KidsMD Health Topics

Our Health Topics

Ewing Sarcoma

  • If your child has been diagnosed with Ewing sarcoma, a cancerous bone tumor, you’re no doubt feeling shocked and scared. And you probably have lots of questions, too: "Can the tumor be removed?" ... "Will my child need chemotherapy?" ... "What is his long-term prognosis?"

    Learning the basics about the condition will help you to prepare for the journey ahead.

    Ewing sarcoma:

    • is a cancer that usually grows in bone or in soft tissue around bone.
    • can occur in any bone, but is most often found in the “long bones,” such as the thigh, shin or upper arm.
    • can also affect the muscle and tissues around the area of the tumor.
    • can spread to the lungs and other bones.

    Usually, the larger the tumor is, the more difficult treatment will be. But rest assured that there is hope: Treatments for Ewing sarcoma have improved dramatically in recent years, and Dana-Farber/Boston Children's Cancer and Blood Disorders Center has extensive experience with all of these treatment approaches. You and your child are in the very best of hands.

    How the Dana-Farber/Boston Children’s approaches Ewing sarcoma

    Here at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, our integrated pediatric oncology service offers—in one specialized program—the combined expertise of a leading cancer center and a premier children’s hospital. Above all, our experts recognize that your child is an individual (never “just a patient”), and we’re here to help your entire family at every step along the way.

    Even when a Ewing sarcoma is very small, it may have spread. For this reason, Ewing always requires treatment across the child’s entire body.

    • Treatment almost always starts with chemotherapy to destroy the tumor cells and prevent the cancer from spreading.
    • Surgery, radiation or a combination of both are used along with chemotherapy.
    • Most children respond very well to chemotherapy.
    • The 5-year cure rate for localized Ewing sarcoma (cancer that has not spread from the primary site) is 70 to 80 percent.

    The Dana-Farber/Boston Children's multidisciplinary team approach allows for comprehensive, whole-body treatment in a carefully developed and coordinated plan. If your child is diagnosed with Ewing sarcoma, his care will involve the following specialists:

    • pediatric oncologists: doctors who completed special training and have extensive experience treating childhood cancers. Your child’s primary oncologist will outline and oversee all aspects of his treatment.
    • orthopedic surgeons: surgeons with special training in procedures on a child’s bones. The orthopedic surgeon will play a central role in any surgical treatment, including limb salvage or amputation surgery, for your child’s Ewing sarcoma. Our orthopedic surgeons who treat patients with Ewing sarcoma specialize in the treatment of bone cancer.
    • surgical oncologists: physicians who perform surgical treatments for cancer, including tumor removal and surgical biopsies
    • radiation oncologists: specially-trained physicians who use targeted radiation therapy to treat certain types of pediatric cancer
    • radiologists: doctors who use several imaging techniques to monitor your child’s cancer and the effects of treatment. Interventional radiologists also perform non-invasive biopsies.
    • physical therapists: professionals who will work with your child to help restore function, improve mobility, relieve pain and prevent or limit permanent physical disabilities from her Ewing sarcoma.
    • pediatric oncology nurses: highly skilled and experienced nurses who will work closely with all members of the team to plan and carry out your child's care. They’re specially certified to treat children with cancer, and they can teach you and your child about procedures, medical terms and medications, as well as provide general support.
    • Child Life specialists: professionals who enhance children's emotional, social and cognitive growth during a hospital stay, giving special consideration to each child's family, culture and stage of development.
    • psychologists and social workers: trained professionals who will offer emotional and mental health support for your child and family before, during and after treatment.

    "Although Ewing sarcoma is rare, we see many patients with these tumors. We are very familiar with diagnosing and treating this disease."

    Megan E. Anderson, MD, orthopedic surgeon at Dana-Farber/Boston Children's Cancer and Blood Disorders Center

  • At Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, we understand how overwhelming a diagnosis of Ewing sarcoma can be. We’ve provided some essential information in the following pages, and our experts will be sure to fully explain your child’s condition and recommended treatment plan when you meet with us.

    Remember: we are always available to address any concerns and questions you have, at any point in the treatment process.

    What is Ewing sarcoma?

    • Ewing sarcoma is one of the Ewing family of tumors, named after the doctor who first described them in the 1920s.

    • All of the tumors in the Ewing group grow from the same kind of stem cell.

