Chemotherapy is the use of medicines to kill cancer cells. Chemotherapy is a systemic treatment because the drugs travel throughout the whole body in the bloodstream. Even when Ewing sarcoma appears to be localized to one area, in most cases small groups of cancer cells have already spread elsewhere in the body. Because of this, chemotherapy is a very important part of treatment for all Ewing sarcomas.
For this treatment, you will see an oncologist. This is a doctor who specializes in using drugs to treat cancer. Cancer cells divide quickly, and anticancer drugs kill rapidly dividing cells.
For Ewing sarcoma, your doctor is likely to give you more than one drug. You will probably take these drugs through an IV into a vein or in a pill by mouth.
A few combinations of chemotherapy drugs are used to treat people with Ewing sarcoma. These are the first group of drugs you may take:
After you have recovered from the side effects of these drugs, you may get this next combination of drugs:
It is possible that your doctor will offer you an opportunity to participate in a clinical trial that is evaluating newer chemotherapy drugs.
You may have chemotherapy treatments in an outpatient part of the hospital, at the doctor's office, or at home. In some cases, depending on your health or the medicines you take, you may need to stay in the hospital during treatment.
Soon after your diagnosis, your doctor may suggest inserting a special device called a central venous catheter into your chest. These catheters are often called Broviac, Hickman, or Port-A-Cath catheters and can stay in place for months. A surgeon inserts the catheter while you are asleep from anesthesia. The catheter allows the doctors and nurses to give you chemotherapy and draw blood without having to stick a needle into your veins each time, which makes the process less painful.
You get chemotherapy in cycles. This means you will be treated for a period of time with chemotherapy and then will have a rest period. It usually takes two to three weeks to recover from the treatment. Each treatment and rest period make up one cycle. You'll likely have many cycles of treatment. Your doctor will better explain what your treatment plan will be and what you can expect.
Chemotherapy affects both normal cells and cancer cells. Side effects depend on the type and amount of drugs you take. Your oncologist and chemotherapy nurse will talk with you about the possible side effects before your treatment begins.
Here are some common side effects that people with Ewing sarcoma have when they take chemotherapy. Ask your doctor which ones are most likely for you:
Mouth and throat sores
Temporary hair loss
If you take the drugs Cytoxan (cyclophosphamide) or Ifex (ifosfamide), you may have these side effects:
Damage to the ovaries or testes
Menstrual cycle changes
Possible future infertility
If you take the drug Adriamycin (doxorubicin), you may have this side effect:
Your doctor may be able to help you control many of these side effects. Most of your side effects should go away after your treatment is complete. New drugs can help reduce the potential side effects and improve your quality of life.
Very rarely, chemotherapy for Ewing sarcoma can cause a type of cancer in the white blood cells, called acute myeloid leukemia.