Ewing sarcoma is cancer that begins in the bones or soft tissues. Metastatic Ewing sarcoma is when the cancer has spread to another area of the body.

Ewing sarcoma is a cancerous tumor that begins in cells within the bone or soft tissue.

Metastatic Ewing sarcoma is the term for Ewing sarcoma that has spread to a different part of the body from where it first began.

This article looks at metastatic Ewing sarcoma, its symptoms, outlook, and more.

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Metastatic Ewing sarcoma occurs when the cancer spreads from the area it first began to another area of the body.

It is most common for Ewing sarcoma of the bone to spread to the lungs, bones other than the bone it began in, or bone marrow.

Healthcare professionals use a staging system to categorize Ewing sarcoma. This helps them identify if the cancer has spread, its severity, and the best treatment options.

There are three SEER stages of Ewing sarcoma, as detailed below.

StageDescription
LocalizedCancer occurs in the bone or soft tissue where it first began. In some people, it may have spread to the surrounding tissues or lymph nodes.
Metastatic or distantEwing sarcoma has spread from the bone or soft tissue where it first began to another area of the body, such as the lungs or other bones.
RecurrentCancer has returned after treatment, either in the same place it began or in a different area.

Metastatic Ewing sarcoma happens when the cancer spreads to other organs or distant tissues.

Symptoms of Ewing sarcoma may include:

People with metastatic Ewing sarcoma may have additional symptoms, such as bone pain or fractures.

Symptoms affecting the whole body, such as fever, fatigue, and unexplained weight loss, may indicate metastatic Ewing sarcoma.

In some instances, tumors near the spine may affect the nerves and cause back pain or numbness and weakness in the legs.

Ewing sarcoma is most common in older children and adolescents, but it can also affect adults.

Certain tests can show if a person has Ewing sarcoma and the tumor’s stage and location.

To diagnose metastatic Ewing sarcoma, doctors may use various tests, such as:

Doctors may use a combination of treatments for metastatic Ewing sarcoma. The standard treatments are:

  • Chemotherapy: Chemotherapy drugs work to destroy cancer cells or prevent them from dividing, and they can help shrink tumors before receiving other treatments. People may take chemotherapy drugs orally or intravenously.
  • Radiation therapy: Radiation therapy uses radiation to destroy cancer cells or prevent them from growing further.
  • Surgery: After chemotherapy or radiation therapy, people may have surgery to remove the remaining cancer.

People may also want to consider talking with a healthcare professional about participating in clinical trials, which may be investigating newer treatment options.

According to the American Cancer Society (ACS), treating those with metastatic Ewing sarcoma at diagnosis may be more challenging than treating those with localized Ewing sarcoma at diagnosis.

The 5-year relative survival rate for those with metastatic Ewing sarcoma between 2010–2016 was 39%. However, as this data is older, the outlook may be better for those who have received a diagnosis more recently.

According to John Hopkins Medicine, it is unclear whether the outlook differs between children and adults with Ewing sarcoma.

Some research suggests the outlook may be better in children, although this may be due to different chemotherapy doses.

Other research suggests that aggressive treatment may lead to improved outcomes in adults.

This section answers some frequently asked questions about metastatic Ewing sarcoma.

Can you survive metastatic Ewing sarcoma?

According to a 2017 article, treatment with chemotherapy has resulted in a significant improvement in survival rates for Ewing sarcoma.

In people with metastatic Ewing sarcoma at the time of diagnosis, the long-term cure may be around 20–30% in people receiving treatment.

According to the ACS, the five-year relative survival rate between 2010–2016 for people with metastatic Ewing sarcoma at diagnosis was 39%.

Various factors can affect survival, and survival rates may increase as treatments improve over time.

Can stage 4 Ewing sarcoma be cured?

According to the ACS, stage 4 sarcomas may be more difficult to cure than earlier stages.

The likelihood of curing stage 4 sarcoma may increase if surgery can remove both the original cancer and the cancer that has spread.

However, there is a risk of metastatic Ewing sarcoma returning after treatment.

According to a 2019 article, people with metastatic Ewing sarcoma at diagnosis may have a higher rate of the cancer returning, which may recur in 50–80% of people, depending on the location of the metastasis.

More than 70% of recurring Ewing sarcoma happens within 2 years of the initial diagnosis. The longer the period between diagnosis and recurrence, the better the outlook may be.

Factors, such as a person’s age and the location of the cancer, may also affect how Ewing sarcoma responds to treatment.

Prompt diagnosis, aggressive treatment, and continuous follow-up care may provide the best outlook.

Metastatic Ewing sarcoma is cancer of the bone or soft tissue that has spread to another area of the body, such as the lungs or other bones.

Metastatic Ewing sarcoma may be more challenging to treat than localized Ewing sarcoma. Treatment options may include a combination of radiation therapy, chemotherapy, and surgery.