    • Ewing sarcoma is different from the other tumors in the Ewing family because it starts in either the bones or in the soft tissue that’s closest to the bones.

    • Ewing sarcoma can occur in any bone, but most often is found in the pelvis, rib cage, spine, thigh or upper arm.

    • Ewing sarcoma cells can spread (this is called metastasizing) to other areas of the body, including the lungs, bone and bone marrow and other soft tissues. This happens in about a third of all children with the disease.

    • The cancerous cells can also spread to the kidneys, heart or adrenal gland, but this is extremely rare.

    Who gets Ewing sarcoma?

    • About 250 children and adolescents are diagnosed with the disease each year: Ewing sarcoma accounts for just 2 to 3 percent of all childhood cancers.
    • Ewing sarcoma tends to affect children and young adults who are between 5 and 20 years old.
    • The disease is extremely rare in children of African descent.
    • Boys are more commonly affected than girls.

    How serious is Ewing sarcoma?

    • Ewing sarcoma is a potentially life-threatening cancer with a high risk of spreading to other parts of the body.
    • Fortunately,treatments for Ewing sarcoma have improved dramatically in recent years.
    • With early diagnosis and proper treatment, many kids who develop Ewing sarcoma have a good chance of recovery.



    Causes

    What causes Ewing sarcoma?

    Ewing sarcoma occurs because a certain type of stem cell starts to grow abnormally, and these cells then form a tumor.

    The exact cause of this abnormal cell growth isn’t fully understood. However, researchers have learned that chromosomal changes in a cell's DNA – the “building blocks” that make up all living organisms – can lead to Ewing sarcoma. These changes are not inherited; they develop in your child after he is born, and they happen for no apparent reason. It’s important to understand that there’s nothing you could have done or avoided doing that would have prevented your child’s cancer from developing.


    Signs and symptoms

    What are the symptoms of Ewing sarcoma?

    While symptoms may vary from child to child, the most common include: 

    • pain around the site of the tumor
    • swelling and/or redness around the site of the tumor
    • fever
    • decreased appetite
    • weight loss
    • fatigue
    • bowel or bladder incontinence (if the tumor is in the spinal region)
    • symptoms related to nerve compression caused by the tumor (such as numbness, tingling or paralysis)

    Because many of these symptoms can also point to other conditions, it’s important to have your child evaluated by a qualified medical professional right away.
     

    Questions to ask your doctor

    After your child is diagnosed with Ewing sarcoma, you may feel overwhelmed with information. It can be easy to lose track of the questions that occur to you.

    Lots of parents find it helpful to jot down questions as they arise – that way, when you talk to your child’s doctors, you can be sure that all of your concerns are addressed. (If your child is old enough, you may want to suggest that she write down what she wants to ask her health care provider, too.)

    Some of the questions you might want to start with include:

    • How did you reach this diagnosis?
    • Is there any other disease my child might have instead?
    • Has my child’s tumor spread?
    • Does he need to start chemotherapy? What about radiation?
    • Can the tumor be treated with surgery?
    • How long will my child need to be in the hospital?
    • What are the possible short and long-term complications of treatment? How will they be addressed?
    • What is the likelihood that my child will be completely cured?
    • What happens if the tumor returns?
    • How should I explain my child’s disease to him?
    • How should I talk about his condition to family members and friends?
    • What services are available to help my child and my family cope?
    • Where can you point me for further information?


    FAQ

    Q: How are pediatric cancers different from adult cancers?

    A: In general, childhood cancers are more successfully treated (meaning a larger percentage of patients are cured) compared with adult cancers. Why is this? Most likely, it’s because childhood cancers are usually more responsive to therapy, and a child can tolerate more intensive therapy when necessary. Read more about childhood cancers.

    Q: Will my child be OK?

    A: Today, many children with Ewing sarcoma can be cured. Even if the tumor comes back, further treatment approaches may be given successfully.

    However, it’s important to understand that your child’s short-term health and long-term health can vary greatly depending on his specific circumstances. Prompt medical attention and intensive therapy are very important, as is continuous follow-up care.

    If your child has Ewing sarcoma, his prognosis depends on:

    • his age and overall health
    • how far his disease has progressed at the time he’s diagnosed
    • the size and location of the tumor(s)
    • whether the tumor has metastasized(spread)
    • how well his cancer responds to therapy
    • his tolerance for specific medications, procedures or therapies

    New methods for improving treatment and decreasing side effects are constantly being explored here at Dana-Farber/Boston Children's.

