rhabdomyosarcoma

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.

Risk factors

Factors that may increase the risk of rhabdomyosarcoma include:

• Family history of cancer. The risk of rhabdomyosarcoma is higher in children with a blood relative, such as a parent or sibling, who has had cancer, particularly if that cancer occurred at a young age. But most children with rhabdomyosarcoma have no family history of cancer.
• Genetic syndromes that increase the risk of cancer. In rare instances, rhabdomyosarcoma has been linked to genetic syndromes that are passed from parents to children, including neurofibromatosis 1, Noonan syndrome, Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome and Costello syndrome.

Complications

Complications of rhabdomyosarcoma and its treatment include:

• Cancer that spreads (metastasizes). Rhabdomyosarcoma can spread from where it started to other areas, making treatment and recovery more difficult. Rhabdomyosarcoma most often spreads to the lungs, lymph nodes and bones.
• Long-term treatment side effects. The aggressive treatments needed to control rhabdomyosarcoma can cause substantial side effects, in both the short and the long terms. Your health care team can help you manage the side effects that happen during treatment and provide you with a list of side effects to watch for in the years after treatment.

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.

Imaging tests

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:

• X-ray
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• Bone scan

Removing a sample of tissue for testing (biopsy)

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:

• Needle biopsy. The doctor inserts a thin needle through the skin and guides it into the tumor. The needle is used to remove small pieces of tissue from the tumor.
• Surgical biopsy. The doctor makes an incision through the skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incisional biopsy).

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).

Surgery

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

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

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.

Coping and support

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:

• Learn enough about rhabdomyosarcoma to make decisions about care. Ask your doctor about this sarcoma, including treatment options. As you learn more, you may become more confident in understanding and making decisions about treatment options. If your child has cancer, ask the health care team for guidance on sharing this information in a caring and age-appropriate way.
• Keep friends and family close. Keeping your close relationships strong can help you deal with cancer. Friends and relatives can provide the practical support you'll need, such as helping take care of your home if your child is in the hospital. And they can serve as emotional support when you feel overwhelmed.
• Ask about mental health support. The concern and understanding of a counselor, medical social worker, psychologist or other mental health professional also may help you. If your child has cancer, ask your health care team for advice on providing emotional and social support and options for professional mental health support. You can also check online for a cancer organization, such as the American Cancer Society, that lists support services.