Ewing’s Sarcoma: Therapy

General measures

  • Nicotine restriction (refraining from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
  • Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised program for the underweight.
    • Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular follow-up examinations for malignant (malignant) bone tumors for early detection of recurrence (recurrence of the disease)
    • Because the recurrence rate is highest in the first three years after diagnosis, recurrence monitoring must be adjusted accordingly.
  • Due to aggressive tumor therapy, long-term side effects such as endocrinopathies (diseases affecting the endocrine system), cardiac and renal diseases, neurocognitive deficits, and osteoporosis (bone loss) should be expected. If the patient wishes to have children, the possibility of sperm donation with cryopreservation (deep freezing) should be addressed before chemotherapy.

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
    • Consume only limited energy-rich foods.
    • Moderate total fat intake
    • Little red meat (pork, beef, lamb, veal) and sausages.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
    • Refrain from polluted foods such as offal and wild mushrooms.
    • Do not eat moldy food
  • Observe the following special dietary recommendations:
    • Calcium-rich (1,000 mg calcium/day) diet: fish, fresh vegetables, dairy products, whole grains and nuts are beneficial for bone formation.
    • Vitamin D-rich diet (supplementation with 800-1,000 IU of vitamin D3 required, since no sufficient absorption of vitamin D from food is possible!)
    • Avoidance of phosphate-containing drinks and foods (eg cola drinks, various sausages and meat products).
    • Note that for optimal bone metabolism must be fed less acid-forming foods and instead more base-donating foods.
    • Diet rich in:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Physical therapy (including physiotherapy)

Psychotherapy