Ewing's family of tumors
Group or family of tumors Ewing (Ewing's family of tumors), and also called tumors Ewing Algarnih (Ewing's sarcoma) are cancerous tumors are rare arise bone and soft tissue (like muscles, and connective tissue Kalottar connecting muscle to bone, and fibrous tissue and cartilage , and tissue Synovial around the joints, in addition to fat, and blood vessels, and nerves), and has named these tumors relative to the doctor, James Ewing (James Ewing), who provided the first medical study by the year 1921, where the study uncovered the presence of tumor bone is different in its properties for Algarnih bone tumors (osteosarcoma) common and known at the time, and then showed the possibility of treatment using radiation treatments, and has become known for this tumor Ewing's tumor of bone, and has not been diagnosed in positions other than the bone before the lapse of years, where was detected after in some soft tissue and was named Ewing tumors outside the bone (extraosseus Ewing's).
Has reported medical research after that for a great similarity in many of the characteristics of tumors Ewing and between tumors of the dermis phenomenon nerve primary (primitive neuroectodermal tumor PNET and the tumors are rare in children may arise tissue soft and bone), where researchers noted the existence of similar patterns of abnormalities of DNA cells of these tumors, as they contain proteins similar rarely found cells other tumors, which is reason to believe that they arise from precancerous same type of cells in the body, and hence was named this tumor group or family of Ewing (Ewing's family of tumors EFT), which represents the percentage of bone Ewing's tumor nearly eighty percent of them.
It should be noted that the cells of tumors Ewing's difficult discrimination, and similar microscopic appearance is confusing with the appearance of many of the cells of other tumors, such as bone tumors Algarnih small cells (small-cell osteosarcoma), or tumors Algarnih planned muscle (Rhabdomyosarcoma), and tumors of neural primitives (neuroblastoma), or tumors of cartilage, can also arise in all Ewing's tumors of the bone, but they often arise humerus and femur and pelvis, and may arise in the chest near the ribs, and should also be noted that when she created the long bones usually starts the bone cavity (other than Algarnih bone tumors that arise bones and body position itself to its turf), with its extension through the crust to the soft tissue surrounding the bone, and on the other hand than usual to move these tumors to the lung or to other bones not connected to the locus of Growing bone in most cases the transition, and while to a lesser extent can be transmitted to neighboring lymph nodes, liver or bone marrow, and rarely move to the central nervous system of any brain and spinal cord.
And in the end set includes Ewing's tumors, tumors following:
Ewing's tumor of bone.
Extraosseous Ewing's tumor (extraosseus Ewing's).
Dermis phenomenon nerve tumor primary (primitive neuroectodermal tumor), and is sometimes called tumor epithelial nerve terminal (peripheral neuroepithelioma).
We point out that the tumors of the dermis phenomenon of neural tumors, Ewing out of the bone called tumors live (Askin's tumor) when there is a wall of the chest, and on the other hand arise these tumors often in adolescents, rarely appearing before age five or after the age of thirty, and it shows equal proportions between males and females in children under the age of thirteen, while after this age than males.
About risk factors for the emergence of Ewing tumors
The term risk factors (Risk factors) to the factors and circumstances that increase the likelihood of the risk of vulnerability to any disease, such as cancer, when any person, and there are risk factors for each type of tumor, and may include risk factors and genetic any associated characteristics of genes, in addition to factors related to the environment or lifestyle and living conditions, and although the factors on the pattern of living, such as smoking and poor nutrition or alcohol consumption are important factors in many of the tumors in adults, but its impact is none or very weak when dealing with tumors of children and of tumors Ewing , and with regard to risk factors related to the environment, not clear to researchers of any link between the emergence of these tumors, and between environmental factors either before or after the birth, such as exposure to toxic chemicals or radiation, or contamination of water and air, also did not prove the existence of any link to other conditions, such as the use of X-rays during pregnancy, or eating different types of drugs, or injury to children bruises or cuts in the same position repeatedly.