    Q: What are the chances that Ewing sarcoma will occur in another child in our family?

    A: Brothers and sisters of children with Ewing sarcoma are not at increased risk for developing this kind of cancer. That’s because children with Ewing sarcoma don’t inherit the disease from their parents (and they can’t pass on any increased risk of developing Ewing to their own children later in life, either).

    Q: Will my child be better after she gets treatment?

    A: Though your child’s prognosis will depend on her specific tumor and circumstances, with prompt and aggressive treatment, most children with Ewing sarcoma are successfully treated with a combination of chemotherapy and surgery and/or radiation. The majority of children have relatively few side effects from treatment.

    Q: Will my child’s overall health be affected as she gets older?

    A: As is the case with most cancers, a child with Ewing sarcoma may develop effects months or even years after treatment ends. These effects are called late effects, and may include:

    • secondary cancers: Some chemotherapy drugs can cause leukemia. Alternatively, a new type of cancer can develop at the site of radiation therapy.
    • fertility issues: All chemotherapy drugs carry fertility risks.

    In addition, there is always the possibility of a recurrence of Ewing sarcoma.

    Whether your child has any late effects, and the kind of effects she develops if she does have them, will depend on the location of her tumor and the specific treatment she received.

    It’s important that you know what kind of treatment your child is getting and what impact these treatments might have on her life as she grows up. Ask your child's doctor to help you stay aware of possible long-term effects. And be sure your adolescent or adult child knows the details of her childhood cancer treatment so she can share that information with her doctors.

    Q: What kind of long-term follow-up care should my child receive?

    A: Some children who are treated for Ewing sarcoma and other pediatric cancers can experience significant long-term problems as a result of their treatment. All kids who have been treated for cancer require ongoing, specialized care to monitor for signs that their cancer may have returned, and to manage any side effects of treatment.

    Here at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, children usually return to us for care for several years after their initial cancer treatment as part of our cancer survivorship program. One of our major goals is to maximize your child’s long-term health. We do this in many ways, including assessing and attending to his:

    • intellectual function and school performance
    • endocrine functions
    • neurological development
    • mental and behavioral health
    • hearing
    • vision

  • The first step in treating your child's Ewing sarcoma is forming an accurate and complete diagnosis.

    How is Ewing sarcoma usually diagnosed?

    Often, the symptoms of Ewing sarcoma are non-specific. For example, a pain in your child’s arm or a lump on her leg may be caused by any number of conditions … not necessarily Ewing.

    But if your child’s symptoms are persistent, you should always see her primary care provider right away. A thorough physical exam and X-rays will usually reveal a tumor if one is present.

    Next, your child will be referred to a pediatric cancer specialist to confirm a diagnosis of Ewing sarcoma through one or more of the following procedures:

    Less often, Ewing sarcoma is diagnosed through:

    • genetic testing Genetic testing for cancer can sometimes help confirm a diagnosis of Ewing sarcoma. Doctors take a biopsy of your child’s tumor and run tests to look for translocations, which occur when part of one chromosome breaks off and attaches to another chromosome. A translocation between chromosomes 11 and 22 usually confirms the diagnosis of Ewing sarcoma and allows doctors to rule out other types of cancer.
    • bone marrow aspiration — This procedure involves taking a small amount of bone marrow fluid and tissue (usually from part of the hip bones) to further examine the number, size and maturity of blood cells and/or abnormal cells.

    After we complete all necessary tests, our experts will meet as a team to review and discuss what they have learned about your child's condition. Then we will meet with you and your family to discuss the results and outline the best treatment options.

    What does “staging” mean and how is Ewing sarcoma staged?

    Once Ewing sarcoma has been diagnosed, the tumor is staged. This is a process that indicates whether the cancer has spread and, if so, how far.

    The system used for staging Ewing sarcoma is simpler than the one used for a lot of other cancers. Ewing sarcoma is classified as either localized or metastatic.

    • Localized means the tumor has not spread beyond the bone where it began, or beyond the closest surrounding tissues.
    • Metastatic means the tumor has spread to the lungs, to bones other than the bone where it first started growing or to other organs or structures in the child’s body.

