V8l8 5 8-5v10zm-8-7L4 6h16l-8 5z"/> </svg> <span class="usa-sr-only"> Email </span> </a> </section> </div> </div> <div id="page" class="grid-container"> <div class="grid-row grid-gap">  <div class="desktop:grid-col-3 nci-no-print"> <nav aria-label="Secondary navigation"> <ul class="usa-sidenav"> <li class="usa-sidenav__item"> <a href="/types/bone" data-menu-id="11882" class="usa-current usa-current--nci-ancestor">Bone Cancer</a> <ul class="usa-sidenav__sublist"> <li class="usa-sidenav__item"> <a href="/types/bone" data-menu-id="939883" class="usa-current usa-current--nci-ancestor">Patient</a> <ul class="usa-sidenav__sublist"> <li class="usa-sidenav__item"> <a href="/types/bone/patient/child-chordoma-treatment-pdq" data-menu-id="1150561">Childhood Chordoma</a> </li> <li class="usa-sidenav__item"> <a href="/types/bone/patient/ewing-treatment-pdq" data-menu-id="947777" class="usa-current" aria-current="page">Ewing Sarcoma Treatment</a> </li> <li class="usa-sidenav__item"> <a href="/types/bone/patient/osteosarcoma-treatment-pdq" data-menu-id="947589">Osteosarcoma Treatment</a> </li> </ul> </li> <li class="usa-sidenav__item"> <a href="/types/bone/hp" data-menu-id="939885" class="nci-has-children">Health Professional</a> </li> <li class="usa-sidenav__item"> <a href="/types/bone/research" data-menu-id="938223">Research</a> </li> </ul> </li> </ul> </nav> </div> <div class="cgdpl desktop:grid-col-9"> <div id="content" class=""> <main class="contentzone has-section-nav" id="main-content"> <div data-drupal-messages-fallback class="hidden"></div>  <article> <div class="resize-content"> <h1>Ewing Sarcoma Treatment (PDQ®)–Patient Version</h1> <div id="cgvBody"> <div class="summary-sections"> <nav class="on-this-page" role="navigation"> <span class="on-this-page__header">On This Page</span> <ul> <li><a href="#_1">General Information About Ewing Sarcoma</a></li> <li><a href="#_28">Stages of Ewing Sarcoma</a></li> <li><a href="#_47">Treatment Option Overview</a></li> <li><a href="#_280">Treatment of Localized Ewing Sarcoma</a></li> <li><a href="#_284">Treatment of Metastatic Ewing Sarcoma</a></li> <li><a href="#_288">Treatment of Recurrent Ewing Sarcoma</a></li> <li><a href="#_142">To Learn More About Ewing Sarcoma</a></li> <li><a href="#_AboutThis_1">About This PDQ Summary</a></li> </ul> </nav> <div class="accordion"> <section id="_1"> <h2>General Information About Ewing Sarcoma</h2> <div id="_section_1" class="pdq-sections"><div class="pdq-hp-patient-toggle"><a href="/types/bone/hp/ewing-treatment-pdq">Go to Health Professional Version</a></div><div class="key-points"><h3 id="_1_kpBoxHdr" do-not-show="toc">Key Points</h3><div id="_kp_section_1_1"><ul><li>Ewing sarcoma is a type of tumor that forms from a certain kind of cell in bone or soft tissue.</li><li>Undifferentiated small round cell sarcoma may also form in the bone or soft tissue.</li><li>A genetic condition may increase the risk of Ewing sarcoma and other sarcomas.</li><li>Signs and symptoms of Ewing sarcoma include swelling and pain near the tumor. </li><li>Tests that examine the bone and soft tissue are used to diagnose and stage Ewing sarcoma.</li><li>A biopsy is done to diagnose Ewing sarcoma. </li><li>Certain factors affect prognosis (chance of recovery).</li></ul></div></div><section id="_2"><h3 id="_3" type="keypoint" do-not-show="toc">Ewing sarcoma is a type of tumor that forms from a certain kind of cell in bone or soft tissue.</h3><p id="_4" tabindex="-1"><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a> most often forms in the bones of the legs, arms, feet, hands, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44996&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044996&version=patient&language=English&dictionary=Cancer.gov'); return(false);">chest</a>, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46246&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046246&version=patient&language=English&dictionary=Cancer.gov'); return(false);">pelvis</a>, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=415914&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000415914&version=patient&language=English&dictionary=Cancer.gov'); return(false);">spine</a>, or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=763008&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000763008&version=patient&language=English&dictionary=Cancer.gov'); return(false);">skull</a>. Less often, it forms in the soft tissue of the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=796908&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000796908&version=patient&language=English&dictionary=Cancer.gov'); return(false);">trunk</a>, arms, legs, head, neck, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=793862&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000793862&version=patient&language=English&dictionary=Cancer.gov'); return(false);">retroperitoneum</a> (area in the back of the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45070&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045070&version=patient&language=English&dictionary=Cancer.gov'); return(false);">abdomen</a> behind the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46683&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046683&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tissue</a> that lines the abdominal wall and covers most of the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=257523&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000257523&version=patient&language=English&dictionary=Cancer.gov'); return(false);">organs</a> in the abdomen), or other areas.</p><p id="_123" tabindex="-1">Ewing sarcoma is most common in adolescents and young adults (teens through mid-20s).</p><p id="_247" tabindex="-1">Ewing sarcoma has also been called peripheral primitive neuroectodermal tumor, Askin tumor (Ewing sarcoma of the chest wall), <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=476629&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000476629&version=patient&language=English&dictionary=Cancer.gov'); return(false);">extraosseous</a> Ewing sarcoma (Ewing sarcoma in tissue other than bone), and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=322134&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000322134&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma family of tumors</a>.</p></section><section id="_279"><h3 id="_271" type="keypoint" do-not-show="toc">Undifferentiated small round cell sarcoma may also form in the bone or soft tissue.</h3><p id="_272" tabindex="-1"> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44775&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044775&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Undifferentiated</a> small round cell sarcoma usually forms in the bones or the muscles that are attached to bones and that help the body move. There are five types of undifferentiated small round cell sarcoma that are treated like Ewing sarcoma:</p><div class="pdq-content-list"><ul id="_273"><li><strong>Undifferentiated small round cell sarcoma with <em class="gene-name">BCOR</em> rearrangements.</strong> This type of bone tumor usually forms in the pelvis, arms, or legs. It may spread to other parts of the body. This type of bone tumor is more common in children younger than 18 years. In this type of round cell sarcoma, the <em class="gene-name">BCOR</em> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45693&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045693&version=patient&language=English&dictionary=Cancer.gov'); return(false);">gene</a> is joined to the <em class="gene-name">CCNB3</em> gene or to other genes. To <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46450&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046450&version=patient&language=English&dictionary=Cancer.gov'); return(false);">diagnose</a> this small round cell sarcoma, the tumor cells are checked for these gene changes.</li><li><strong>Undifferentiated small round cell sarcoma with <em class="gene-name">CIC::DUX4</em> rearrangements.</strong> This type of soft tissue tumor usually forms in the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=796908&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000796908&version=patient&language=English&dictionary=Cancer.gov'); return(false);">trunk</a>, arms, or legs. It is most common in males and in young adults between 21 and 40 years of age. In this type of small round cell sarcoma, the <em class="gene-name">CIC</em> gene is joined to the <em class="gene-name">DUX4</em> gene. To diagnose this small round cell sarcoma, the tumor cells are checked for this gene change.</li><li><strong>Undifferentiated small round cell sarcoma with <em class="gene-name">CIC::NUTM1</em> rearrangements.</strong> This type of soft tissue tumor usually forms in the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46481&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046481&version=patient&language=English&dictionary=Cancer.gov'); return(false);">central nervous system</a>, but it can also form in the trunk. It is most common in younger patients.</li><li><strong>Undifferentiated small round cell sarcoma with <em class="gene-name">EWSR1::NFATC2</em> and <em class="gene-name">FUS::NFATC2</em> rearrangements.</strong> This type of soft tissue tumor may be a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45614&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045614&version=patient&language=English&dictionary=Cancer.gov'); return(false);">benign</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46461&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046461&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cyst</a> or a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45772&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045772&version=patient&language=English&dictionary=Cancer.gov'); return(false);">malignant</a> (cancer) tumor. It usually forms in the arms and legs. The malignant tumor is more common in males and in adults.</li><li><strong>Undifferentiated small round cell sarcoma with <em class="gene-name">EWSR1::PATZ1</em> fusions.</strong> This type of soft tissue tumor usually forms in the trunk and is more common in adults.</li></ul></div></section><section id="_334"><h3 id="_335" type="keypoint" do-not-show="toc">A genetic condition may increase the risk of Ewing sarcoma and other sarcomas.