And unlike some tumors common among children, such as tumors Jveat retina and tumors, and Wilms' renal, and bearing the signs of genetic and may appear in quick succession for several generations of one family, as a result of the inheritance of certain types of imbalance blades genetic DNA of some cells of the body and the presence of some types of birth defects, which increase the rates of risk for the emergence of these tumors do not indicate medical studies to any factors or reasons for hereditary can be considered risk factors important for the emergence of tumors, Ewing, and it is very rare to show these tumors in more than one child one family.
About the emergence of Ewing tumors
We need to understand how the emergence of cancer cells, knowledge of some basic information about the genetic characteristics and genes (genes), Valmorth is a part of the DNA Alrebonowi (deoxyribonucleic acid DNA) carries the characteristics of specific genetic and has a vital function specific, and an example set of genes color of the eyes and skin or blood group, and this acid is a chemical that carries instructions for the system and the life cycle of cells, and the control of all its activities, and is the type of changes anomalies in the DNA of the genes influencing factor in determining the type of disease that may affect humans, and genes are parts of chromosomes (chromosomes), which can be likened to a band of linear DNA Mazfor high length, containing thousands of genes lined end to end, and the DNA is organized strictly in the 23 pairs of chromosomes, inherits half of each pair from one parent.
And there are multiple types and so many of the genes, and each of them vital functions and characteristics of specific genetic, and contains some of the types of instructions and codes of genetic control in the mechanism of growth and division, and thus replication and reproduction for the production of new cells, and from these genes of certain urges and modify operations cell division, called idiomatically genes tumor (oncogenes), and genes other slow and inhibit the division and reproduction, or give instructions to the annihilation of the self-cell, when needed, and called genes inhibiting the swelling (Tumor suppressor genes).
And other words, the cells multiply and divide and grow under the guidance of the program is encrypted Bhamadha nuclear, and receive a signal to stop at a certain point where the available amount desired of cells, depends divide and multiply, and run programs next directed the cells to produce proteins necessary for the cells become very able to carry out the tasks entrusted to it, ie, that the system of division, growth and employment, stops and starts and is active as a sequential staggered, and free of errors to produce normal cells intact, and there are many ways to block and district progress of this system systematically, for example, if deficiencies in the signal to stop and did not work for some reason, continue to the cells to divide and multiply unchecked and the mass of abnormal enlarged, or when a failure in the work of genes inhibiting the swelling, which produces a certain protein is responsible for the arrest of the cell when there is damage to DNA, whether to fix bugs or to exterminate self when you can not reform, when not working this protein for some reason, continue to cells with damaged DNA in the division, and production of new cells, causing more damage in genes other, which control the growth and development of cells and end up with the emergence of cancer.
On the other hand may inherit one some of the changes the anomalous (or defects), DNA from his parents, which explains the appearance of some illnesses are common in some families, and called these changes Balthorat or changes the root of the structure (mutations), which also arise for reasons incomprehensible and unjustified imbalance just like the other images that affect this acid, which can be summarized in the following ways:
Distraction of the chromosomes and the exchange sites (Translocation) between the two parts of the DNA, that is, a section of DNA Besbga a homeless HOS Besbga different and asymmetric with him, leading to rearrange programs encoded DNA of the cell with the stability of error and system crashes, context-oriented for the different stages, and this imbalance in particular is responsible for the emergence of some types of tumors of children, such as certain types of leukemia, in addition to the group of Ewing's tumors.
Reflection or the coup (inversion), which means that part of the chromosome is inverted, and overlay in reflected light it is still linked to the same chromosome.
Addendum (addition) of any part of the chromosome (chromosome or the whole) has doubled and many copies of it are located the cell, and is referred to with reference number chromosome positive (+7, for example).
Loss or erasure (deletion) of some of the clips DNA Besbga specific, and referred to as the chromosome number with a negative sign, eg -7 means that there is a missing part of chromosome VII.
And from here can Ttsrtun normal cells at any of the above-mentioned types of imbalance structure of DNA (ie, mutations or abnormal structure of chromosomes fugue or a reversal or erasure or addition), which in turn paid (directly or indirectly) to run the testator tumor without controls (which lose the ability to control cell growth and reproduction), or invalidate the work of genes inhibiting the swelling, and end up with the emergence of a cancerous tumor, and it is important to know that, and except for genetic disorders that increase the level of risk for the emergence of some tumors, ( and Ewing's tumors are not into this category) Scientists do not know the real reasons and confirmed that lead to an imbalance types of DNA, (which trigger or trigger) and that lead to carcinogenesis of normal cells and tumor.
