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Nicholas DuBrul, a 25-year survivor of Ewing's Sarcoma Presented at the 2007 Annual Cancer Survivorship Celebration
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Ewing's sarcoma was first described here at Memorial Sloan-Kettering in 1921 by Dr. James Ewing. It is a tumor that involves the bone as well as the soft tissue. It tends to appear in the middle area of bones -- most often in the hip, ribs, upper arm, and thigh. Annually, approximately 300 to 400 new cases are diagnosed in the United States. Pain and swelling are the most common presenting complaints for patients with Ewing's sarcoma.
Screening & Diagnosis
When a physician suspects that a patient has Ewing's sarcoma, the diagnosis is confirmed using x-rays, CT scans, and MRI. Since Ewing's sarcoma can spread widely throughout the body, examination of the bone marrow and radiologic imaging studies with CT scans of the chest as well as bone scans are done as part of the initial work-up to evaluate how far the tumor has spread. In addition, a tiny piece of the tumor is removed by our surgeons to be examined by our pathologists who specialize in the diagnosis of sarcomas.
Treatment
Once a diagnosis of Ewing's sarcoma has been confirmed, patients will be treated with chemotherapy to shrink the tumor and to prevent new tumors from forming. Patients also undergo surgery to remove all areas of tumor involvement. Depending on the site of tumor involvement, radiation therapy may also be used to treat Ewing's sarcoma. Standard chemotherapy medications in Ewing's sarcoma include vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Patients treated for Ewing's sarcoma here have the highest long-term survival rates in the nation -- an 85 percent five-year survival rate when treated with chemotherapy, surgery, and/or radiation therapy.
Treatment for patients with relapsed disease is individualized based on the therapy previously received. In the context of clinical trials, new treatment agents with activity in Ewing's sarcoma are employed in the relapse setting. Additional surgery and/or radiation therapy are also possible treatment approaches. Based on laboratory studies conducted here at Memorial Sloan-Kettering, we offer a series of innovative, disease-specific clinical trials for this group of high-risk patients.
