Treatment & Care
It’s entirely natural that you are concerned right now about your child’s health; a diagnosis of leiomyosarcoma can be frightening. But you can be rest assured that, at Children’s, your child is in good hands. Our physicians are bright, compassionate and committed to focusing on the whole child, not just her condition – that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.
Traditional treatments for leiomyosarcoma
Surgery to remove the entire tumor, along with surrounding healthy muscle and other tissue is usually the best option in attacking leiomyosarcoma. Radiation and chemotherapy may also be used to treat some forms of leiomyosarcoma. Surgery is preferable since radiation and chemotherapy are not as effective against certain types of leiomyosarcoma, such as the type that arises from the gastrointestinal tract.
Treatment may include some combination of the following:
Depending on the size and location of the tumor, your child may either need:
- limb-salvage surgery, which helps preserve the limb by removing the tumor and wide margins of healthy tissue surrounding the tumor
- amputation may be necessary if the tumor cannot be removed (for example, if it involves the nerves and blood vessels)
Surgical removal is usually the first and most important treatment option. If the tumors are, completely removed, it won’t re-appear in another part of the body.
Our doctors use precisely targeted and dosed radiation to kill cancer cells left behind after your child’s surgery. Radiation is necessary if surgery does not completely remove the tumor and some of the tumor is left behind.
Chemotherapy is a drug that interferes with the cancer cell’s ability to grow or reproduce.
- 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.
- The main purpose of chemotherapy is to stop the cancer from metasizing, and moving to other parts of the body.
- Can be used pre-operatively (neo-adjuvant), or before surgery, to clear tumors in “hard to reach” areas where there are vital organs, and make surgical removal easier.
- Post-operative (adjuvant), or after surgery, can be helpful for leiomyosarcoma in extremities such as fingers.
While chemotherapy can be quite effective in treating certain cancers, the agents do not differentiate normal healthy cells from cancer cells. In other words, the chemotherapy will attack normal healthy cells as well as the cancer cells since the chemotherapy drugs can’t tell the difference. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help the care team, parents, and child prepare, and, in some cases, prevent these symptoms from occurring, if possible.
Chemotherapy is a systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill cancer cells. Chemotherapy can be given:
- as a pill to swallow
- as an injection into the muscle or fat tissue
- intravenously (IV), directly to the bloodstream
What is the recommended long-term care for children treated for leiomyosarcoma?
Children treated for leiomyosarcoma 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
Preparing your child for chemotherapy
Chemotherapy is a treatment option if your child’s leiomyosarcoma is not completely removed with surgery. It is a category ofdrug treatments that works by interfering with the cancer cell's ability to grow or reproduce. Chemotherapy can be difficult on a child’s body, and it can be hard for a child to cope with the treatment. Learn more about some ways to help prepare your child for chemotherapy from Lisa Diller, MD, clinical director of Pediatric Oncology at the Children’s/Dana Farber Cancer Institute.
Coping & support
Your child will face unique challenges in coping with her diagnosis of leiomyosarcoma. There's a lot of support available here at Children's for you and your family, and here are some of the ways we can help. Learn more about the cancer specific support services available at the Dana-Farber/Children's Hospital Cancer Center.