Rhabdomyosarcoma

Rhabdomyosarcoma

 

Rhabdomyosarcoma is a type of cancer that affects the skeletal muscle cells, which are responsible for movement in the body. It is the most common soft tissue sarcoma in children, but it can also occur in adults.

It typically occurs in young children and is more common in the –

• Head and neck area
• A urinary system such as the bladder
• A reproductive system such as the vagina, uterus, and testes
• Arms and legs

Types of Rhabdomyosarcoma

There are two main types of rhabdomyosarcoma – 

1. Embryonal rhabdomyosarcoma – It is the more common type and accounts for about 60% of cases. It typically occurs in young children and is more likely to be found in the head and neck area, urinary or reproductive organs, or the muscles surrounding the eye.
2. Alveolar rhabdomyosarcoma – It is less common, accounting for about 20% of cases. It tends to occur in older children and teenagers and is more likely to be found in the trunk, arms, or legs. This type of rhabdomyosarcoma has a higher risk of spreading to other parts of the body.

Rhabdomyosarcoma

There are also two less common subtypes of rhabdomyosarcoma i.e Pleomorphic and Spindle cell/sclerosing. 

1. Pleomorphic rhabdomyosarcoma – tends to occur in adults and has a more aggressive growth pattern.
2. Spindle cell/sclerosing rhabdomyosarcoma – is rare and typically occurs in the head and neck area. It is common in children, adolescents, and adults.

Causes and Risk Factors

The actual cause of rhabdomyosarcoma is not yet known. However, there are some risk factors that may increase a person’s likelihood of developing this type of cancer –

1. Age – Rhabdomyosarcoma is most commonly diagnosed in children under the age of 10, although it can occur in people of any age.
2. Family history – In rare cases, there may be a genetic predisposition to developing rhabdomyosarcoma. People with a family history of the disease may be at increased risk.
3. Exposure to radiation – Exposure to high doses of radiation, particularly during childhood, may increase the risk of developing rhabdomyosarcoma.
4. Certain genetic disorders – Some genetic disorders, such as Li-Fraumeni syndrome and neurofibromatosis type 1, may increase the risk of developing rhabdomyosarcoma.
5. Certain infections – In rare cases, infections with certain viruses, such as HIV or Epstein-Barr virus, may increase the risk of developing rhabdomyosarcoma.

It’s important to note that most people with rhabdomyosarcoma do not have any known risk factors.

Signs and Symptoms

The signs and symptoms of rhabdomyosarcoma can vary depending on the location and size of the tumor. Some common signs and symptoms may include –

1. Swelling or a lump that can be felt under the skin.
2. Pain in the affected area.
3. Difficulty moving the affected area.
4. Numbness or weakness in the affected area.
5. Unexplained weight loss.
6. Fever.
7. Fatigue or weakness.
8. Changes in bowel or bladder habits.
9. Blood in the stool or urine.

Many of these symptoms can be caused by conditions other than rhabdomyosarcoma. However, if you or your child are experiencing any of these symptoms, it’s important to see a doctor to determine the cause and receive appropriate treatment.

Diagnostic Tests

Rhabdomyosarcoma is a rare type of cancer that affects the muscles and is typically found in children. The diagnosis of rhabdomyosarcoma usually involves a combination of tests and procedures to determine the presence and extent of cancer.

Here are some of the common diagnostic tests and procedures for rhabdomyosarcoma –

1. Physical exam – The doctor may perform a physical examination to check for any lumps, swelling, or other signs of cancer.

2. Imaging tests – Imaging tests such as X-ray, MRI, CT scans, or PET scans may be used to identify the location and extent of the tumor.

• X-ray – An X-ray of the organs and bones inside the body. It makes pictures of areas inside the body.
• Magnetic Resonance Imaging (MRI) – It makes detailed images of inside areas of the body such as the skull, brain, and lymph nodes.
• Positron Emission Tomography (PET) – A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose is injected into the vein and tumor cells show up brighter in the image because they absorb more glucose than normal cells.
• Bone scan – It checks if there are rapidly dividing cells in the bone. Radioactive material helps in the detection of cancer.

3. Biopsy – A biopsy involves removing a sample of the tumor tissue and examining it under a microscope to check for the presence of cancer cells.

4. Blood tests – Blood tests may be done to check for certain markers that may be elevated in the presence of rhabdomyosarcoma.

5. Bone marrow aspiration and biopsy – If the cancer is suspected to have spread to the bone marrow, a bone marrow aspiration, and biopsy may be done to check for the presence of cancer cells.

The diagnosis of rhabdomyosarcoma can be challenging, and it is important to seek medical attention if you or your child is experiencing any symptoms or signs of cancer. A team of specialists, including pediatric oncologists, radiologists, and pathologists, may be involved in the diagnosis and treatment of rhabdomyosarcoma.

Staging

The staging of rhabdomyosarcoma for your child’s treatment will be determined by –

• Where the cancer is located
• Cancer spread
• How large the tumor is
• Outlook of cancer
• Treatment options

The cancer stages for Rhabdomyosarcoma are –

Stage 1 – The tumor is any size and has spread to lymph nodes. It is usually located in the head and neck, eyes, gallbladder, or reproductive parts of the body.

Stage 2 – The tumor is located at an unfavorable site. The tumor size is less than 5 cm and is not spread to lymph nodes.

Stage 3 – The tumor is located at an unfavorable site. And one of the conditions may occur –

• The tumor size is no larger than 5 cm and it has not spread to nearby lymph nodes
• The tumor size is larger than 5 cm and it has spread to nearby lymph nodes

Stage 4 – The tumor is of any size and the cancer has spread to nearby lymph nodes. It usually occurs in the lungs, bone, or bone marrow.

It is best to consult your healthcare provider on your child’s cancer stage for effective treatments.

Treatments

The treatment options provided by the healthcare team for rhabdomyosarcoma depend on the stage, type, possible side effects, and person’s overall health and preferences.

The specific types of treatments used for treating rhabdomyosarcoma are –

1. Chemotherapy – The medications are injected through veins into the bloodstream that stops the growth and multiplication of cancer cells. It is also a preferred choice in children to limit the chances of cancer cells from coming back.
2. Surgery – A surgical procedure in which a specific part or entire part of a tumor is removed to stop the spread of cancer cells in other organs of the body.
3. Radiation Therapy – It uses high-energy beam rays to destroy or stop the growth of cancer cells.
4. Palliative care – It treats a person’s symptoms and treatment side effects. It also provides support and care for emotional, mental, and social needs. The options included are medication, nutrition, and therapeutic services.

Rhabdomyosarcoma is a rare type of cancer and people with the disease usually get treated with clinical trials. As clinical trials test new treatments which are effective in treating rare and deadly diseases. Talk to your healthcare provider if your child is eligible to participate in these clinical trials. 

Outlook

The long-term outlook for Rhabdomyosarcoma to around 70% of the population is five-year or longer. The range of survival in an individual depends on specific factors such as –

• Age
• Type of rhabdomyosarcoma 
• Location and size of a tumor
• Stage of cancer
• The success of chemotherapy, surgery, and radiation therapy treatments
• The cancer spread to other organs 
• Risk groups i.e low, medium, and moderate levels of cancer.

Your healthcare provider can provide you with a detailed healthcare report and prognosis of your child to plan a treatment strategy.