And on the range of tumors, Ewing's benefit medical studies about the existence of some types of imbalance, which is directly responsible for the emergence of these tumors, most notably the presence of distraction and exchange sites between the chromosomes atheist th and the second and twenty-cell tumor in most cases, while and the small percentage of cases there is an exchange between chromosomes atheist and twenty second and twenty, and on the other hand research shows that these exchanges abnormal and associated with the emergence of tumors, Ewing is the glitches acquired and casual after birth and during the stages of children's lives, and not shifting the inheritance, as indicated that there is no clear causes or risk factors known and uncertain lead to their occurrence, and thus there was no what can be done to avoid the emergence of cancer.
About the symptoms and diagnosis
Early symptoms usually appear in the form of swelling or tumor mass of overgrown position looks soft and cohesive, fast growth, without the accompanying pain or problems with side effects, and especially if the concentration of the tumor in the trunk or limbs, and the child may feel pain when you press them, or after contact with period of its appearance is clear, and may appear to place more heat at the touch of the rest of the body, while the show pain or ulceration at growth and inflation, swelling and pressure on nerves nearby, and appear like this block, inflation, the rate of more than 60% of tumors Ewing's bone and almost all Ewing's tumors outside the bone, and the other is the bone pain of the most common symptoms and appears in more than 85% of cases, which may result either from the transfer of the tumor under the periosteal bone or laceration and broken bone after tumor growth.
And in most cases seems to tumor bones soft and more heat when touched and may show fever in the child continuously, while it is customary to show with most of the tumors of soft tissue physical symptoms in general, such as fever and weight loss or sweating, but when there is a transition of the tumor from the position of its inception, and in this case may show symptoms of multiple as the subject of transition, such as swollen lymph nodes or fatigue or loss of weight, which gives an indication on the movement of tumor cells to the lymph nodes or bone marrow, while and in rare cases, when the emergence of the tumor near the spinal cord may show symptoms such as motor weakness or paralysis.
And when the onset of symptoms to the child, which can indicate the presence of any of the tumors, Ewing, the doctors perform a series of tests and laboratory tests to determine the various aspects of the growth of the tumor accurately, and conduct imaging studies of different, such as tomography (Computed tomography scan), Planning MRI magnetic (Magnetic resonance imaging using radio waves, magnetic to put multiple images of the body), in addition to planning the bones and take X-rays, many of which include chest to investigate the extent of transmission of the tumor to the lungs in particular, are also analyzes different blood, the most important of analysis investigates rates of enzymes yeast with claims of hydrogen salts of lactic acid (lactate dehydrogenase LDH), which is the high rates at diagnosis indicate a transition of the tumor, as well as a complete blood count, which will explain how transmission tumor cells of the bone marrow, and, of course, are blood tests and urine, which explore the functions of the liver and kidneys, and measuring the ratios of salts in the body.
On the other hand, and although the symptoms and tests soundtracks of various types could clearly confirm the presence of tumors, Ewing, but the only way to be absolutely sure, and then differentiate these tumors from other tumors like, and characterization of the vital precisely, osteotomy is a surgical (biopsy), which aims to extract a biopsy of the tumor tissue to be examined microscopically, and it should be noted that in all cases and is a biopsy of the bone marrow (Bone marrow biopsy) to investigate the extent of transmission of the tumor cells.
(Please go to a page that tests and laboratory tests to see more details on these various tests).
Classification of tumors Ewing
As is usual with the various types of tumors, are classified as tumors of Ewing as classification systems of the progress of the tumor (staging), and through the extraction of data from tests and laboratory tests and imaging, in addition to testing the direct tumor tissue, and any tissues derived following the surgery, in order to determine the size of the tumor and its properties vital, and ascertain the extent of his move from the position of its inception to the surrounding tissue or to any other sites, and determine the amount the cancer is located and body positions concentration and area of spread, it is necessary to know these facts and determine the classification for planning treatments and to explore evidence on cost-effective treatment possible.
