Rhabdomyosarcoma (RMS) is a rare type of cancer that forms in soft tissue — specifically skeletal muscle tissue or sometimes hollow organs such as the bladder or uterus. RMS can occur at any age, but it most often affects children.
Although RMS can arise anywhere in the body, it's more likely to start in the:
The outlook (prognosis) and treatment decisions depend on the type of rhabdomyosarcoma, where it starts, tumor size and whether the cancer has spread. Treatment is usually with a combination of surgery, chemotherapy and radiation therapy.
Major advancements in the treatment of rhabdomyosarcoma have significantly improved outcomes. After completion of treatment, people need lifelong monitoring for potential late effects of intense chemotherapy and radiation.
Signs and symptoms of rhabdomyosarcoma depend on where the cancer is located.
For example, if the cancer is in the head or neck area, signs and symptoms may include, among others:
If the cancer is in the urinary or reproductive system, signs and symptoms may include, among others:
If the cancer is in the arms or legs, signs and symptoms may include, among others:
It's not clear what causes rhabdomyosarcoma.
Doctors know that rhabdomyosarcoma begins when a cell develops changes in its DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cell to multiply quickly and to go on living when healthy cells would normally die. The result is a mass (tumor) of abnormal cells that can invade and destroy healthy body tissue. The abnormal cells can break away and spread (metastasize) throughout the body.
Factors that may increase the risk of rhabdomyosarcoma include:
Complications of rhabdomyosarcoma and its treatment include:
Rhabdomyosarcoma diagnosis usually begins with a physical exam to better understand the symptoms you or your child may be experiencing. Based on those findings other tests and procedures may be recommended.
Your doctor may recommend one or more imaging tests to investigate symptoms, look for cancer and look for signs that the cancer has spread.
Imaging tests may include:
A biopsy procedure is used to collect a sample of suspicious cells for laboratory testing. Tests can show whether the cells are cancerous and determine the type of cancer.
Types of biopsy procedures used to diagnose rhabdomyosarcoma include:
Determining the type of biopsy needed and the specifics of how it should be performed requires careful planning by the medical team. Doctors need to perform the biopsy in a way that won't interfere with future surgery to remove the cancer. For this reason, ask your doctor before the biopsy for a referral to a team of experts with extensive experience in treating rhabdomyosarcoma.
Rhabdomyosarcoma treatment usually involves a combination of treatments, including chemotherapy, surgery and radiation therapy.
Which treatments your doctor recommends will depend on the location of the cancer, the size of the tumor, whether the cells are aggressive, and whether the cancer is confined to one area (localized rhabdomyosarcoma) or it has spread to other areas of the body (metastatic rhabdomyosarcoma).
The goal of surgery is to remove all of the cancer cells. But it's not always possible to do that if the rhabdomyosarcoma has grown around or near organs or other important structures. When the cancer can't be removed completely with surgery, doctors may remove as much as possible and then use other treatments, such as chemotherapy and radiation, to kill any cancer cells that might remain.
Chemotherapy uses powerful drugs to kill cancer cells. The treatment usually involves a combination of drugs, which are usually administered through a vein. Which drugs are given and how often varies depending on your particular situation.
Chemotherapy is often used after surgery or radiation therapy to kill any cancer cells that might remain. It can also be used before other treatments to shrink a tumor to make surgery or radiation therapy more effective.
Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. It's usually done with a machine that moves around you as it aims the radiation at precise points on the body.
Radiation therapy might be recommended after surgery to kill any cancer cells that remain. It can also be used instead of surgery when the rhabdomyosarcoma is located in an area where surgery isn't possible because of nearby organs or other important structures.
Clinical trials are studies to investigate new ways of treating cancer. Ask your doctor or your child's doctor about whether you may be eligible to join a trial.
A diagnosis of rhabdomyosarcoma can be frightening — especially for the family of a newly diagnosed child. With time you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find that it helps to:
If there are signs and symptoms that worry you, you'll likely start by making an appointment with your primary care doctor — or the pediatrician if the concern is with your child. If your doctor suspects rhabdomyosarcoma, make sure you're referred to an experienced specialist.
Rhabdomyosarcoma typically needs to be treated by a team of specialists, which may include:
Before the appointment, make a list of:
Whether the appointment is for you or for your child, your questions might include, for example:
Your doctor will likely ask several questions. Be ready to answer them to allow more time to cover other points you want to address. Whether the appointment is for you or for your child, the doctor may ask:
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