</h3><p id="_336" tabindex="-1">Anything that increases a person's chance of getting a disease is called a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45873&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045873&version=patient&language=English&dictionary=Cancer.gov'); return(false);">risk factor</a>. Not every child with one or more of these risk factors will develop Ewing sarcoma or other sarcomas, and they can develop in some children who don't have any known risk factors. Children with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45499&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045499&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Fanconi anemia</a> may be at increased risk for Ewing sarcoma. Talk with your child's doctor if you think your child may be at risk.</p></section><section id="_14"><h3 id="_15" type="keypoint" do-not-show="toc">Signs and symptoms of Ewing sarcoma include swelling and pain near the tumor. </h3><p id="_16" tabindex="-1">These and other <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=750109&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000750109&version=patient&language=English&dictionary=Cancer.gov'); return(false);">signs</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45022&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045022&version=patient&language=English&dictionary=Cancer.gov'); return(false);">symptoms</a> may be caused by Ewing sarcoma or by other <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=651193&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000651193&version=patient&language=English&dictionary=Cancer.gov'); return(false);">conditions</a>. Check with your child’s doctor if they have any of the following: </p><div class="pdq-content-list"><ul id="_115"><li>A lump (which may feel soft and warm) in the arms, legs, chest, or pelvis.</li><li>Pain and/or swelling near the lump.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=450108&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000450108&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Fever</a> for no known reason.</li><li>A bone that breaks for no known reason.</li></ul></div></section><section id="_18"><h3 id="_19" type="keypoint" do-not-show="toc">Tests that examine the bone and soft tissue are used to diagnose and stage Ewing sarcoma.</h3><p id="_224" tabindex="-1">Procedures that make pictures of the bones and soft tissues and nearby areas help diagnose Ewing sarcoma and show how far the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45333&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045333&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cancer</a> has spread. The process used to find out if cancer cells have spread within and around the bones and soft tissues or to other parts of the body is called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46597&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046597&version=patient&language=English&dictionary=Cancer.gov'); return(false);">staging</a>.</p><p id="_225" tabindex="-1">To plan treatment, it is important to know whether the cancer has spread to other parts of the body. Tests and procedures to detect, diagnose, and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45885&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045885&version=patient&language=English&dictionary=Cancer.gov'); return(false);">stage</a> Ewing sarcoma are usually done at the same time.</p><p id="_20" tabindex="-1">In addition to asking about your child's <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=642019&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000642019&version=patient&language=English&dictionary=Cancer.gov'); return(false);">personal</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=642015&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000642015&version=patient&language=English&dictionary=Cancer.gov'); return(false);">family health history</a> and doing a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270871&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270871&version=patient&language=English&dictionary=Cancer.gov'); return(false);">physical exam</a>, your child's doctor may perform the following tests and procedures to diagnose or stage Ewing sarcoma:</p><div class="pdq-content-list"><ul id="_21"><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45788&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045788&version=patient&language=English&dictionary=Cancer.gov'); return(false);">MRI</a> (magnetic resonance imaging)</strong>: A procedure that uses a magnet, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=651209&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000651209&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body, such as the area where the tumor formed. This procedure is also called nuclear magnetic resonance imaging (NMRI).<figure id="figure_242" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/775532.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_242" alt="Magnetic resonance imaging (MRI) scan; drawing shows a child lying on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body." title="Magnetic resonance imaging (MRI) scan; drawing shows a child lying on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body." src="https://nci-media.cancer.gov/pdq/media/images/775532-750.jpg"><figcaption class="caption-container">Magnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.</figcaption></figure></li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46033&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046033&version=patient&language=English&dictionary=Cancer.gov'); return(false);">CT scan</a> (CAT scan)</strong>: A procedure that makes a series of detailed pictures of areas inside the body, such as the area where the tumor formed or the chest, taken from different angles. The pictures are made by a computer linked to an <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45944&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045944&version=patient&language=English&dictionary=Cancer.gov'); return(false);">x-ray</a> machine. A <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=409764&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000409764&version=patient&language=English&dictionary=Cancer.gov'); return(false);">dye</a> may be <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44678&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044678&version=patient&language=English&dictionary=Cancer.gov'); return(false);">injected</a> into a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=476471&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000476471&version=patient&language=English&dictionary=Cancer.gov'); return(false);">vein</a> or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.<figure id="figure_243" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/775531.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_243" alt="Computed tomography (CT) scan; drawing shows a child lying on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body." title="Computed tomography (CT) scan; drawing shows a child lying on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body." src="https://nci-media.cancer.gov/pdq/media/images/775531-750.jpg"><figcaption class="caption-container">Computed tomography (CT) scan. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of areas inside the body.</figcaption></figure></li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=742485&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000742485&version=patient&language=English&dictionary=Cancer.gov'); return(false);">PET-CT scan</a></strong>: A procedure that combines the pictures from a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46140&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046140&version=patient&language=English&dictionary=Cancer.gov'); return(false);">PET scan</a> and a computed tomography (CT) scan. The PET and CT scans are done at the same time on the same machine. The pictures from both scans are combined to make a more detailed picture than either test would make by itself.<figure id="figure_244" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/775456.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_244" alt="Positron emission tomography (PET) scan; drawing shows a child lying on table that slides through the PET scanner." title="Positron emission tomography (PET) scan; drawing shows a child lying on table that slides through the PET scanner." src="https://nci-media.cancer.gov/pdq/media/images/775456-750.jpg"><figcaption class="caption-container">Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do. </figcaption></figure></li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46499&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046499&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Bone scan</a></strong>: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46550&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046550&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radioactive</a> material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.<figure id="figure_245" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/775451.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_245" alt="Bone scan; drawing shows a child lying on a table that slides under the scanner, a technician operating the scanner, and a computer monitor that will show images made during the scan." title="Bone scan; drawing shows a child lying on a table that slides under the scanner, a technician operating the scanner, and a computer monitor that will show images made during the scan." src="https://nci-media.cancer.gov/pdq/media/images/775451-750.jpg"><figcaption class="caption-container">Bone scan. A small amount of radioactive material is injected into the child's vein and travels through the blood. The radioactive material collects in the bones. As the child lies on a table that slides under the scanner, the radioactive material is detected and images are made on a computer screen.