    The stage, which is determined based on the results of imaging tests and biopsies of the tumor, helps your doctors decide on treatment options and prognosis.

    Your child’s prognosis is an indication of what the likely course of the disease is, and the chances that treatment will be effective. It's often stated in terms of a five-year survival rate. For patients with localized Ewing tumors, the five-year survival rate is close to 70 to 80 percent. For metastatic tumors, the five-year survival rate is 20 to 30 percent.

  • At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, our multidisciplinary approach to care ensures in-depth discussion of each case and personalized treatment plans for every patient. Through our Bone and Soft Tissue Program, we integrate expertise from:

    • pediatric oncologists, surgical oncologists and radiation oncologists
    • pediatric experts from all other medical subspecialties
    • highly skilled and experienced pediatric oncology nurses
    • Child Life specialists, psychologists, social workers and resource specialists who provide supportive care for your child before, during and after treatment

    In addition, our cancer center offers the following services:

    • Expert diagnosis by pathologists, using advanced molecular diagnostic testing to identify your child's type of tumor. Knowing the molecular composition of a tumor helps predict which treatments are more likely to work.
    • Access to unique Phase I clinical trials, from our own investigators and from the Children's Oncology Group.
    • Expert surgical care from experienced pediatric surgeons, several of whom developed approaches used at centers across the country.
    • Support services to address all of your child and family's needs.

    Where will my child be treated if we come to Dana-Farber/Boston Children's?

    Children treated through Dana-Farber/Boston Children's Cancer and Blood Disorders Center receive outpatient care at the Jimmy Fund Clinic on the third floor of the Dana-Farber Cancer Institute. If your child needs to be admitted to the hospital, she will stay at Boston Children's Hospital on the ninth floor of the Berthiaume Building. Learn more about our shared pediatric cancer facilities.

    We know how difficult a diagnosis of Ewing sarcoma can be, both for your child and for your whole family. That's why our clinicians are focused on family-centered care: From your first visit, you'll work with a team of professionals who are committed to supporting all of your child's – and your family's – medical and emotional needs.

    If your child has been diagnosed with Ewing sarcoma, you'll naturally be eager to know how his team plans to treat the tumor. The treatment team will determine a specific course of therapy based on several factors, including:

    • your child's age, overall health and medical history
    • the type, location and size of the tumor
    • the extent of the disease (whether it has metastasized, or spread, and if so, how much and how far)
    • how your child's doctors expect the disease to progress
    • your child's tolerance for specific medications, procedures or therapies
    • your family's preferences for treatment

    There are a number of treatments we may recommend. Some of them help to treat the tumor itself, while others are intended to address complications of the disease or potential side effects of treatment.
     

    Treatment options

    Most of the time, there are two components in treating children with Ewing sarcoma: local control – treating the tumor itself, usually through surgery, radiation or both – and systemic therapy – preventing the tumor from spreading, usually through chemotherapy.

    Unfortunately, Ewing sarcoma has a high likelihood of metastasizing (spreading), so local control alone is only effective in about 20 percent of all cases. This means systemic therapy is key.

    Chemotherapy

    At Dana-Farber/Boston Children's, treatment for Ewing sarcoma almost always starts with chemotherapy. Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the whole body to kill cancer cells.

    Chemotherapy drugs interfere with cancer cells' ability to grow or reproduce. They're usually given for several cycles before surgery or radiation to help shrink the size of the tumor and prevent the cancer from spreading to other parts of the body.

    Chemotherapy can be given:

    • as a pill to swallow
    • intravenously (through a vein), going directly to the bloodstream (this is also called IV)

    Most children with Ewing sarcoma respond very well to chemotherapy.

    • A combination of chemotherapy drugs is usually used.
    • Chemotherapy is usually given over a period of a few days every two weeks.
    • Chemotherapy for Ewing sarcoma is typically given for two to three months before trying surgery, radiation or both. After surgery or radiation, chemotherapy is continued for another 6 months in order to eliminate all the cancerous cells in the body.

    Depending on your child's tumor, interval compression – a way of giving chemotherapy more intensely, every two weeks instead of three – may be recommended. Studies show that interval compression improves outcomes for children with Ewing sarcoma.