And rolling for Ewing tumors classified according to their positions and the transition into two categories:
Topical administration, confined tumors, and tumors transmitted and dispersed, in addition of course to the recurrent tumors after treatment, while some schools are classified as medical extraosseous Ewing's tumors (Extraosseous Ewing's) according to the classification of tumors Algarnih muscles planned (Rhabdomyosarcoma). (Please refer to page Algarnih tumors of the muscles planned for more details).
Localized tumor Almnhsr (Localized)
And include this rating oncology administration, confined placements tion of origin without moving to other places, in addition to tumors transmitted locally to the tissues adjacent to the subject of the emergence of the tumor, such as muscles or tendons, but it is confined to these places and not crossover to the members and places far away, and of course not can be regarded as tumor confined without the various imaging studies and accurate without a biopsy of bone marrow, confirming the absence of any transition of the cell tumor to the places or distant organs or bone marrow, and is worth mentioning that, and in all circumstances be treated in this category plans therapeutic assuming the presence of microscopic tumor cells and shifting the locus of what most of the cases, without showing tests and imaging can not be detected only by microscopic examination of various tissues.
Circulating tumor or Almenbt (Metastatic)
And include this rating transmitted tumors arise from sites of origin to other places the body, such as the lungs or other bones are not connected to the original placement origination or bone marrow, or lymph nodes, liver, and as noted above it is rare to move to Ewing's tumors of the brain or cord cord.
Recurrent tumors (Recurrent)
And include this rating tumors that belong to the growth and appear after the treatments, and may return in the same position of origination where the original started, or tissue surrounding or back position of the body, and may occur during short periods or after the passage of years from the end of treatment the initial .
On processors
There are treatments for all cases of this type of tumor in children, and most of them are curable to varying degrees, and the dependent child's chances of recovery and treatment options on several factors combined, the most important position of the tumor and the extent of concentration, and vital cells, and classified and how he moved out of position Growing the original, and its interaction with the treatments, in addition to the child's age and general health condition, and usually follow the standard treatments that have proven their effectiveness.
And targeted treatments, of course, to cure with the effort in maintaining the functions of the infected parts whenever possible, in addition to reducing the complications of different treatments to the minimum possible, which calls for the need for the treatment center specialist tumors of children and the involvement of a team of specialists to manage the plans treatment, ranging from surgeons and specialists Oncology and Radiotherapy, and Pathology and specialists in natural treatments and rehabilitation, in addition to social workers and nursing staff who specializes in treating children with cancer patients.
As is the case with solid tumors, is a surgical process line initial and primary tumors, Ewing, combined with chemotherapy and radiation therapy, but treatment plans may vary of course depending on the situation and depending on the factors mentioned above, and may be carried out transplants of stem cells generated cells blood (stem cell transplant), or marrow transplant bone marrow (Bone marrow transplant), after receiving intensive treatment for some cases.
It is worth mentioning that the cells of tumors Ewing is particularly sensitive to drugs and chemical radiation, and in that, in very few cases can eliminate a large part of the fabric of the tumor during an osteotomy surgery for diagnosis (and when to make sure precancerous tumor in the case), and the condition to make sure not a disability or significant damage position of the tumor, but that is not possible in most cases.
While, and traditionally the majority of cases are receiving several cycles of chemotherapy with a combination of several drugs and for periods ranging from six to nine weeks, and then re-assess the situation and is performed surgery extirpation if available and appropriate, while when you can not work surgical or when you keep some tissue tumor highly visible cradle of the tumor and non-root, is to start immediately treatments radiation effective alternative, followed by the start again to receive sessions prolonged chemotherapy, and for periods ranging from six to nine months, and to point out that chemotherapy is essential to control the cancer cells in transition and that are present in most cases, even if they never show the various imaging tests.
On the other hand, and when there is movement of certain of these tumors at diagnosis, are receiving doses of more intensive drug chemicals, and can sometimes eradicate the tumor with the original tumors in transition that were few and were positioned accurately, and following the receipt of chemotherapy for periods ranging from six to nine weeks, and may be used with radiation therapy or surgery alone for each specific places to move, and then start again at doses of chemical drugs for periods ranging from six to eight weeks.
