Research

EWING ’S SARCOMA – THE NEED FOR RESEARCH

Dr Ian Lewis MBChB, FRCP, FRCPCH , Consultant Paediatric and Adolescent Oncologist, Leeds, UK and Chairman of Bone Cancer Research Trust Scientific Advisory Panel

EWING ’S SARCOMA is a cancer named after Dr James Ewing who first described it nearly 90 years ago. It arises most commonly in bone but can also arise in non-bony soft tissue. The cause is unknown although its development may be in some way related to times of rapid bone growth. The most common sites are bones of the pelvis, thigh, lower leg, upper arm, and rib.

EWING ’S SARCOMA is a cancer of young people, typically aged between 10 – 20 years old, although it can also arise in very young children or older adults. We do not know what kind of cell gives rise to this cancer but there are some features that suggest it arises from cells that help to form the nervous system.

The most common early signs of Ewing's sarcoma are pain and swelling. Like other sarcomas, Ewing's sarcoma can spread to other parts of the body. Even when the tumour is detected at a very small size, there may be evidence of microscopic spread. For this reason, Ewing's sarcoma always requires treatment to the whole body. This treatment includes chemotherapy. Chemotherapy is intended to destroy the tumour cells which have spread to the rest of the body and to shrink the main mass of tumour cells. Successful treatment also requires another form of treatment to the main mass of tumour. This can be surgery, radiation therapy, or a combination of the two. Treatment can extend over many months and, whilst many patients now survive, many do not. Currently, the survival rate at 5 years is around 60%.

Current treatment has achieved much but it is now clear that there has been little improvement in survival from this cancer for the past 15 years despite the use of more intensive treatments. This means that young lives like Bláthnaid are being lost to this cancer, each one a tragedy for the young person, their families and communities.

It is clear that if we are to improve the outcome then we need to increase our understanding about the nature of the cancer in order to diagnose the cancer at an earlier stage and develop more effective treatments in the future. This can only be done by proper research, funding trained scientists and doctors to look into various aspects of Ewing’s Sarcoma so that we can increase the number of young people who survive this disease.

 

Areas Identified by the Bone Cancer Research Trust for Research Into Ewing’s Sarcoma

1. Epidemiology  i.e. causation
            For example smoking causes Lung Cancer
            Addressed by Public Health
            Addressed by personal behaviour
            Addressed by genetic screening

2. Biology understanding cancer
            Provide new ways of treatment and/or diagnosis

3. Treatment
            ‘Standard’ - largely already funded
            Experimental

4. Supportive Care

5. Surgical/Technical
            Radiotherapy/Local treatments

6. Health Service
            What happens an individual as a patient
            e.g. Quicker diagnosis improves treatment pathway

 

As a result of the first round of bids for the BCRT 3 applications were received

1st - Institute of Child Health, a study into gene therapy

2nd - A group in Newcastle, interested in an epidemiology study into bone tumours in children and young adults.  i) To undertake a review of all published work to date and ii) start looking at regional bone cancers.  The reviewers thought that the initial population too small and they expanded the base to include Yorkshire, the West Midlands and North West

3rd - Reviewers did not consider funding as it was a biology study that was considered too ambitious and not detailed enough

The closing date for the next round of BCRT grants is the 19th of March

Another aim of the BCRT is to assemble an international advisory team for local therapy.  The Department of Health in the UK are keen to support this project and the aim would be that any Doctor with a bone cancer patient can bring a case to the panel for advice.

There is to be a meeting for the Patients and Supporters Conference on Saturday 19th May at the Royal Orthopaedic Hospital, Birmingham and Michael Francis, the chairperson for the BCRT has extended an invitation to go.  The UKCCSG (now the CCLG) is to mark it’s 30th anniversary in Dublin in July and Ian Lewis and Rob Grimer from the BCRT have indicated they would like to come to Sligo to meet us when they attend this conference in the summer

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