    While chemotherapy can be quite effective in treating certain cancers, the drugs cannot differentiate normal healthy cells from cancer cells. As a result, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help the care team, child and family prepare (and, in some cases, prevent) these complications from occurring, if at all possible.

    Surgery

    After some chemotherapy cycles have been given, surgery may be performed to remove the remaining parts of the tumor.

    Amputation surgery

    • involves the removal of part or all of an arm or leg
    • performed only if a pressing reason exists not to save the limb
    • may be necessary if your child has a large tumor, or when the cancer has spread to surrounding essential nerves, blood vessels or muscles that cannot be removed

    During amputation, surgeons take the remaining muscles and skin and form a “cuff” around the amputated bone. The cuff is made so that it can later fit snugly into an artificial limb.

    Whenever possible, surgeons avoid amputation by removing only the cancerous section of the bone and replacing it with an artificial device, which is called an endoprosthesis.

    Limb-salvage surgery

    Although amputation of a limb is sometimes necessary, chemotherapy before and after surgery has made limb-salvage surgery possible in most cases. During this surgery:

    • surgeons try to remove all the cancer, but still leave the limb in working order
    • the tumor and a portion of tissue around the tumor's edge are removed
    • the removed bone is replaced with either a bone graft or an endoprosthesis
      • A bone graft can be bone taken from elsewhere in your child's body, or bone donated by another person. The bone is shaped to fit the gap left by the removed portion.
      • An endoprosthesis is an artificial support made of metal or other materials that take the place of bone inside the child's body.

    Radiation therapy

    Children with Ewing sarcoma occurring in a location where surgical removal is difficult will receive radiation therapy instead of surgery. Some children need both surgery and radiation therapy. Radiation is used to either shrink the tumor or to destroy it completely.

    • The good news is that Ewing sarcoma is very sensitive to radiation therapy: It has a 75- to 80-percent cure rate.
    • Here at Dana-Farber/Boston Children's, we use precisely targeted and dosed radiation to kill any cancer cells left behind after your child's surgery.

    In some cases, we may use proton beam therapy, which delivers radiation to a more targeted area than standard radiation (which is delivered with X-rays).

    • Proton beam therapy spares more of the surrounding healthy tissue and organs, and causes fewer side effects for patients.
    • The location and size of the tumor determines whether proton beam therapy is possible. If the tumor area is too large, the protons won't be effective. Tumors in well-confined areas respond best.

    What will my child need after treatment?

    Your child may need physical therapy after surgery to help him restore strength and function in the affected limb. If his leg was affected, he may need crutches for some part of the two to three months of healing time.

    Are stem cell transplants/bone marrow transplants an option for treating Ewing sarcoma?

    Stem cell transplants are more applicable to treating leukemias than to solid tumors like Ewing sarcoma.

    However, autologous bone marrow transplants might play a helpful role for some children with Ewing sarcoma. In this treatment approach:

    • The child's bone marrow is frozen before she starts chemotherapy.
    • A standard chemotherapy regimen begins.
    • Doctors incorporate “megatherapy” – giving the child a very high dose of chemotherapy before rejuvenating her body by re-transplanting her own bone marrow.

    This approach seems to be effective in some children with Ewing sarcoma that has metastasized or relapsed, but the data is not conclusive. In short, it's a potentially promising treatment method but it still needs to be fully explored by researchers.
     

    Side effects and complications

    What are the possible side effects and complications of treatment for Ewing sarcoma?

    Like any type of cancer, Ewing sarcoma carries a range of possible long-term complications:

    Orthopedic complications

    Bones in the area where the tumor was may break easily, after only mild bumps or falls, because they have been weakened. This is called a pathologic fracture.

    Children may develop osteomyelitis, an inflammation caused by infection in the bone.

    Systemic complications caused by chemotherapy and/or radiation

    • Radiation often causes inflammation of the surrounding tissues.
    • Chemotherapy drugs can cause leukemia. Unfortunately, Ewing sarcoma is – along with Hodgkin lymphoma – the childhood cancer most likely to lead to this type of leukemia.
    • Some children develop cardiomyopathy after undergoing chemotherapy.
    • Chemotherapy can also cause fatigue, diarrhea, constipation and headaches.
    • Kidney damage is also possible.
    • All chemotherapy drugs increase the chance that a person will experience infertility later in life.

    How are these side effects and complications managed?