In terms of returns therapeutic According to some medical studies that cure rates for the five-year standard in cases of tumors administration, confined (where the main tumor position one and does not exceed the size of eight centimeters and can be removed completely with surgery with the use of treatments chemotherapy and radiation) ratio of more than 80%, (indicates the five-year cure rate of standard to the proportion of patients who live at least five years since diagnosed with cancer specific, and of course many people recover fully and live much more, and this rate is usually used as an indication of when the statistical cancer cases), while this drops to about 70% when you can not eradication, the total of the tumor (and still is small in size), and decreases to about 60% of tumors large size and that can not be eradicated completely with surgery, and on the other, and when there is transmission of the tumor at diagnosis had rates down to about 30 % depending on the move, and multiple placements, and these studies indicate that rates have improved much since the first use of chemotherapy for Ewing's tumors, and the ratios are much better in children age less than the tenth to those of the older and adolescents.
Surgery
And that a surgery where possible to eradicate as many as possible of the tumor tissue, and some healthy tissue surrounding the position, followed by receiving doses of chemotherapy or radiation, and may postpone the surgery until the end of the introductory courses of chemotherapy and then remove the tissue the tumor, while in the case of the tumor prevents the placement of the surgery and can not eradication, is limited to surgical work on the extraction of tissue biopsies examined.
And of course will depend Options surgery on the position of the tumor, and its kind within the tumors, Ewing, and how that will affect the surgical work on the function and effectiveness of the injured part of the body, which can be removed many tumors that are located tissue soft, and some types of bone, which positioned parts is essential to the body, without causing a disability or disabilities, while in others, such as that show most of the bones of the arms and legs, can not be eliminated entirely without affecting the effectiveness of a patient, and during the past decades, adopted the treatment of such tumors to amputation, while in the present time has made surgical treatments, and made Member salvage surgery (Limb-salvage surgery), so that it can remove large parts of the bones, vaccinations and replacing bone, or metal sheets, rods, industrial or alternatives (prosthesis), such as bones and joints made of plastics or metals, to make up part of the bone that has been eradicated with the tumor, and in many cases can replace the bone the whole alternative industry, and of course Such surgery is complex, and require a several operations and months of physical therapy, to be able to the child from the use of a patient effectively.
It is worth mentioning that it is possible to remove the femur including the knee and planting alternative, industrial, and link them to the bottom of the man, while the most difficult is to remove the lower part of the men and redone again, and the bones of the upper arm is deemed more suitable for surgical replacement, as it not bear the weight of the body, also point out that surgical techniques have evolved greatly, so that it can replace most of the bones of the pelvis, which was the replacement impossible in the past.
On the other hand, and when repositioning the tumor area of the chest wall, the surgeon usually removes the position the patient, in addition to one of the ribs or more (from the rib to three ribs), and be replaced by alternatives to industrial to close the chest wall, and when there is a transition of the tumor to the lung, are opening the chest and lung tumor removal process chest incision (thoracotomy), and from the habitual use of radiation therapy for such cases.
While it may not perform the surgery replacement in some cases for several reasons, such as the presence of tumor bone is difficult to replace, or tumor may have spread to the tissues of neural basic, or blood vessels is impossible to remove without causing barbed substantial user injured, and here is handled such cases, radiation therapy only instead of surgery.
It should be noted to the complications of surgical work, both in the short term or long term, such as infection of different and slow wound healing, and of course increase the seriousness of such complications with the presence of the side effects of Alajan radiation and chemotherapy, either before surgery or after its completion, which may interferes with the natural ability to heal wounds and recover.
(Please go to surgery, to view more details about the surgical aspects of the work).
Radiation therapy
Radiation therapy is the treatment using the different applications of ionizing radiation (ionizing radiation), to destroy cancer cells and shrink tumors, both using the elements and isotopes, or by using a stream of radiation, revived and high-energy, x-rays, or radiation such as gamma rays, or stream of neutrons or protons, and the effectiveness of the radiation is concentrated in its ability to undermine and break up the DNA of tumor cells, and is a vital and fundamental article of the various cellular functions, leading to elimination.
