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The treatment for Ewing’s sarcoma usually involves chemotherapy, radiation
therapy, and/or surgery. Radiation or surgery are the typical treatments
for tumors that have not spread elsewhere. A doctor’s first choice
is usually to remove the tumor surgically. Sometimes, however, doing so
proves difficult because the tumor is located in such a spot that the doctor
thinks its surgical removal may harm the person’s use of that particular
body part. In that case, the doctor may turn to radiation therapy to kill the
tumor cells. The doctor may also use a combination of surgery and radiation.
For instance, if surgery does not remove all of the tumor, the doctor
may then use radiation to treat the leftover tumor. In addition, doctors
sometimes use radiation to make sure the cancer does not return.
Doctors turn to chemotherapy especially when the tumor has spread,
because chemotherapy kills both tumor cells and additional cancer cells
in other areas of the body. The doctor will observe the tumor continuously
as the patient is undergoing chemotherapy to determine whether
the tumor is shrinking. When the tumor has shrunk sufficiently, a surgeon
may remove it.
During surgery for Ewing’s sarcoma, a doctor removes the tumor and
makes repairs at the tumor site. Repairs may include reconstructing the
bone or joint, and perhaps using artificial joints or bone grafts. A bone
graft is new bone or another material, such as a metal rod, that replaces
the bone that was lost in the surgery. These artificial joints and bone
grafts, along with physical therapy after the surgery, can help individuals
return to many of their normal activities. The doctor directs the patient
to avoid athletic competition and other movements that put too much
stress on the repaired bones or joints. Occasionally, individuals need additional
operations later in life to keep bones or joints functioning properly.
Subsequent operations occur often among children, whose bones are
still developing. Doctors may need to do several surgeries to lengthen the
repaired bone as the child grows.
In the late 20th century, amputation of arms or legs was a common
treatment for Ewing’s sarcoma. That is no longer the case. In the early 2000s,
doctors can remove the tumors in most patients without having to amputate
a limb. Occasionally, however, some patients with Ewing’s sarcoma
must have a limb amputated. After an amputation, individuals typically
receive an artificial limb, called a prosthesis, and work with physical and
occupational therapists to learn how to use it to the greatest advantage.
Even after individuals have the tumor removed, they still have
to return for follow-up care to make sure that the tumor is indeed
gone.

This care may include additional diagnostic tests, such as x-rays
or bone scans. Overall, the survival rate for Ewing’s sarcoma varies
greatly and depends to a great extent on many factors. Some of these
factors are:

• The size of the tumor
  
• The location of the tumor
  
• Whether the cancer has spread to other parts of the body
  
• How well the tumor responds to chemotherapy or other treatment
  
• The overall health of the patient

In addition to these treatments, a doctor may recommend psychological
therapy to help individuals cope with the disease and its effect
on their life. Teenagers may especially benefit from psychological therapy
because they are also dealing with adolescent issues that can already be
quite challenging.