    All kids who have been treated for cancer require ongoing, specialized care to monitor for signs that their cancer may have returned, and to manage any side effects of treatment.

    Here at Dana-Farber/Children's Hospital Cancer Center, children usually return to us for care for several years after their initial cancer treatment. One of our major goals is to maximize your child's long-term health. We do this in many ways, including assessing and attending to his:

    • intellectual function and school performance
    • endocrine functions
    • neurological development
    • mental and behavioral health
    • hearing
    • vision

    We have special survivorship clinics to provide follow-up care for patients who have been treated for pediatric cancers.

    In addition, we also offer complementary or alternative medicines as additions to (but not replacements for) standard medical and surgical treatment. These therapies, which may help control pain and side effects from surgery, chemotherapy and radiation, include:

    • acupuncture/acupressure
    • therapeutic touch
    • massage
    • herbs
    • special dietary recommendations

    Talk to your child's physician about whether complementary or alternative medicine might be a good supplement to your child's treatment plan.
     

    Long-term monitoring and follow-up

    What long-term care will my child need?

    Because Ewing sarcoma does have a tendency to recur later in life – even as many as 10 years after treatment – long-term follow-up care is essential.

    Here at Dana-Farber/Boston Children's, we see patients with Ewing sarcoma for x-rays or MRI of the primary tumor site and CT scan of the chest every three months after treatment is completed. If all goes well, the frequency of the visits will decrease for the next five years.

    One of our major goals is to maximize your child's long-term health. We do this in many ways, including optimizing your child's:

    • intellectual function and school performance
    • endocrine functions
    • neurologic functions
    • psychosocial well-being
    • hearing
    • vision

    To monitor for recurrence and address short and long-term side effects of treatment, children treated for pediatric cancer receive follow-up care at our survivorship clinics.

    Survivorship clinics

    To assist the many children successfully treated for malignant tumors, we have established multidisciplinary survivorship clinics that address the medical, psychological and social consequences of a cancer diagnosis and subsequent treatments. Childhood cancer survivors of any age are invited to visit our clinics. 

    Coping and support

    We understand that a cancer diagnosis is an event that affects the entire family. In addition to providing exceptional medical care, the Dana-Farber/Boston Children's team also strives to meet all of your family's emotional and quality-of-life needs.

    Our patient and family support services can help address many of your needs and concerns. 

    In addition, Boston Children's Hospital offers the following for parents and families:

    • Children's Center for Families is dedicated to helping families locate the information and resources they need to better understand their child's particular condition and take part in their care. All patients, families and health professionals are welcome to use the center's services at no extra cost. The Center for Families is open Monday through Friday from 8 a.m. to 7 p.m., and on Saturdays from 9 a.m. to 1 p.m. Please call 617-355-6279 for more information.
       
    • For children and families affected by life-threatening illness, our Pediatric Advanced Care Team (PACT) is available to provide supportive treatments intended to optimize the quality of life and promote healing and comfort. In addition, PACT can provide emotional support and help arrange end-of-life care when necessary. Please call 617-632-5042 for more information.
       
    • Children's Behavioral Medicine Clinic helps children who are being treated on an outpatient basis at the hospital—as well as their families—understand and cope with their feelings about:
      • being sick
      • facing uncomfortable procedures
      • handling pain
      • taking medication
      • preparing for surgery
      • changes in friendships and family relationships
      • managing school while dealing with an illness
         
    • The Experience Journal was designed by Children's psychiatrist-in-chief, David DeMaso, MD, and members of his team. This online collection features thoughts, reflections and advice from kids and caregivers about living with a variety of medical conditions, the “befores” and “afters” of surgery and going through many other medical experiences.
       
    • Children's Psychiatry Consultation Service provides several services, including:
      • short-term therapy for children admitted to one of the hospital's inpatient units
      • parent and sibling consultations
      • teaching healthy coping skills for the whole family
      • educating members of the medical treatment team about the relationship between physical illness and psychological distress
         
    • Children's Department of Psychiatry offers a free booklet, “Helping Your Child with Medical Experiences: A Practical Parent Guide.” (Adobe Acrobat required to view and download) Topics in the booklet include:
      • talking to your child about her condition
      • preparing for surgery and hospitalization
      • supporting siblings
      • taking care of yourself during your child's illness
      • adjusting to life after treatment
         
    • The Children's chaplaincy is a source of spiritual support for parents and family members. Our program includes nearly a dozen clergy members—representing Episcopal, Jewish, Lutheran, Muslim, Roman Catholic, Unitarian and United Church of Christ traditions—who will listen to you, pray with you and help you observe your own faith practices during your child's treatment.
       