</figcaption></figure></li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46505&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046505&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Bone marrow aspiration</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46506&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046506&version=patient&language=English&dictionary=Cancer.gov'); return(false);">biopsy</a></strong>: The removal of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45622&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045622&version=patient&language=English&dictionary=Cancer.gov'); return(false);">bone marrow</a> and a small piece of bone by inserting a hollow needle into the hipbone. Samples are removed from both hipbones. A <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46244&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046244&version=patient&language=English&dictionary=Cancer.gov'); return(false);">pathologist</a> views the bone marrow and bone under a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=638184&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000638184&version=patient&language=English&dictionary=Cancer.gov'); return(false);">microscope</a> to see if the cancer has spread.<figure id="figure_246" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/775458.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_246" alt="Bone marrow aspiration and biopsy; drawing shows a child lying face down on a table and a bone marrow needle being inserted into the right hip bone. An inset shows the bone marrow needle being inserted through the skin into the bone marrow of the hip bone." title="Bone marrow aspiration and biopsy; drawing shows a child lying face down on a table and a bone marrow needle being inserted into the right hip bone. An inset shows the bone marrow needle being inserted through the skin into the bone marrow of the hip bone." src="https://nci-media.cancer.gov/pdq/media/images/775458-750.jpg"><figcaption class="caption-container">Bone marrow aspiration and biopsy. After a small area of skin is numbed, a bone marrow needle is inserted into the child’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.</figcaption></figure></li><li><strong>X-ray</strong>: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body, such as the chest or the area where the tumor formed.</li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45107&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045107&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Complete blood count</a> (CBC)</strong>: A procedure in which a sample of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270735&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270735&version=patient&language=English&dictionary=Cancer.gov'); return(false);">blood</a> is drawn and checked for the following:<div class="pdq-content-list"><ul id="_144" class="list-dash"><li>The number of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46124&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046124&version=patient&language=English&dictionary=Cancer.gov'); return(false);">red blood cells</a>, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45993&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045993&version=patient&language=English&dictionary=Cancer.gov'); return(false);">white blood cells</a>, and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45840&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045840&version=patient&language=English&dictionary=Cancer.gov'); return(false);">platelets</a>.</li><li>The amount of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45108&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045108&version=patient&language=English&dictionary=Cancer.gov'); return(false);">hemoglobin</a> (the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46092&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046092&version=patient&language=English&dictionary=Cancer.gov'); return(false);">protein</a> that carries <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=538149&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000538149&version=patient&language=English&dictionary=Cancer.gov'); return(false);">oxygen</a>) in the red blood cells.</li><li>The portion of the blood sample made up of red blood cells. </li></ul></div></li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=304685&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000304685&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Blood chemistry studies</a></strong>: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=354462&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000354462&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lactate dehydrogenase</a> (LDH), released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease. </li></ul></div></section><section id="_155"><h3 id="_145" type="keypoint" do-not-show="toc">A biopsy is done to diagnose Ewing sarcoma. </h3><p id="_203" tabindex="-1">Tissue samples are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for signs of cancer. It is helpful if the biopsy is done at the same center where treatment will be given. The following types of biopsy are used to diagnose Ewing sarcoma:</p><div class="pdq-content-list"><ul id="_204"><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46698&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046698&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Incisional biopsy</a></strong>: For an incisional biopsy, a sample of tissue is removed through an <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46353&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046353&version=patient&language=English&dictionary=Cancer.gov'); return(false);">incision</a> in the skin. </li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45798&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045798&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Needle biopsy</a></strong>: For this biopsy, a sample of tissue is removed using a needle. </li></ul></div><p id="_210" tabindex="-1">The <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=478785&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000478785&version=patient&language=English&dictionary=Cancer.gov'); return(false);">specialists</a> (pathologist, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46546&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046546&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radiation oncologist</a>, and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44306&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044306&version=patient&language=English&dictionary=Cancer.gov'); return(false);">surgeon</a>) who will treat the patient usually work together to decide the best site to place the needle or biopsy incision. The selection of the biopsy site is important. A biopsy site that is not properly selected may result in more extensive <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">surgery</a> to remove the tumor or a larger area that is treated with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44971&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044971&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radiation therapy</a>.</p><p id="_205" tabindex="-1">If there is a chance that the cancer has spread to nearby <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45762&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045762&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lymph nodes</a>, one or more lymph nodes may be removed and checked for signs of cancer.</p><p id="_147" tabindex="-1">The following tests may be done on the tissue that is removed:</p><div class="pdq-content-list"><ul id="_148"><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=798756&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000798756&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Cytogenetic analysis</a></strong>: A <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46590&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046590&version=patient&language=English&dictionary=Cancer.gov'); return(false);">laboratory test</a> in which the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46470&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046470&version=patient&language=English&dictionary=Cancer.gov'); return(false);">chromosomes</a> of cells in a sample of tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.</li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=653117&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000653117&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Immunohistochemistry</a></strong>: A laboratory test that uses <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44918&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044918&version=patient&language=English&dictionary=Cancer.gov'); return(false);">antibodies</a> to check for certain <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46086&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046086&version=patient&language=English&dictionary=Cancer.gov'); return(false);">antigens</a> (<a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45776&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045776&version=patient&language=English&dictionary=Cancer.gov'); return(false);">markers</a>) in a sample of a patient’s tissue. The antibodies are usually linked to an <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46081&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046081&version=patient&language=English&dictionary=Cancer.gov'); return(false);">enzyme</a> or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.</li><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=335066&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000335066&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Flow cytometry</a></strong>: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of the cells, such as size, shape, and the presence of tumor (or other) <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46636&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046636&version=patient&language=English&dictionary=Cancer.gov'); return(false);">markers</a> on the cell surface. The cells from a sample of a patient's blood, bone marrow, or other tissue are stained with a fluorescent dye, placed in a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44669&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044669&version=patient&language=English&dictionary=Cancer.gov'); return(false);">fluid</a>, and then passed one at a time through a beam of light. The test results are based on how the cells that were stained with the fluorescent dye react to the beam of light.