Ewing Sarcoma: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Ewing Sarcoma?
A pediatric oncologist, a doctor who specializes in treating children with cancer, usually leads care for Ewing sarcoma. A surgical or orthopedic oncologist (a cancer surgeon who treats bone tumors) and a radiation oncologist may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Ewing sarcoma?
Ewing sarcoma is a type of cancer that forms in a bone or in the soft tissue near a bone. Soft tissues connect, support, and surround other body parts. It most often starts in the long bones of the arms and legs, the pelvis, or the chest.
It is most common in teens and young adults, from the teens through the mid-20s. In rare cases it happens in adults. Ewing sarcoma can spread, most often to the lung, other bones, and bone marrow.
Symptoms
Pain, and sometimes swelling, at the site of the tumor is the most common symptom. Check with a doctor if you or your child has:
- A lump in the arms, legs, chest, or pelvis. It may feel soft and warm.
- Pain or swelling near the lump.
- Fever with no known reason.
- A bone that breaks for no known reason, or breaks after a minor injury.
- A limp when walking.
- Fatigue (deep tiredness) or weight loss.
- Anemia (low red blood cells) or shortness of breath.
- Back pain, or numbness in the arms or legs.
These symptoms may be caused by problems other than Ewing sarcoma. The only way to know is to see a doctor.
Causes and who gets it
Ewing sarcoma is caused by changes in the way bone cells grow and divide into new cells. Often the exact cause of these changes is unknown. Children with Fanconi anemia, an inherited blood disorder, may be at higher risk. Not every child with a risk factor gets Ewing sarcoma, and it can happen in children with no known risk factor.
It usually develops during puberty, when bones grow quickly. It is more common in White children than in Black or Asian children.
How doctors diagnose it
The doctor asks when symptoms started and about family medical history. Then the doctor does a physical exam and may order more tests. Tests can include:
- Imaging tests, such as x-ray, MRI, CT scan, PET-CT scan, and bone scan. These make pictures of the tumor and show whether it has spread.
- Blood tests, such as a complete blood count and a blood chemistry study. The chemistry study measures substances such as lactate dehydrogenase (LDH).
- A biopsy, which removes a sample of tissue from the tumor. A pathologist, a doctor who studies tissue, checks it under a microscope. Lab tests can look for gene changes in the sample.
- A bone marrow test, used only if other tests show the cancer may have spread.
Treatment
A team of experts in childhood cancer plans treatment. Treatment depends on the stage of the cancer, the person's age and sex, and results from the biopsy sample. The best chance for cure is a combination of treatments that includes chemotherapy plus radiation or surgery.
- Chemotherapy uses drugs to kill cancer cells or stop them from dividing. It is often the first treatment and lasts about 6 to 12 months.
- Surgery removes the whole tumor when possible. Removed bone may be replaced with a graft or an implant.
- Radiation therapy uses high-energy rays to kill cancer cells. It is used when surgery cannot remove the tumor or would affect important body functions.
- Stem cell transplant gives back stored blood-forming cells after high-dose chemotherapy. It is used for localized and recurrent Ewing sarcoma.
Cancer treatment can cause side effects. Problems that start 6 months or later after treatment are called late effects. Follow-up tests are done from time to time.
When to see a doctor
Contact a doctor if your child has any symptoms of Ewing sarcoma. An early diagnosis can increase the chance of a favorable outcome.
Call 911 or go to the emergency room if there is bleeding that will not stop. Do the same for chest pain lasting two minutes or more, fainting, sudden confusion, sudden weakness or paralysis in the arms or legs, or severe trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine a lump or bone pain and order a first test, such as an x-ray. This doctor can refer you to a cancer specialist and help with follow-up.
Common questions
Is Ewing sarcoma cancer?
Yes, Ewing sarcoma is a type of cancer. It forms from a certain kind of cell in bone or soft tissue.
Who gets Ewing sarcoma?
Ewing sarcoma is most common in teens and young adults, from the teens through the mid-20s. It is more common in White children than in Black or Asian children, and it happens in adults only in rare cases.
Can Ewing sarcoma spread?
Yes, Ewing sarcoma can spread. It most often spreads to the lung, other bones, and bone marrow. Spread is seen at diagnosis in about 25% of children.
What affects the outlook for Ewing sarcoma?
Several things affect the outlook. These include whether the tumor has spread, where in the body it started, and how large it is at diagnosis.
Sources
- MedlinePlus - Ewing sarcoma
- National Cancer Institute - Ewing Sarcoma Treatment (PDQ) - Patient Version
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