Radiation therapy is topical treatment, and is divided into two types; internal (Internal), radioactive elements are grown directly into the tumor tissue, or close to it, either temporarily or permanently, and external (external), where the broadcast radiation from the radiation machine shed the positions of the tumors, and may be used both types in some types of tumors, while, and often uses external radiation to the cases of tumors, Ewing, and of course, and to avoid the effects of radiation, is to take preventive measures during radiation therapy, to protect tissues and organs natural sound field processing .
And may be the use of radiation therapy alone, treatment only, or jointly with treatments other tumors, and may use a substitute for surgery as initial therapy, when some solid tumors, may also be used by the direct action surgical known as the treatment initial Assistant (neoadjuvant therapy), order to reduce the size of the tumor; to facilitate the eradication, or is used after excision surgery as a treatment additive (adjuvant therapy); in order to eliminate any tumor cells is characteristic may be outstanding.
And, of course, for the treatment of radiation complications and side effects associated with, linked to the overall locus of treatment, and result in general from affected cells and tissues rapidly growing and replacement, and from these effects: complications of skin and skin, and fatigue, and infections and dry mouth, and hair loss, nausea, gastrointestinal problems, and thwart the bone marrow, and is taking some preventive measures and support, and taking medication assistance; to avoid such effects and to alleviate it.
On the other hand there are complications appear late in the long run, the most important of the risk of developing secondary tumors placement of radiation (and that was a small percentage), growth retardation and delayed physical growth of natural bone and muscle treatment position, and shows that, particularly in young children where still the body is a minor and incomplete growth, while less of these complications if the child is going through puberty or near where almost the growth of bones and muscles to be completed, and to avoid such late complications Young children are very keen to treatment plans to use low doses to tumors Ewing and primary tumors of the dermis, and studies have shown that it can achieve the same therapeutic benefits when using low doses and less dense than the doses used in the past with these tumors.
(Please go to radiation therapy, to view more details about this treatment and methods of administration).
Chemotherapy
Chemotherapy is the treatment using special drugs known drug chemical anti-cancer, the elimination of cancer cells and destroy them, and so disrupt and undermine the coordinated biological processes within them, and come the main advantage of this treatment in his ability to deal with tumors of mobile and deployed, whereas the radiation therapy or work on the surgical treatment of specific placements administration, confined tumors, its effectiveness and unique due to the fact that cancer cells, in a way, is more sensitive and more susceptible to chemicals than normal cells. And may be used as a treatment only in some cases, or part of a treatment program integrated includes several treatments in common, and decision-making by using this treatment, the balance between effectiveness and side effects and complications of the future, and between the seriousness of cancer, and of course Vamadaafath and its acceptable compared to the same disease, in addition to the positive therapeutic yield significantly.
And may be called the chemotherapy treatment systemically (systemic); due to movement of drugs, chemicals via the blood to all parts of the body, and its ability to destroy cancer cells wherever notified, and may be used before the direct surgeries when solid tumors preparation for her and in order to facilitate; Bhzareth and shrink the tumor, what is known as chemotherapy Initial Assistant (Neoadjuvant), may also be used after surgery and eradication of the tumor; to eliminate any cells of a tumor is characteristic may be outstanding, and help avoid the return of cancer, what is known as chemotherapy additive (adjuvant).
And be dealt with chemotherapy drugs in ways and different channels, some of which are taken orally in the form of tablets or capsules or liquids, and most of the body is injected, the injection of different ways: by intravenous injection, intramuscular injection, injection into an artery or a major injection topically directly under the skin, and if intravenous is the most widely used method, and may use other means to assist in the injection, such as catheters (catheters), which is implanted usually chest and can be used for long periods, and is injected drugs directly into the spinal fluid cerebrospinal surrounding the spinal cord and brain, known as the injection vaginalis, both to eliminate tumor cells, or to protect the central nervous system and brain, and is usually injected through the lumbar spine down the spine, or via a catheter especially planted under the scalp known as portfolio Omaya ( Ommaya reservoir).