    • Children's International Center is a resource for patients and families from countries outside the United States. The center can provide assistance with everything from reviewing medical records to setting up appointments and locating lodging. Contact the center by phone at 01-617-355-5209 or via e-mail at international.center@childrens.harvard.edu.

    Did you know?
    Children's has an Integrative Therapies Team, offering services like therapeutic touch, massage therapy, Reiki and more.

    Helpful links

    Please note that neither the Dana-Farber/Boston Children's Cancer and Blood Disorders Center nor the Children's Department of Orthopedic Surgery unreservedly endorses all of the information found at the sites listed below. These links are provided as a resource.

    Helpful links for parents and families

    Helpful links for teens

  • If your child has a progressive or recurrent tumor, he may be eligible for a number of experimental therapies available at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

    Dana-Farber/Boston Children’s Cancer and Blood Disorders Center was one of the first centers in the United States to use chemotherapy and perform limb-salvage surgery for patients with bone cancers like Ewing sarcoma. We are now conducting numerous research studies to help better understand and treat childhood cancers, and our researchers are directing and participating in national and international clinical trials to develop novel treatments.

    Some of our most relevant research breakthroughs include:

    • Dana-Farber participated in a recently completed study investigating whether interval compression, a way of giving chemotherapy more intensively, improves outcomes for Ewing sarcoma patients.

      With the help of hematopoietic growth factors (proteins that stimulate marrow cells to grow and produce blood cells), patients can receive chemotherapy every two weeks instead of three, increasing the amount of therapy administered over a given time period.

      The results of this trial show that interval compression does improve outcome; interval compression has now become the standard treatment for Ewing sarcoma. .
       
    • We are also conducting a laboratory-based study with the goal of developing a method for detection of Ewing sarcoma cells in the bone marrow. Standard bone marrow tests can identify Ewing sarcoma cells if they are present at a high level – but the method being developed in this study may allow detection of a very low level of Ewing sarcoma cells, too.
       

    Clinical trials

    Dana-Farber/Boston Children’s Cancer and Blood Disorders Center is one of the top pediatric research centers in the world. Our research program includes laboratory scientists and clinical researchers from both Dana-Farber Cancer Institute and Boston Children’s Hospital. We investigate conditions from every angle—from examining cells under the microscope to tracking response to current drug regimens—so that we can create better treatments for your child.

    Clinical trials, or research studies evaluating new treatment approaches, are a major offering at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. Clinical trials are very important for children with hard-to-treat or relapsed conditions. We offer enrollment on several independent, as well as cooperative, treatment studies, many of which are available only at our center.

    For many children with rare or hard-to-treat conditions, clinical trials provide new options.

    In addition:

    • The Children's Oncology Group is a consortium of cancer treatment centers across the United States, Canada, and other countries that conduct studies of nearly every kind of pediatric cancer. Our participation in this group gives children with cancer unparalleled access to the newest clinical trials. Learn more.
       
    • Dana-Farber/Boston Children’s Cancer and Blood Disorders Center has a number of Phase I studies available. If your child has progressive or recurrent Ewing sarcoma, he may be eligible for a number of experimental therapies available through these groups, or through one of our independent clinical investigators. Learn more

Request an Appointment

If this is a medical emergency, please dial 9-1-1. This form should not be used in an emergency.

Patient Information
Date of Birth:
Contact Information
Appointment Details
Send RequestIf you do not see the specialty you are looking for, please call us at: 617-355-6000.International visitors should call International Health Services at +1-617-355-5209.
Please complete all required fields

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

Thank you.

Your request has been successfully submitted

You will be contacted within 1 business day.

If you have questions or would like more information, please call:

617-355-6000 +1-617-355-6000
close
Find a Doctor
Search by Clinician's Last Name or Specialty:
Select by Location:
Search by First Letter of Clinician's Last Name: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
More optionsSearch
Condition & Treatments
Search for a Condition or Treatment:
Show Items Starting With: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
View allSearch
Visitor Information

Contact the Cancer and Blood Disorders Center

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO
Close