</li><li><strong>Molecular test</strong>: A laboratory test to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid. A molecular test may be done with other procedures, such as biopsies, to help diagnose some types of cancer. Molecular tests check for certain gene or chromosome changes that occur in some Ewing sarcomas.</li><li><strong>Reverse transcription–polymerase chain reaction (<a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=783669&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000783669&version=patient&language=English&dictionary=Cancer.gov'); return(false);">RT–PCR</a>) test</strong>: A laboratory test in which the amount of a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46391&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046391&version=patient&language=English&dictionary=Cancer.gov'); return(false);">genetic</a> substance called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=662001&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000662001&version=patient&language=English&dictionary=Cancer.gov'); return(false);">mRNA</a> made by a specific gene is measured. An enzyme called reverse transcriptase is used to convert a specific piece of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46568&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046568&version=patient&language=English&dictionary=Cancer.gov'); return(false);">RNA</a> into a matching piece of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45671&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045671&version=patient&language=English&dictionary=Cancer.gov'); return(false);">DNA</a>, which can be amplified (made in large numbers) by another enzyme called DNA polymerase. The amplified DNA copies help tell whether a specific mRNA is being made by a gene. RT–PCR can be used to check the activation of certain genes that may indicate the presence of cancer cells. This test may be used to look for certain changes in a gene or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46470&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046470&version=patient&language=English&dictionary=Cancer.gov'); return(false);">chromosome</a>, which may help diagnose cancer.</li></ul></div></section><section id="_22"><h3 id="_23" type="keypoint" do-not-show="toc">Certain factors affect prognosis (chance of recovery).</h3><p id="_24" tabindex="-1">The factors that affect <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45849&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045849&version=patient&language=English&dictionary=Cancer.gov'); return(false);">prognosis</a> are different before and after treatment. </p><p id="_152" tabindex="-1">Before any treatment is given, prognosis depends on:</p><div class="pdq-content-list"><ul id="_128"><li>Where in the body the tumor started.</li><li>Whether the tumor formed in the bone or in soft tissue.</li><li>Whether the tumor has spread to lymph nodes or distant parts of the body. </li><li>How large the tumor is when the tumor is diagnosed.</li><li>Whether the LDH level in the blood is higher than normal.</li><li>Whether the tumor has certain gene changes. </li><li>Whether tumor <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45671&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045671&version=patient&language=English&dictionary=Cancer.gov'); return(false);">DNA</a> has been found in the blood.</li><li>The patient's age. </li><li>The patient's sex. </li><li>Whether the patient has had treatment for a different cancer.</li><li>Whether the tumor has just been diagnosed or has <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46556&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046556&version=patient&language=English&dictionary=Cancer.gov'); return(false);">recurred</a> (come back).</li></ul></div><p id="_149" tabindex="-1">After treatment is given, prognosis is affected by:</p><div class="pdq-content-list"><ul id="_150"><li>Whether the tumor was completely removed by surgery.</li><li>Whether the tumor <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44085&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044085&version=patient&language=English&dictionary=Cancer.gov'); return(false);">responded</a> to <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45214&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045214&version=patient&language=English&dictionary=Cancer.gov'); return(false);">chemotherapy</a> or radiation therapy.</li></ul></div><p id="_226" tabindex="-1">If the cancer recurs after initial treatment, prognosis depends on:</p><div class="pdq-content-list"><ul id="_227"><li>Whether the cancer came back more than two years after the initial treatment.</li><li>Whether the cancer came back where it first formed and in other parts of the body, or whether the cancer came back in only one site.</li></ul></div></section></div> </section> <section id="_28"> <h2>Stages of Ewing Sarcoma</h2> <div id="_section_28" class="pdq-sections"><div class="key-points"><h3 id="_28_kpBoxHdr" do-not-show="toc">Key Points</h3><div id="_kp_section_28_2"><ul><li>After Ewing sarcoma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.</li><li>Ewing sarcoma is described as localized, metastatic, or recurrent. <ul><li>Localized Ewing sarcoma</li><li>Metastatic Ewing sarcoma</li><li>Recurrent Ewing sarcoma</li></ul></li><li>There are three ways that cancer spreads in the body.</li><li>Cancer may spread from where it began to other parts of the body.</li></ul></div></div><section id="_29"><h3 id="_30" type="keypoint" do-not-show="toc">After Ewing sarcoma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.</h3><p id="_31" tabindex="-1">The process used to find out if <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45333&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045333&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cancer</a> has spread from where it began to other parts of the body is called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46597&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046597&version=patient&language=English&dictionary=Cancer.gov'); return(false);">staging</a>. There is no standard <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=689095&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000689095&version=patient&language=English&dictionary=Cancer.gov'); return(false);">staging system</a> for <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a>. The results of the <a href="/types/bone/patient/ewing-treatment-pdq#_18">tests and procedures</a> done to <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46450&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046450&version=patient&language=English&dictionary=Cancer.gov'); return(false);">diagnose</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45885&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045885&version=patient&language=English&dictionary=Cancer.gov'); return(false);">stage</a> Ewing sarcoma are used to help make decisions about treatment. Treatment is based on whether the cancer is <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45754&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045754&version=patient&language=English&dictionary=Cancer.gov'); return(false);">localized</a>, <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44058&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044058&version=patient&language=English&dictionary=Cancer.gov'); return(false);">metastatic</a>, or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45862&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045862&version=patient&language=English&dictionary=Cancer.gov'); return(false);">recurrent</a>. </p></section><section id="_106"><h3 id="_107" type="keypoint" do-not-show="toc">Ewing sarcoma is described as localized, metastatic, or recurrent. </h3><section id="_108"><h4 id="_109" type="keypoint" do-not-show="toc">Localized Ewing sarcoma</h4><p id="_110" tabindex="-1">The <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45333&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045333&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cancer</a> is found in the bone or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45882&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045882&version=patient&language=English&dictionary=Cancer.gov'); return(false);">soft tissue</a> where it began and may have spread to nearby <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46683&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046683&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tissue</a>, including nearby <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45762&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045762&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lymph nodes</a>.</p></section><section id="_111"><h4 id="_112" type="keypoint" do-not-show="toc">Metastatic Ewing sarcoma</h4><p id="_113" tabindex="-1"> The <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45333&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045333&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cancer</a> has spread from the bone or soft tissue where it began to other parts of the body. In Ewing tumor of bone, the cancer most often spreads to the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270740&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270740&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lung</a>, other bones, and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45622&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045622&version=patient&language=English&dictionary=Cancer.gov'); return(false);">bone marrow</a>. </p></section><section id="_268"><h4 id="_269" type="keypoint" do-not-show="toc">Recurrent Ewing sarcoma</h4><p id="_270" tabindex="-1">The cancer has <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46556&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046556&version=patient&language=English&dictionary=Cancer.gov'); return(false);">recurred</a> (come back) after it has been treated. The cancer may come back in the bone or soft tissue where it began or in another part of the body. </p></section></section><section id="_157"><h3 id="_158" type="keypoint" do-not-show="toc">There are three ways that cancer spreads in the body.