Ewing's sarcoma

Ewing's sarcoma is a type of bone tumor. These tumors are most commonly associated with pubescent children. They are very rare in both African-American children, and those under the age of 10.

Since Ewing's sarcoma is associated with growth, it should come as no surprise that the most common locations in which it occurs are on the lengthening limb bones. Unfortunately, its nature also leads to a high liklehood of metastatic tumors developing. At the time of diagnosis approximately one third of all patients have already developed metastatic tumors.

Pain is the most common symptom, but swelling at the tumor site may be visible. Fever is rarely caused by this disease. These features are not diagnostic however, and scans and biopsies are necessary to confirm what the problem is.

While Ewing's sarcoma is indeed a bone cancer generally seen in young children, older individuals can get it too. My best friend and former roommate, had metastatic Ewing's two years ago at age 21.

He was complaining of a pain at his hip, but wrote it off in his mind for several months as the re-emergence of an old injury he'd sustained while diving years before. The story didn't make sense to me, but I wasn't alarmed until one day, in the kitchen, we had a conversation that went something like this:

He: "I think I'm growing new body parts or something! That diving injury is coming back with a vengeance."

Me: "What do you mean?"

He: "Well, I have, like, a golf ball growing out of my hip now. Oh, and look, I'm growing one on my forehead too."

Me: "Um, James . . . that's really not good. Has it occurred to you that it could be cancer?"

He: "Well, I seriously doubt it, but I have an appointment with my doctor anyway."

And as it turns out, it was Ewing's sarcoma. The following year would see surgeries, chemotherapy, hair- and weight- loss, and an emotionally difficult ride for those around him. But he had an enormously positive attitude . . . and against all odds, he has survived, with the cancer apparently gone.

The most interesting aspect of the treatment in my roommate's case, BTW, is that the surgeons re-routed a portion of his abdominal muscles into his leg, to replace the tissue that was removed. We used to joke that this could have unintended consequences, such as, perhaps, involuntarily kicking whenever he coughed, or some such thing. This is not the case, of course, because even though the abdominal muscles were still attached to his abdomen near the waistline, the muscles would "learn" to "obey" the electrochemical commands destined for the leg, not the abdomen.

His parents just happen to work at a world-renowned cancer treatment hospital, and we happen to live near the US National Institutes of Health (NIH), and so my roommate was well cared-for, and also quite involved in the many research programs currently funded by the US government. It seems that there is quite a bit of hope on the horizon for Ewing's patients, and I am happy to know that.

Most of all, I am happy that my friend survived this round. I do hope very much that he doesn't present with more tumors, and that, if he wants to one day, he can still father children. Statistically, I have been told by family friends who are doctors that he is both unlikely to remain tumorless (for Ewing's has a high recurrence rate), and unlikely to successfully father a child.

But my friend is a person, not a statistic. And I have admired him greatly for his courage and upbeat spirit in all of this. He was far more concerned about the emotional state of his family and friends throughout the ordeal than he was about his own cancer. He had declared at the beginning that it was not going to be a "big deal", and he was determined not to let it be so.