Rhabdomyosarcoma

How is rhabdomyosarcoma treated?

Treatment for rhabdomyosarcoma requires close coordination between surgeons, pediatric oncologists and radiotherapists. The response of tumors is very much dependent on their site of origin.

A series of studies have been performed by the Intergroup Rhabdomyosarcoma Study (IRS), which has outlined the treatment of rhabdomyosarcoma. Children's plays an active role in this organization.

We'll generally do surgery to both provide a diagnosis of the tumor type as well as give your child's doctor information regarding the stage of the tumor. Treatment with chemotherapy, with or without radiation therapy, is then determined by the extent of removal of the tumor as well as by its stage and location.

• A tumor in the bladder or prostate requires chemotherapy prior to attempts at surgical removal or treatment with radiation.
• A tumor in the muscles of the arms or legs is often treated initially with surgical removal, which may be followed by chemotherapy, with or without radiation.
• Tumors around the eye are very responsive to chemotherapy and radiation, so they rarely require surgical removal.

In addition to surgery, treatment for malignant odontogenic tumors may include:

Radiation therapy

This treatment can help stop the growth of abnormal cells in specific areas of the body. Radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill abnormal cells.

Chemotherapy

This treatment is used in cases of advanced or aggressive tumor growth. This treatment can help stop the growth of abnormal cells throughout the body. Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill or slow the growth of targeted cells.

• Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors.
• Often, a combination of chemotherapy drugs is used.
• Certain chemotherapy drugs may be given in a specific order depending on the type of cancer it is being used to treat.

Chemotherapy can be given:

• as a pill to swallow
• as an injection into the muscle or fat tissue
• intravenously (directly to the bloodstream)
• intrathecally (directly into the spinal column with a needle)

While chemotherapy can be quite effective in treating certain cancers, the agents don't completely differentiate normal healthy cells from abnormal cells. Because of this, your child could have adverse side effects during treatment.

• Lumbar puncture – To administer medication and treat cancer cells directly if found in this site.
• Stem cell transplant – A treatment involving stem cells, a specific type of cell from which all blood cells develop. Transplantation of normal stem cells from another person is used to help restore normal blood production in patients whose own ability to make any or all of these blood cells has been compromised by cancer, intensive cancer treatment, or other types of damage or abnormality.
  • Stem cell transplantation and the treatment needed to manage its effects are very complex. Your physician will give you more detailed information on what to expect.

What's my child's long-term outlook?

It varies widely from child to child and greatly depends on:

• the extent of the disease
• the size and location of the tumor
• the tumor's characteristics when examined under a microscope
• the presence or absence of metastasis
• the tumor's response to therapy
• the age and overall health of your child
• your child's tolerance of specific medications, procedures, or therapies
• new developments in treatment

Prompt medical attention and aggressive therapy are important for the best prognosis.

What is the recommended long-term care for children treated for rhabdomyosarcoma?
Your child should visit a survivorship clinic every year to:

• manage disease complications
• screen for early recurrence of cancer
• manage late effects of treatment

A typical follow-up visit may include some or all of the following:

• a physical exam
• laboratory testing
• imaging scans

Through the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, childhood cancer survivors receive a comprehensive follow-up evaluation from their cancer care team.

• Our childhood cancer survivorship clinic is held weekly.
• In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuro-psychologists or alternative/complementary therapy specialists.
• We also offer the following services:
  • patient and family education
  • psychosocial assessment
  • genetic counseling
  • reproductive and fertility evaluation and counseling
  • opportunities to speak with other childhood cancer survivors