Ewing Sarcoma Treatment in India

Ewing Sarcoma is a rare type of cancer that primarily affects the bones or soft tissues. It is most commonly diagnosed in children and young adults (usually between the ages of 10 and 20), although it can occur at any age. Ewing sarcoma typically forms in the long bones (such as the femur or tibia), pelvis, and ribs, but it can also affect the soft tissues around the bones.

Ewing sarcoma is part of a group of cancers known as sarcomas, which develop in the connective tissues. It is a highly aggressive cancer that can spread (metastasize) to other parts of the body, including the lungs, bones, and bone marrow.

What is Ewing's Sarcoma?

Ewing Sarcoma is part of a group of cancers known as Ewing Sarcoma Family of Tumors (ESFT). It was first described by Dr. James Ewing in the 1920s. This cancer affects bones and nearby tissues and can spread to other parts of the body.

Due to its rapid growth, early detection and treatment are critical in managing the disease.

Causes of Ewing Sarcoma

The exact causes of Ewing Sarcoma remain unclear, but genetic factors play a role. Unlike some cancers, lifestyle or environmental factors do not appear to contribute significantly to its development. However, a specific genetic mutation called the EWSR1-FLI1 fusion gene is often found in Ewing Sarcoma cells.

Factors that may increase the risk include:

• Age: Most common between ages 10-20.
• Gender: Males are slightly more likely to develop this cancer.

Types of Ewing Sarcoma

There are different types of Ewing Sarcoma, classified based on the location of the tumor:

1. Bone Ewing Sarcoma: The most common form, it occurs in long bones like the femur, tibia, or humerus.
2. Soft Tissue Ewing Sarcoma (Extraskeletal): This form arises in soft tissues rather than bones.
3. Askin Tumor: A rare subtype found in the chest wall.
4. Peripheral Primitive Neuroectodermal Tumor (PNET): A related tumor that can occur in soft tissues or bones.

Symptoms of Ewing Sarcoma

Early symptoms of Ewing Sarcoma can be mistaken for minor injuries or general pain, making early diagnosis challenging. If you or your child experiences any of the following symptoms, it’s essential to seek medical attention:

• Persistent bone pain or tenderness
• Swelling around the affected area
• Fever without an apparent cause
• Weight loss
• Fatigue or lethargy
• Fractures with minimal trauma

Diagnosis of Ewing Sarcoma

Accurate and timely diagnosis is vital for effective treatment. Dr. Rahul Bhargava and his team use a range of diagnostic tools to identify Ewing Sarcoma:

1. Physical Examination: A thorough examination of the affected area.
2. Imaging Tests:
   • X-rays: To detect bone abnormalities.
   • MRI or CT scans: For detailed images of soft tissue and bone.
   • Bone Scans: To see if the cancer has spread to other bones.
3. Biopsy: A small tissue sample is taken from the tumor and examined under a microscope to confirm the diagnosis.
4. Genetic Testing: To detect the specific genetic mutation (EWSR1-FLI1 fusion gene) associated with Ewing Sarcoma.

Ewing Sarcoma Treatment Options in India

Dr. Rahul Bhargava provides a multi-disciplinary approach to treating Ewing Sarcoma. Treatment plans are personalized based on the stage of cancer, location, and overall health of the patient. The main treatment options include:

1. Chemotherapy: The first line of treatment, chemotherapy, aims to shrink the tumor before surgery and target any cancer cells that may have spread.
2. Surgery: Surgical removal of the tumor is often necessary after chemotherapy. In some cases, limb-sparing surgery can be performed, avoiding amputation.
3. Radiation Therapy: Used when surgery is not possible or in combination with chemotherapy to destroy remaining cancer cells.
4. Targeted Therapy: Innovative treatments that focus on specific cancer cell pathways and mutations.
5. Stem Cell Transplant: For advanced cases, a stem cell transplant may be recommended to restore bone marrow after intensive chemotherapy.

Cost of Treatment and Stay in India

The cost of treating Ewing Sarcoma in India is significantly more affordable compared to many Western countries, making it an appealing choice for medical tourism. The total cost of treatment, including the necessary hospital stay, can vary depending on the type of treatment, the stage of the disease, and the healthcare facility. Here’s an overview of the costs:

• Chemotherapy (per cycle):
  USD: $500 – $2,500
  INR: ₹40,000 – ₹2,00,000

• Surgery (including limb-sparing surgery if applicable):
  USD: $2,000 – $10,000
  INR: ₹1,50,000 – ₹7,50,000

• Radiation Therapy (per session/course):
  USD: $300 – $2,000
  INR: ₹25,000 – ₹1,50,000

• Targeted Therapy (per month):
  USD: $1,500 – $5,000
  INR: ₹1,20,000 – ₹4,00,000

• Stem Cell Transplant:
  USD: $15,000 – $25,000
  INR: ₹12,00,000 – ₹20,00,000

• Hospital Stay (per night):
  USD: $30 – $200
  INR: ₹2,500 – ₹15,000 per night

India offers advanced healthcare services at a fraction of the cost found in many Western countries. Patients have access to high-quality care, state-of-the-art treatments, and expert oncologists, making it an excellent destination for Ewing Sarcoma treatment.