</h3><p id="_157_md_69" tabindex="-1">Cancer can spread through <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46683&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046683&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tissue</a>, the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45764&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045764&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lymph system</a>, and the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270735&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270735&version=patient&language=English&dictionary=Cancer.gov'); return(false);">blood</a>:</p><div class="pdq-content-list"><ul id="_157_md_70"><li>Tissue. The cancer spreads from where it began by growing into nearby areas. </li><li>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=269462&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000269462&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lymph vessels</a> to other parts of the body. </li><li>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45020&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045020&version=patient&language=English&dictionary=Cancer.gov'); return(false);">blood vessels</a> to other parts of the body. </li></ul></div></section><section id="_207"><h3 id="_208" type="keypoint" do-not-show="toc">Cancer may spread from where it began to other parts of the body.</h3><p id="_207_md_66" tabindex="-1">When cancer spreads to another part of the body, it is called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46710&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046710&version=patient&language=English&dictionary=Cancer.gov'); return(false);">metastasis</a>. Cancer cells break away from where they began (the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45847&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045847&version=patient&language=English&dictionary=Cancer.gov'); return(false);">primary tumor</a>) and travel through the lymph system or blood.</p><div class="pdq-content-list"><ul id="_207_md_67"><li>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46634&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046634&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tumor</a> (<a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44058&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044058&version=patient&language=English&dictionary=Cancer.gov'); return(false);">metastatic</a> tumor) in another part of the body.</li><li>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</li></ul></div><p id="_209" tabindex="-1">The metastatic tumor is the same type of cancer as the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45847&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045847&version=patient&language=English&dictionary=Cancer.gov'); return(false);">primary tumor</a>. For example, if Ewing sarcoma spreads to the lung, the cancer cells in the lung are actually Ewing sarcoma cells. The disease is metastatic Ewing sarcoma, not <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=445043&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000445043&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lung cancer</a>.</p><div data-embed-button="media_entity_embed" data-entity-embed-display="view_mode:media.video_display_medium_no_title" data-entity-type="media" data-caption="" class="embedded-entity align-center"><figure class="video"><div id="ytplayer-fQwar_-QdiQ" class="flex-video widescreen" data-video-url="https://www.youtube.com/embed/fQwar_-QdiQ?feature=oembed&autoplay=1" data-video-title="metastasis: how cancer spreads"><iframe width="560" height="315" src="https://www.youtube-nocookie.com/embed/fQwar_-QdiQ?rel=0" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" title="metastasis: how cancer spreads" alt="metastasis: how cancer spreads" allowfullscreen=""></iframe></div><figcaption class="caption-container">Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</figcaption></figure></div></section></div> </section> <section id="_47"> <h2>Treatment Option Overview</h2> <div id="_section_47" class="pdq-sections"><div class="key-points"><h3 id="_47_kpBoxHdr" do-not-show="toc">Key Points</h3><div id="_kp_section_47_3"><ul><li>There are different types of treatment for children with Ewing sarcoma.</li><li>Children with Ewing sarcoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children.</li><li>Four types of treatment are used:<ul><li>Chemotherapy</li><li>Radiation therapy</li><li>Surgery</li><li>High-dose chemotherapy with stem cell rescue</li></ul></li><li>New types of treatment are being tested in clinical trials. <ul><li>Immunotherapy</li></ul></li><li>Treatment for Ewing sarcoma may cause side effects.</li><li>Patients may want to think about taking part in a clinical trial.</li><li>Patients can enter clinical trials before, during, or after starting their cancer treatment.</li><li>Follow-up tests may be needed.</li></ul></div></div><section id="_48"><h3 id="_49" type="keypoint" do-not-show="toc">There are different types of treatment for children with Ewing sarcoma.</h3><p id="_50" tabindex="-1">Different types of treatments are available for children with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a>. Some treatments are <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=346525&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000346525&version=patient&language=English&dictionary=Cancer.gov'); return(false);">standard</a> (the currently used treatment), and some are being tested in <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45961&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045961&version=patient&language=English&dictionary=Cancer.gov'); return(false);">clinical trials</a>. A treatment clinical trial is a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=651211&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000651211&version=patient&language=English&dictionary=Cancer.gov'); return(false);">research study</a> meant to help improve current treatments or obtain information on new treatments for patients with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45333&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045333&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cancer</a>. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.</p><p id="_51" tabindex="-1">Because cancer in children and adolescents is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.</p></section><section id="_52"><h3 id="_53" type="keypoint" do-not-show="toc">Children with Ewing sarcoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children.</h3><p id="_54" tabindex="-1">Treatment will be overseen by a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=693555&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000693555&version=patient&language=English&dictionary=Cancer.gov'); return(false);">pediatric oncologist</a>, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=650566&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000650566&version=patient&language=English&dictionary=Cancer.gov'); return(false);">health care providers</a> who are experts in treating children with Ewing sarcoma and who specialize in certain areas of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=482419&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000482419&version=patient&language=English&dictionary=Cancer.gov'); return(false);">medicine</a>. These may include the following <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=478785&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000478785&version=patient&language=English&dictionary=Cancer.gov'); return(false);">specialists</a>:</p><div class="pdq-content-list"><ul id="_55"><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=757278&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000757278&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Pediatrician</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44735&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044735&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Surgical oncologist</a> or orthopedic <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46260&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046260&version=patient&language=English&dictionary=Cancer.gov'); return(false);">oncologist</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46546&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046546&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Radiation oncologist</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=318821&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000318821&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Pediatric nurse specialist</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44730&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044730&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Social worker</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=318825&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000318825&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Rehabilitation specialist</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44716&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044716&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Psychologist</a>. </li></ul></div></section><section id="_56"><h3 id="_57" type="keypoint" do-not-show="toc">Four types of treatment are used:</h3><section id="_65"><h4 id="_66" type="keypoint" do-not-show="toc">Chemotherapy</h4><p id="_151" tabindex="-1"><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45214&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045214&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Chemotherapy</a> is a cancer treatment that uses <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=348921&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000348921&version=patient&language=English&dictionary=Cancer.gov'); return(false);">drugs</a> to stop the growth of cancer <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46476&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046476&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cells</a>, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44678&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044678&version=patient&language=English&dictionary=Cancer.gov'); return(false);">injected</a> into a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=476471&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000476471&version=patient&language=English&dictionary=Cancer.gov'); return(false);">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=301626&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000301626&version=patient&language=English&dictionary=Cancer.gov'); return(false);">systemic chemotherapy</a>). <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45650&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045650&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Combination chemotherapy</a> is treatment using more than one anticancer drug.