Rhabdomyosarcoma
Medically reviewed by Drugs.com. Last updated on Feb 5, 2024.
Sarcomas are a type of cancer that develops from the soft tissues (fleshy parts) of the body, as well as from bone and fatty tissue. This type of cancer is different from carcinomas. Carcinomas develop more frequently in the body's organs, especially those organs that contain glands. Examples of carcinomas include lung cancer, colon cancer, pancreatic cancer, breast cancer, prostate cancer.
Rhabdomyosarcoma is a cancer that forms in the skeletal muscles. Skeletal muscles attach to bones. They help the body move. Most rhabdomyosarcomas occur in children and teenagers.
Rhabdomyosarcoma can occur anywhere in the body. It typically appears in the arms, legs, head and neck, bladder, reproductive organs, chest, and abdomen. Rhabdomyosarcoma can spread to other organs.
There are two main types of rhabdomyosarcoma:
- Embryonal rhabdomyosarcoma usually affects children under age 6.
- Alveolar rhabdomyosarcoma usually affects older children or teenagers. It tends to be more aggressive than embryonal rhabdomyosarcoma.
A third type, called anaplastic rhabdomyosarcoma, is the least common type. Adults are more likely than children to develop it.
Symptoms
The signs of rhabdomyosarcoma depend largely on the size and location of the cancer. These tumors may not cause symptoms until they are large.
Common symptoms include:
- Persistent lump or swelling in the body that may be painful
- Bulging of the eye or a drooping eyelid
- Headache and nausea
- Trouble urinating or having bowel movements
- Blood in the urine
- Earache or sinus infection symptoms
- Bleeding from the nose, throat, vagina, or rectum
- Vomiting, abdominal pain, constipation
These symptoms do not necessarily mean cancer. But it is important to contact your doctor if you or your child experiences any of them.
Diagnosis
Your doctor will look for signs of disease with a physical exam and medical history. He or she will ask about your health habits and past illnesses and treatments.
Your doctor may also recommend one or more of the following tests: Diagnosis will also require some combination of the following tests and procedures:
- X-ray. Uses energy beams to make pictures of tissues, bones, and organs.
- Computed tomography (CT) scan. Uses a rotating x-ray camera to take detailed, cross-sectional pictures of the tumor as well as to see if the tumor has spread to other organs (for example, the lungs or abdomen).
- Magnetic resonance imaging (MRI). Employs a strong magnet and radio waves to take detailed pictures inside the body.
- PET scan: Doctors sometimes use this test to see if and where the cancer may have spread.
- Bone scan. Uses a scanner and low-level radioactive material to detect whether cancer cells have spread to the bone.
- Biopsy. Surgery in which cells or tissues are removed for examination. Biopsies can be performed using a needle or by cutting through the skin. Specially trained doctors called pathologists can then study the tissue under the microscope.
- Bone marrow aspiration and biopsy. Bone and bone marrow fluid is removed from the bones of the lower back and pelvis to see if the cancer has spread.
Staging
Staging assesses how much cancer exists, and where and how far it has spread. The stage of rhabdomyosarcoma is based on three factors:
- Type of rhabdomyosarcoma
Embryonal or alveolar
- Clinical group
Rhabdomyosarcoma is assigned a clinical group (I-IV). The group is based on the extent of the disease and how much tumor is initially removed during surgery.
- TNM rating
The TNM rating is based on:
- T (tumor size)
- N (whether the cancer has spread to nearby lymph nodes)
- M (whether the cancer has spread to distant organs)
Doctors will then classify the patient as low, intermediate, or high risk to determine the likelihood that the cancer has or will metastasize (spread) at some future date.
Expected Duration
Rhabdomyosarcoma will continue to grow until treated. If left untreated, it may spread elsewhere in the body.
Prevention
Certain inherited conditions increase a person's risk of developing rhabdomyosarcoma. These include range of genetic abnormalities that make people more likely to develop this type of cancer as well as cancers:
- Li-Fraumeni syndrome
- Neurofibromatosis type 1
- Beckwith-Wiedemann syndrome
- Costello syndrome
- Noonan syndrome
There are no known preventable risk factors for this disease. Genetic testing may help identify other family members who may be at risk for this type of sarcoma or other types of cancers.
Treatment
Your doctor will recommend treatment based on several factors, including:
- Location and extent of the tumor
- Patient's age
- Patient's ability to tolerate the therapies, many of which can have serious side effects
- Treatment usually involves some combination of surgery, chemotherapy, and radiation therapy.
The surgeon removes as much of the tumor as possible. He or she will try to minimize damage or disfigurement when doing so, but that can be difficult. In some cases, the surgeon must remove all or part of a limb. In other cases, the limb can be saved.
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy is almost always given after surgery. It destroys any remaining cancer cells where the tumor was removed. It can also kill small pockets of cancer cells that may be present in other parts of the body.
The doctor may recommend radiation therapy for some patients. Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. It may be recommended if the entire tumor was not removed during surgery. It may also be used if the cancer is higher risk but has not spread to distant sites. It may be necessary to surgically remove cancer (sarcoma) deposits that have landed in the lung. This can be especially effective in selected circumstances.
Treatments for rhabdomyosarcoma may cause side effects. These include hair loss, nausea, fatigue, and increased susceptibility to infection. Your doctor will help you to manage these side effects.
Longer term side effects can also occur later on in life. This can include the early development of heart disease or problems with memory.
Doctor's will choose the treatment most likely to help cure the patient of the sarcoma. Without treatment, the disease may be fatal.
Treating cancer in children requires special considerations. The medical team should consider and try to limit the possible long-term side effects of cancer treatment. These include:
- Problems with fertility
- Increased risk of developing a second cancer as a result of the radiation or chemotherapy that is used to treat the rhabdomyosarcoma initially.
- Problems with bone growth
- Problems with the growth of soft tissues
- Damage to the heart as a result of the chemotherapy or radiation that is used
- Problems with mental ability
- Long term abnormalities of the thyroid gland, since this area of the body can be damaged by radiation that is used to treat the cancer.
Treatment options
The following list of medications are related to or used in the treatment of this condition.
When To Call a Professional
Call your doctor if you or your child experiences any symptoms of rhabdomyosarcoma including:
- A persistent lump or swelling in part of the body
- Bulging of the eye or a swollen eyelid
- Headache and nausea
- Trouble urinating or having bowel movements
- Blood in the urine
- Bleeding from the nose, throat, vagina, or rectum
- Enlargement of one side of the scrotum
Prognosis
The outlook depends on many factors, including:
- The tumor's type, location, and size
- Whether the tumor can be surgically removed
- Whether the cancer has spread
- Patient's age and general health
- The particular characteristics of the tumor cells
- Whether the cancer contains that can be targets for specific therapies
It is important to get prompt medical attention and continuous follow-up care for rhabdomyosarcoma. Because these cancers are relatively rare, it is very important to get treatment at a hospital with experience treating children with this type of cancer. Pediatric oncologists are constantly striving to improve the outcomes of young patients with this disease. Your doctor may even suggest that your child participate in a study testing new therapies for this type of sarcoma.
Additional Info
National Cancer Institute (NCI)
https://www.cancer.gov/
American Cancer Society (ACS)
https://www.cancer.org/
Sarcoma Foundation of America
https://www.curesarcoma.org/
Dana-Farber Cancer Institute
https://www.dana-farber.org/
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
