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How the Ewing’s family of tumors are treated
It is important for patients to be evaluated by several specialists as early as
possible so that treatment may be coordinated effectively from the beginning.
These specialists may include: a radiologist, chemotherapist, pathologist,
surgeon, or orthopedic oncologist and a radiation oncologist. Before treatment
decisions are made patients will probably be required to undergo several diagnostic tests including tissue sampling, x-rays, magnetic resonance imaging
(MRI) scans, and computed tomography (CT) scans.
There are treatments for all patients with one of the Ewing’s family of tumors.
Three kinds of treatment are used:
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Surgery (taking out the cancer in an operation)
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Radiation therapy (using high-dose x-rays to kill cancer cells)
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Chemotherapy (using drugs to kill cancer cells)
Surgery may be used in certain cases to try to remove the cancer and some of
the tissue around it. Surgery may also be used to remove any tumor that is
left after chemotherapy or radiation therapy.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation for the Ewing’s family of tumors usually comes
from a machine outside the body (external radiation therapy). Clinical trials
are evaluating radiation given inside the body during surgery (intraoperative
radiation therapy).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in a vein or muscle.
Chemotherapy is called a systemic treatment because the drug enters the blood
stream, travels through the body, and can kill cancer cells throughout the
body. When more than one drug is given to kill tumor cells, the treatment is
called combination chemotherapy. Treatment for the Ewing's family of tumors may include surgery or radiation to remove or shrink the tumor as much as possible, followed by chemotherapy to kill any cancer cells that remain in the body.
A supplement to the treatment options listed above is myeloablative therapy
with stem cell support. Myeloablative therapy is a very intense regimen of
chemotherapy designed to destroy all cells that divide rapidly. These cells
include some blood cells and hair cells, as well as malignant (cancer) cells.
Stem cells are self-renewing cells that create all of the other various types
of blood cells. Stem cell support involves enriching the stem cells to
increase the number of these important cells circulating in the blood after the
chemotherapy has been given to kill the remaining tumor cells.
Treatment for the Ewing’s family of tumors depends on where the cancer is
located, how far the cancer has spread, the stage of the disease, and the age
and general health of the patient.
A patient may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or may choose to go into
a clinical trial. Not all patients are cured with standard therapy and some
standard treatments may have more side effects than are desired. For these
reasons, clinical trials are designed to find better ways to treat cancer
patients and are based on the most up-to-date information.
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