</p><p id="_199" tabindex="-1">Systemic combination chemotherapy is part of the treatment for all patients with Ewing <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46634&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046634&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tumors</a>. It is often the first treatment given and lasts for about 6 to 12 months. Chemotherapy is often given to shrink the tumor before <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">surgery</a> or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44971&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044971&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radiation therapy</a> and to kill any tumor cells that may have spread to other parts of the body.</p><p id="_250" tabindex="-1">For more information, see <a href="https://www.cancer.gov/about-cancer/treatment/drugs/soft-tissue-sarcoma" title="https://www.cancer.gov/about-cancer/treatment/drugs/soft-tissue-sarcoma">Drugs Approved for Soft Tissue Sarcoma</a>.</p></section><section id="_62"><h4 id="_63" type="keypoint" do-not-show="toc">Radiation therapy</h4><p id="_64" tabindex="-1">Radiation therapy is a cancer treatment that uses high-energy <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45944&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045944&version=patient&language=English&dictionary=Cancer.gov'); return(false);">x-rays</a> or other types of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45072&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045072&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radiation</a> to kill cancer cells or keep them from growing. <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46686&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046686&version=patient&language=English&dictionary=Cancer.gov'); return(false);">External radiation therapy</a> uses a machine outside the body to send radiation toward the area of the body with cancer.</p><p id="_200" tabindex="-1">Radiation therapy is used when the tumor cannot be removed by surgery or when surgery to remove the tumor will affect important body functions or the way the child will look. It may be used to make the tumor smaller and decrease the amount of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46683&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046683&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tissue</a> that needs to be removed during surgery. It may also be used to treat any tumor that remains after surgery and tumors that have spread to other parts of the body.</p><p id="_337" tabindex="-1">Radiation therapy may also be used as palliative therapy to relieve symptoms caused by the tumor in the bone.</p></section><section id="_206"><h4 id="_192" type="keypoint" do-not-show="toc">Surgery</h4><p id="_193" tabindex="-1">Surgery is usually done to remove cancer that is left after chemotherapy or radiation therapy. When possible, the whole tumor is removed by surgery. <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46683&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046683&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Tissue</a> and bone that are removed may be replaced with a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46373&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046373&version=patient&language=English&dictionary=Cancer.gov'); return(false);">graft</a>, which uses tissue and bone taken from another part of the patient's body or a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=643010&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000643010&version=patient&language=English&dictionary=Cancer.gov'); return(false);">donor</a>. Sometimes an <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=285636&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000285636&version=patient&language=English&dictionary=Cancer.gov'); return(false);">implant</a>, such as artificial bone, is used.</p><p id="_194" tabindex="-1">After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45587&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045587&version=patient&language=English&dictionary=Cancer.gov'); return(false);">adjuvant therapy</a>. </p></section><section id="_233"><h4 id="_234" type="keypoint" do-not-show="toc">High-dose chemotherapy with stem cell rescue</h4><p id="_235" tabindex="-1">High <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44664&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044664&version=patient&language=English&dictionary=Cancer.gov'); return(false);">doses</a> of chemotherapy are given to kill cancer cells. Healthy cells, including <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270735&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270735&version=patient&language=English&dictionary=Cancer.gov'); return(false);">blood</a>-forming cells, are also destroyed by the cancer treatment. <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46695&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046695&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Stem cell transplant</a> is a treatment to replace the blood-forming cells. <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46598&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046598&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Stem cells</a> (immature blood cells) are removed from the blood or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45263&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045263&version=patient&language=English&dictionary=Cancer.gov'); return(false);">bone marrow</a> of the patient and are frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and given back to the patient through an <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45738&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045738&version=patient&language=English&dictionary=Cancer.gov'); return(false);">infusion</a>. These reinfused stem cells grow into (and restore) the body's blood cells. Chemotherapy with stem cell rescue is used to treat <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45754&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045754&version=patient&language=English&dictionary=Cancer.gov'); return(false);">localized</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45862&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045862&version=patient&language=English&dictionary=Cancer.gov'); return(false);">recurrent</a> Ewing sarcoma.</p></section></section><section id="_80"><h3 id="_81" type="keypoint" do-not-show="toc">New types of treatment are being tested in clinical trials. </h3><p id="_156" tabindex="-1">This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the <a href="https://www.cancer.gov/research/participate/clinical-trials" title="https://www.cancer.gov/research/participate/clinical-trials">NCI website</a>.</p><section id="_262"><h4 id="_263" type="keypoint" do-not-show="toc">Immunotherapy</h4><p id="_264" tabindex="-1"><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45729&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045729&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Immunotherapy</a> helps a person's immune system fight cancer. Types of immunotherapy include:</p><div class="pdq-content-list"><ul id="_267"><li><strong><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=771302&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000771302&version=patient&language=English&dictionary=Cancer.gov'); return(false);">CAR T-cell therapy</a>:</strong> This treatment changes the patient's T cells (a type of immune system cell) so they will attack certain proteins on the surface of cancer cells. T cells are taken from the patient and special <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44958&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044958&version=patient&language=English&dictionary=Cancer.gov'); return(false);">receptors</a> are added to their surface in the laboratory. The changed cells are called chimeric antigen receptor (CAR) T cells. The CAR T cells are grown in the laboratory and given to the patient by infusion. The CAR T cells multiply in the patient's blood and attack cancer cells. CAR T-cell therapy is being studied to treat recurrent Ewing sarcoma.<figure id="figure_257" class="image-center"><a href="https://nci-media.cancer.gov/pdq/media/images/774647.jpg" target="_blank" class="article-image-enlarge">Enlarge</a><img id="_257" alt="CAR T-cell therapy; drawing of blood being removed from a vein in a patient’s arm to get T cells. Also shown is a special receptor called a chimeric antigen receptor (CAR) being made in the laboratory; the gene for CAR is inserted into the T cells and then millions of CAR T cells are grown. Drawing also shows the CAR T cells being given to the patient by infusion and binding to antigens on the cancer cells and killing them." title="CAR T-cell therapy; drawing of blood being removed from a vein in a patient’s arm to get T cells. Also shown is a special receptor called a chimeric antigen receptor (CAR) being made in the laboratory; the gene for CAR is inserted into the T cells and then millions of CAR T cells are grown. Drawing also shows the CAR T cells being given to the patient by infusion and binding to antigens on the cancer cells and killing them." src="https://nci-media.cancer.gov/pdq/media/images/774647-750.jpg"><figcaption class="caption-container">CAR T-cell therapy. A type of treatment in which a patient’s T cells (a type of immune cell) are changed in the laboratory so they will bind to cancer cells and kill them. Blood from a vein in the patient’s arm flows through a tube to an apheresis machine (not shown), which removes the white blood cells, including the T cells, and sends the rest of the blood back to the patient. Then, the gene for a special receptor called a chimeric antigen receptor (CAR) is inserted into the T cells in the laboratory. Millions of the CAR T cells are grown in the laboratory and then given to the patient by infusion. The CAR T cells are able to bind to an antigen on the cancer cells and kill them.