And usually consist of treatment programs from several repeated cycles separated by periods of recovery, and may receive the patient during each session, a combination common in many medicines chemical, or are limited to one drug, by type of tumor and the planned therapeutic approach in each case, and in general are the use of chemotherapy during the time periods prolonged to reduce how much the cancer cells gradually, to the extent that it could when the immune system control of any growth and throw, in addition to that space of time between doses are placed in order to achieve the greatest effect on cancer cells, and at the same time give the sufficient to allow cells and tissue normal to recover from the effect of drugs, chemicals, since the types of drugs of different effects to varying degrees on the cells and organs of natural sound, especially the cells and tissues fast-growing and heavy reproduction and a permanent replacement, such as bone marrow cells and blood cells, and cells and tissues of the digestive system, in addition to some vital organs like the liver and kidneys, which in turn leads to complications side effects, which vary in intensity and quality of the drug to another and from one person to another, and of course of treatment to another even for the same person , and depend mainly on the type and dose of the drug user and the interaction of the body about it, and these multiple effects; frustration include bone marrow (and thus decrease blood cell count), and complications of the mouth and gums (such as inflammation and ulceration, and drought), and loss temporary hair, and constipation and diarrhea, and fatigue, nausea, vomiting, loss of appetite, and feel the skin and skin, and usually take drugs to help and take some preventive measures and support; to avoid such effects and to prevent them and to alleviate it, remedial courses before and during and after its completion.
And in general is the use of chemotherapy in all tumors, Ewing, whether administration, confined Bmoadaha or transmitted, where, as noted above is a tumor limited to the absence of a transition and a clear and visible tests soundtrack, but it is assumed in all cases, the presence of cells, microscopic crossover and too small to show these tests, and research has confirmed that it is not used in cases of chemotherapy administration, confined tumors can these microscopic cells to grow and develop into new tumors in the end.
Than usual and the most cases of Ewing's tumors and primary tumors of the dermis using a combination of two sets of chemical drugs are receiving alternately in cycles each of which takes periods ranging from three to four weeks, including the first group Saakulovosvamaid drug (cyclophosphamide), and vincristine (vincristine ), and Dotxorobaisin (doxorubicin), while Group B consists of a real estate Ivosvamaid (ifosfamide) and Aitoboseid (etoposide), and are receiving such courses treatment from three to four times, and of course you are given these drugs at doses more intense when there is a transition of tumors tion of positions.
(Please go to chemotherapy, to view more details about this treatment and methods of its management and its complications).
Marrow transplant bone marrow
May require treatment plans in some cases, the tumors Ewing's need to use doses of therapeutic intensive drug chemicals to eliminate them, which in turn affects the bone marrow cells and destroys them, which in turn calls the need to resort to bone marrow transplant or stem cell periodic, in parallel with the treatments received of these tumors.
And in the following paragraphs an overview of such processes and types:
Bone marrow is the spongy tissue soft, called the spinal cord of red and located within the part of the bone known as bone spongy, and is the main function in the production of blood cells, and is composed of cells mutant (turn into blood cells), and fat cells, and tissues help the growth of blood cells, bone marrow and there in almost all the bones in infants, while Prior to puberty, is concentrated mostly in the flat bones, such as skull bone, and shoulders, and ribs, and pelvic bones, and joints of the arms and legs.
And cells at the beginning of the configuration (initial) called cells Aboriginal or stem cells (Stem cells), and is the division's self-multiply, producing stem cells, new, or you through a series of divisions, cumulative, and the phases of growth of successive production of cells of different blood (blood cells white and red and platelets), which continues to stages of growth and maturity within the bone marrow.
Come and the need for a transplant marrow bone marrow (Bone marrow transplant), or stem cell transplant
(Stem cells transplant) when unable to spinal cord on the performance of its functions, and caused the deficit either by the effects of the cancer itself, which makes him either a product of cells of a tumor abnormal, or a product of small numbers of blood cells, or resulting from the effects of drugs, chemical and radiation therapy severe, the be necessary to eliminate cancer cells, (especially when the tumors of blood and lymphatic tumors, and some types of solid tumors), follow the treatment programs is strong, dose-intensive lead to frustration and the destruction of cells of the bone itself, and hence the target of transplantation, replacement of stem cells spinal cord with cancer, or frustrating treatments, cells intact and healthy, capable of growth and reproduction and the production of blood cells, and possible sources, to extract stem cells and used for transplantation, including bone marrow and blood circulation, either from the patient himself or from a donor, and conducted Studies of the newly drawn from the umbilical cords of newborns.
