What to Know About Radiation Therapy for Ewing Sarcoma

Radiation therapy is another way to treat Ewing sarcoma. This treatment is also called radiotherapy. It uses beams of X-rays or radioactive particles to kill cancer cells and shrink tumors.

Radiation is a local treatment. That means it kills cancer cells only in the area treated.

For this treatment, you will see a radiation oncologist. This doctor tells you about your treatment plan. The plan details how often you need radiation and at what dose.

You may be given radiation before surgery to make the tumor smaller and easier to remove. It may also be used after surgery in some cases to try to kill any remaining cancer cells. Or it may be used instead of surgery if the tumor can't be removed completely. In any case, chemotherapy is part of the treatment as well. 

Radiation is delivered by external beam treatments, which means the radiation comes from a machine outside of your body. To get your treatment you will go to the hospital or clinic five days a week for several weeks. The treatments last only a couple of minutes and are painless. However, as a treatment episode progresses, damage can occur to normal tissues also receiving radiation. Long-term side effects from radiation are a concern, particularly in children, because their bones and other organs are still growing and developing. For that reason, radiation is usually reserved to treat Ewing sarcoma only when surgery is not possible or adequate.

Potential side effects of radiation therapy for Ewing sarcoma

Radiation affects both normal cells and cancer cells. This means it can cause side effects. These side effects depend on what part of your body is being treated.  

A radiation oncologist will explain the possible side effects of radiation.

During treatment, side effects might include a sunburn-like skin reaction in the area being treated and a feeling of being very tired. Radiation to the abdomen or pelvis can cause nausea, diarrhea, and problems with urination.

Here are some long-term side effects that people with Ewing sarcoma might have after they get radiation therapy:

• Uneven bone growth in children

• Bladder or bowel damage if the tumor is in the pelvis

• Scar tissue that limits joint or intestine movement

• Nerve damage if the tumor is in the spinal cord

• Headaches or trouble thinking if the tumor is in the skull

• Loss of fertility if tumor is in the pelvis 

• Lung damage or shortness of breath if the tumor is in the chest area

Radiation may also cause a second cancer to grow at the radiation site years later. This may be an important issue if you are deciding between surgery and radiation.