</figcaption></figure></li></ul></div></section></section><section id="_118"><h3 id="_255" type="keypoint" do-not-show="toc">Treatment for Ewing sarcoma may cause side effects.</h3><p id="_118_md_76" tabindex="-1">To learn more about <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46580&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046580&version=patient&language=English&dictionary=Cancer.gov'); return(false);">side effects</a> that begin during treatment for cancer, visit <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" title="https://www.cancer.gov/about-cancer/treatment/side-effects">Side Effects</a>.</p><p id="_120" tabindex="-1"> Side effects from cancer treatment that begin after treatment and continue for months or years are called <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=390292&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000390292&version=patient&language=English&dictionary=Cancer.gov'); return(false);">late effects</a>. Late effects of cancer treatment may include the following: </p><div class="pdq-content-list"><ul id="_130"><li>Physical problems.</li><li>Changes in mood, feelings, thinking, learning, or memory.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46658&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046658&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Second cancers</a> (new types of cancer). Patients treated for Ewing sarcoma have an increased risk of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46347&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046347&version=patient&language=English&dictionary=Cancer.gov'); return(false);">acute myeloid leukemia</a> and <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45266&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045266&version=patient&language=English&dictionary=Cancer.gov'); return(false);">myelodysplastic syndrome</a>. There is also an increased risk of <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45562&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045562&version=patient&language=English&dictionary=Cancer.gov'); return(false);">sarcoma</a> in the area treated with radiation therapy.</li></ul></div><p id="_131" tabindex="-1">Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. For more information, see <a href="/types/childhood-cancers/late-effects-pdq">Late Effects of Treatment for Childhood Cancer</a>. </p></section><section id="_159"><h3 id="_160" type="keypoint" do-not-show="toc">Patients may want to think about taking part in a clinical trial.</h3><p id="_159_md_23" tabindex="-1">For some patients, taking part in a <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45961&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045961&version=patient&language=English&dictionary=Cancer.gov'); return(false);">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44930&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044930&version=patient&language=English&dictionary=Cancer.gov'); return(false);">standard treatment</a>.</p><p id="_159_md_24" tabindex="-1">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="_159_md_25" tabindex="-1">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></section><section id="_161"><h3 id="_162" type="keypoint" do-not-show="toc">Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="_161_md_29" tabindex="-1">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46580&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046580&version=patient&language=English&dictionary=Cancer.gov'); return(false);">side effects</a> of cancer treatment.</p><p id="_161_md_30" tabindex="-1">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/research/participate/clinical-trials-search" title="https://www.cancer.gov/research/participate/clinical-trials-search">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" title="https://clinicaltrials.gov/">ClinicalTrials.gov</a> website.</p></section><section id="_163"><h3 id="_164" type="keypoint" do-not-show="toc">Follow-up tests may be needed.</h3><p id="_163_md_55" tabindex="-1">As your child goes through treatment, they will have follow-up tests or check-ups. Some tests that were done to <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46450&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046450&version=patient&language=English&dictionary=Cancer.gov'); return(false);">diagnose</a> or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45885&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045885&version=patient&language=English&dictionary=Cancer.gov'); return(false);">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="_163_md_56" tabindex="-1">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred (come back). </p></section></div> </section> <section id="_280"> <h2>Treatment of Localized Ewing Sarcoma</h2> <div id="_section_280" class="pdq-sections"><p id="_281" tabindex="-1">For information about the treatments listed below, see the <a href="/types/bone/patient/ewing-treatment-pdq#_56">Treatment Option Overview</a> section.</p><p id="_282" tabindex="-1"><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44930&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044930&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Standard treatments</a> for newly <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46450&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046450&version=patient&language=English&dictionary=Cancer.gov'); return(false);">diagnosed</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45754&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045754&version=patient&language=English&dictionary=Cancer.gov'); return(false);">localized</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a> include:</p><div class="pdq-content-list"><ul id="_283"><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45214&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045214&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Chemotherapy</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Surgery</a> and/or <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44971&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044971&version=patient&language=English&dictionary=Cancer.gov'); return(false);">radiation therapy</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=346522&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000346522&version=patient&language=English&dictionary=Cancer.gov'); return(false);">High-dose chemotherapy</a> with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=666718&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000666718&version=patient&language=English&dictionary=Cancer.gov'); return(false);">stem cell rescue</a> with the patient's own <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46476&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046476&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cells</a>.</li></ul></div><p id="_TrialSearch_280_19" tabindex="-1">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" title="https://www.cancer.gov/research/participate/clinical-trials-search">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" title="https://www.cancer.gov/research/participate/clinical-trials">General information</a> about clinical trials is also available.</p></div> </section> <section id="_284"> <h2>Treatment of Metastatic Ewing Sarcoma</h2> <div id="_section_284" class="pdq-sections"><p id="_285" tabindex="-1">For information about the treatments listed below, see the <a href="/types/bone/patient/ewing-treatment-pdq#_56">Treatment Option Overview</a> section.</p><p id="_286" tabindex="-1"><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44930&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044930&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Standard treatments</a> for newly <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46450&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046450&version=patient&language=English&dictionary=Cancer.gov'); return(false);">diagnosed</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44058&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044058&version=patient&language=English&dictionary=Cancer.gov'); return(false);">metastatic</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a> include:</p><div class="pdq-content-list"><ul id="_287"><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45214&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045214&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Chemotherapy</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Surgery</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44971&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044971&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Radiation therapy</a>.</li></ul></div><p id="_TrialSearch_284_19" tabindex="-1">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" title="https://www.cancer.gov/research/participate/clinical-trials-search">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" title="https://www.cancer.gov/research/participate/clinical-trials">General information</a> about clinical trials is also available.</p></div> </section> <section id="_288"> <h2>Treatment of Recurrent Ewing Sarcoma</h2> <div id="_section_288" class="pdq-sections"><p id="_289" tabindex="-1">For information about the treatments listed below, see the <a href="/types/bone/patient/ewing-treatment-pdq#_56">Treatment Option Overview</a> section.