And planting operations are divided into two types according to a source of stem cells, self-transplantation (Autologous) where these cells are derived from blood or the patient's own marrow, and gay culture or lineage (Allogeneic) where a pool of blood or marrow donor, and donor selection is appropriate, following analysis of tissue specific blood, known analysis antigens leukocytes (human leukocyte antigens HLA), and aims of this analysis match the blades genetic protein antigens, produced by white blood cells, and are special proteins Highlight the cells self for exotic, and supports the success of agriculture the tissue match between donor and recipient, and is a perfect fit, which brings together six groups of these proteins, and the donor twin brother is the ideal ADSL, followed by the brothers, then a parent, a donor or a non-kin of the patient.
The spinal primary source of stem cells, and when using the implant self, is to draw the amount of marrow of the child, and is processed to eliminate any cancer cells, and then kept under the freeze, and after completion of receiving the treatment intensive, and that would destroy the bone marrow, are spinal implant processor.
While when using the implant gay, is to draw the amount of marrow donor, after the tests and analyzes different; to make sure that his general health and free from infectious diseases, and is the selection and collection of stem cells separately, and after the stages of creating a patient for transplantation, giving doses high chemical drugs with or without radiation therapy, in order to eliminate cancer cells, and thwart the immune system to the lowest degree, is implanted stem cells selected and injected intravenously.
And is extracted stem cells from blood circulation, and know in this case stem cells peripheral or periodic (peripheral stem cells), and the quantity is usually sufficient to collect and use for transplantation of self becomes a practice, when there is the possibility to urge the bone marrow in the patient, the excretion within the blood circulation in sufficient quantities for transplantation, but when planting homosexual, are collected from the blood circulation of the donor; passing the blood through a machine to filter, the separation of these cells separately, and it should be noted that it is normal to the tumors of Ewing's use of autotransplantation to collect stem cells periodic patient.
And of course involves transplantation of the complexities and different complications, such as difficulty in finding a donor matching, and complications associated with the process, the effects of treatments chemotherapy and radiation, and the risk of rejection of the implant, and the failure of cells cultured in the stability and reproduction, but all of these risks less When you use a self-transplant.
(Please go to Page marrow transplant bone marrow to view more details about the transplantation).
On the treatment of recurrent tumors
May occur relapse and recurrence in the short periods or during the years following the end of treatment the primary, and when you return is a comprehensive assessment of the situation, to determine how focused the tumor and the area of presence and degree, and adopt the treatment plan depends on several factors, notably the position of the tumor, and what that returned in the same position of its inception, the first or the locus of another, and the amount can be removed surgically, in addition to treatments that were followed in the past, may be an additional surgery to eradicate the many as tumor tissue, and that this is not possible for any reason, may be the use of chemotherapy the same drugs or previous medications other chemicals, or high doses followed by transplantation of self-purified bone marrow, while that returned the tumor and the back of the lungs, it is usually surgery to remove it, and that the back of placements to the side of the lungs, are usually the use of chemotherapy, and clinical studies under way to test novel therapies.
After the treatments
Necessary to conduct tests periodically comprehensive last for several years after the end of treatments, in order to investigate any signs of the return of tumors, Ewing, or movement, or the emergence of new tumors, as well as to monitor complications and side effects of different treatments received, whether immediate or delayed, which may appear years later ( Please go to a page of late complications of treatments for tumors to see more details), and include these tests in addition to clinical examination of flour, measuring growth rates, lab tests types and imaging studies and X-rays of different, especially for the position of the tumor and the lungs, and are made to schedule a specific time vary according to each individual case, and (than usual in all cases, some imaging studies per month during the first six months and then every three months the first year and a rate of less than later years).
It is very important, of course, be notified of the medical team in the case when the appearance of any symptoms or complications of a new, which may indicate the occurrence of relapse and a return to growth tumor, or indicate the presence of complications and side effects of treatments received, in order to take action necessary medical early.