</p><p id="_290" tabindex="-1">There is no <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44930&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044930&version=patient&language=English&dictionary=Cancer.gov'); return(false);">standard treatment</a> for <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45862&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045862&version=patient&language=English&dictionary=Cancer.gov'); return(false);">recurrent</a> <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46031&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046031&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Ewing sarcoma</a> but treatment options may include the following:</p><div class="pdq-content-list"><ul id="_291"><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45650&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045650&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Combination chemotherapy</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Surgery</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44971&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044971&version=patient&language=English&dictionary=Cancer.gov'); return(false);">Radiation therapy</a> to bone <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46634&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046634&version=patient&language=English&dictionary=Cancer.gov'); return(false);">tumors</a>, as <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45815&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045815&version=patient&language=English&dictionary=Cancer.gov'); return(false);">palliative therapy</a> to relieve <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45022&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045022&version=patient&language=English&dictionary=Cancer.gov'); return(false);">symptoms</a> and improve the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45417&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045417&version=patient&language=English&dictionary=Cancer.gov'); return(false);">quality of life</a>.</li><li> Radiation therapy that may be followed by <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=45570&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000045570&version=patient&language=English&dictionary=Cancer.gov'); return(false);">surgery</a> to remove tumors that have spread to the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=270740&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000270740&version=patient&language=English&dictionary=Cancer.gov'); return(false);">lungs</a>. </li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=346522&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000346522&version=patient&language=English&dictionary=Cancer.gov'); return(false);">High-dose chemotherapy</a> with <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=666718&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000666718&version=patient&language=English&dictionary=Cancer.gov'); return(false);">stem cell rescue</a> with the patient's own <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=46476&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000046476&version=patient&language=English&dictionary=Cancer.gov'); return(false);">cells</a>.</li><li><a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=771302&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000771302&version=patient&language=English&dictionary=Cancer.gov'); return(false);">CAR T-cell therapy</a> is being studied to treat recurrent Ewing sarcoma.</li></ul></div><p id="_TrialSearch_288_19" tabindex="-1">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" title="https://www.cancer.gov/research/participate/clinical-trials-search">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" title="https://www.cancer.gov/research/participate/clinical-trials">General information</a> about clinical trials is also available.</p></div> </section> <section id="_142"> <h2>To Learn More About Ewing Sarcoma</h2> <div id="_section_142" class="pdq-sections"><p id="_143" tabindex="-1">For more information from the <a class="definition" type="GlossaryTermRefs" href="/Common/PopUps/popDefinition.aspx?id=44266&version=patient&language=English&dictionary=Cancer.gov" onclick="javascript:popWindow('defbyid','CDR0000044266&version=patient&language=English&dictionary=Cancer.gov'); return(false);">National Cancer Institute</a> about Ewing sarcoma, see the following:</p><div class="pdq-content-list"><ul id="_180"><li><a href="https://www.cancer.gov/types/bone" title="https://www.cancer.gov/types/bone">Bone Cancer Home Page</a></li><li><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/ct-scans-fact-sheet" title="https://www.cancer.gov/about-cancer/diagnosis-staging/ct-scans-fact-sheet">Computed Tomography (CT) Scans and Cancer</a></li><li><a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy" title="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy">Immunotherapy to Treat Cancer</a></li><li><a href="https://www.cancer.gov/types/bone/bone-fact-sheet" title="https://www.cancer.gov/types/bone/bone-fact-sheet">Bone Cancer</a></li></ul></div><p id="_142_md_44" tabindex="-1">For more childhood cancer information and other general cancer resources, visit:</p><div class="pdq-content-list"><ul id="_142_md_45"><li><a href="https://www.cancer.gov/about-cancer" title="https://www.cancer.gov/about-cancer">About Cancer</a></li><li><a href="https://www.cancer.gov/types/childhood-cancers" title="https://www.cancer.gov/types/childhood-cancers">Childhood Cancers</a> </li><li><a href="http://www.curesearch.org/" title="http://www.curesearch.org/">CureSearch for Children's Cancer</a> </li><li><a href="/types/childhood-cancers/late-effects-pdq">Late Effects of Treatment for Childhood Cancer</a></li><li><a href="https://www.cancer.gov/types/aya" title="https://www.cancer.gov/types/aya">Adolescents and Young Adults with Cancer</a></li><li><a href="https://www.cancer.gov/publications/patient-education/guide-for-parents" title="https://www.cancer.gov/publications/patient-education/guide-for-parents">Children with Cancer: A Guide for Parents</a></li><li><a href="https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet" title="https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet">Cancer in Children and Adolescents</a></li><li><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" title="https://www.cancer.gov/about-cancer/diagnosis-staging/staging">Staging</a></li><li><a href="https://www.cancer.gov/about-cancer/coping" title="https://www.cancer.gov/about-cancer/coping">Coping with Cancer</a></li><li><a href="https://www.cancer.gov/about-cancer/coping/questions" title="https://www.cancer.gov/about-cancer/coping/questions">Questions to Ask Your Doctor about Cancer</a></li><li><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" title="https://cancercontrol.cancer.gov/ocs/resources/survivors.html">For Survivors and Caregivers</a> </li></ul></div></div> </section> <section id="_AboutThis_1"> <h2>About This PDQ Summary</h2> <div id="_section_AboutThis_1" class="pdq-sections"><section id="_AboutThis_2"><h3 id="_AboutThis_2_toc">About PDQ</h3><p id="_AboutThis_3" tabindex="-1">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" title="https://www.cancer.gov/espanol/publicaciones/pdq">Spanish</a>.</p><p id="_AboutThis_4" tabindex="-1">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></section><section id="_AboutThis_5"><h3 id="_AboutThis_5_toc">Purpose of This Summary</h3><p id="_AboutThis_6" tabindex="-1">This PDQ cancer information summary has current information about the treatment of childhood Ewing sarcoma. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></section><section id="_AboutThis_7"><h3 id="_AboutThis_7_toc">Reviewers and Updates</h3><p id="_AboutThis_8" tabindex="-1">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change. </p><p id="_AboutThis_9" tabindex="-1">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment" title="https://www.cancer.gov/publications/pdq/editorial-boards/pediatric-treatment">PDQ Pediatric Treatment Editorial Board</a>. </p></section><section id="_AboutThis_10"><h3 id="_AboutThis_10_toc">Clinical Trial Information</h3><p id="_AboutThis_11" tabindex="-1">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. </p><p id="_AboutThis_12" tabindex="-1">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" title="https://www.cancer.gov/research/participate/clinical-trials">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" title="https://www.cancer.gov/contact/contact-center">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237). </p></section><section id="_AboutThis_13"><h3 id="_AboutThis_13_toc">Permission to Use This Summary</h3><p id="_AboutThis_14" tabindex="-1">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].” </p><p id="_AboutThis_15" tabindex="-1">The best way to cite this PDQ summary is:</p><p id="_AboutThis_21" tabindex="-1">PDQ® Pediatric Treatment Editorial Board. PDQ Ewing Sarcoma Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq" title="https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq">https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389350]</p><p id="_AboutThis_16" tabindex="-1">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" title="https://visualsonline.cancer.gov/">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images. </p></section><section id="_AboutThis_17"><h3 id="_AboutThis_17_toc">Disclaimer</h3><p id="_AboutThis_18" tabindex="-1">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" title="https://www.cancer.gov/about-cancer/managing-care">Managing Cancer Care</a> page.</p></section><section id="_AboutThis_19"><h3 id="_AboutThis_19_toc">Contact Us</h3><p id="_AboutThis_20" tabindex="-1">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" title="https://www.cancer.gov/contact">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" title="https://www.cancer.gov/contact/email-us">E-mail Us</a>.</p></section></div> </section> </div> </div> </div> </div> <footer class="article-footer"> <div class="document-dates horizontal"> <ul class="clearfix"> <li> <strong>Updated:</strong> <time datetime="2024-02-22T12:00:00Z">February 22, 2024</time> </li> </ul> </div> <div id="nvcgSlPublicUse"> <div class="slot-item only-SI"> <div class="public-use"> <div id="block-ncids-trans-public-use"> <p><em>If you would like to reproduce some or all of this content, see <a href="/policies/copyright-reuse">Reuse of NCI Information</a> for guidance about copyright and permissions. 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