What is Rhabdomyosarcoma?
Rhabdomyosarcoma is a soft tissue cancer that originates from the muscles. According to statistics, Rhabdomyosarcoma showed as the most common soft tissue that occurs in children. Rhabdomyosarcoma is mostly seen in areas where skeletal muscles are scarce such as head and neck.
Rhabdomyosarcoma is a rare form of cancer, it can also affect adults, but that case is extremely rare. Children are the common victim of Rhabdomyosarcoma. Like any other tumors that occur in our childhood, the definite cause of this condition is unknown. In some cases, an alteration to the child’s chromosomal structure is present.
A. Alveolar Rhabdomyosarcoma
This type of rhabdomyosarcoma affects children of older ages (teenagers mostly). This type of rhabdomyosarcoma is often seen in the large muscles of the body such as the extremities and the trunk. Alveolar Rhabdomyosarcoma grows fast, thus, it will need an aggressive treatment.
Alveolar Rhabdomyosarcoma of the Thighs
B. Embryonal Rhabdomyosarcoma
Embryonal Rhabdomyosarcoma occurs in infants and mostly toddlers, they simultaneously grow with the child’s muscles. They are seen in the small muscles of the body, for example in the neck and head area of the child. This type is very treatable because the growth rate is slow.
Embryonal Rhabdomyosarcoma in the Head
C. Pleomorhpic Rhabdomyosarcoma
This type of rhabdomyosarcoma is also called as anaplastic rhabdomyosarcoma and undifferentiated sarcoma, this is an uncommon type of sarcoma that targets adults. Although this can occur in children, this is very rare. Doctors use an intensive and an aggressive therapy for this type of rhabdomyosarcoma because the growth of the sarcoma is very fast.
Pleomorphic Rhabdomyosarcoma of The Hands
- Respiratory Difficulty – This can be present if the tumor is located in an area where it can impede the normal function of the lungs.
- Fever – Although this is a general defense mechanism of our body against systemic infection and other foreign bodies, this can be present in a patient with Rhabdomyosarcoma. Please note that this can also be associated with other disease that is why fever is not a definitive symptom of Rhabdomyosarcoma.
- Pain – This is not a definitive symptom because this can be an indication of other diseases present in the patient.
- Eye and Vision problems – This can be present if the tumor originated in an area near the eyes. This will impede with the normal function of our eyes.
Rhabdomyosarcoma of the Eyes
- Painless Scrotal Mass – This can be present if the tumor is located in an area near the testicles.
- Bladder and Bowel problems – This can be present when the tumor is located near the urinary tract or in the gastrointestinal tract.
Causes of Rhabdomyosarcoma
The exact reason that causes Rhabdomyosarcoma remains unclear as of this day, although genetic syndromes and various other factors are associated with this condition. I will list down other factors that were associated with Rhabdomyosarcoma.
- Smoking – This is included in our Risk Factors because most of the cancers are induced by smoking.
- Radiation – This can cause a change or mutation in our normal cells
- Drug Abuse – studies have shown that the use of illegal drugs are connected with adults who have Rhabdomyosarcoma
Diagnosis of Rhabdomyosarcoma
To fully diagnose Rhabdomyosarcoma, we need to have a series of tests done to the patient. Like any other cancers, we need to properly diagnose the disease before proceeding to the treatment regimen.
- X-ray – An x-ray will be ordered to know how deep is the tumor. It will also give us the general location of the tumor. Please note that this procedure will only give a minimum exposure to radiation, this will not likely be the cause/aggravate the status of the tumor.
- Advanced Imaging Tests – This includes MRI and CT Scan, they are both specialized imaging test that is used to scan the tumor deeper. It will produce a detailed result on the status of the tumor. This can also be ordered after the treatment regimen to know if the treatment is successful.
- Biopsy – Biopsy will be used to extract specimens from the tumor. The type of biopsy will be needed will depend on the location of the tumor, bone biopsy and fine needle biopsy is used commonly.
Treatment of Rhabdomyosarcoma
Children is the most common victim of Rhabdomyosarcoma, chemotherapy is a treatment regimen that halts the growth and multiplication of the cancer cells, but this therapy will also halt the growth and multiplication of all cells in our body. In that case, it is normally to think that we will need to use chemotherapy as a last resort treatment regimen because if we use chemotherapy, this will stunt the growth and development process of the child.
Although that is a fact, this logic is not followed by doctors because they believe that we should intervene with these types of diseases immediately. This conflict caused a controversy whether to choose a safer treatment for the child or use chemotherapy.
This therapy is used to kill cancer cells. Although radiation can cause cancer. It can also kill cancer cells by having the correct amount of radiation pointed to the location of the cancer cells. This method is only used when the tumor is superficial, if this is used in a tumor that is deep in the body, it can cause destruction of adjacent cells and will produce more side-effects.
This is the most preferred method because this will remove the tumor out of our body. Also, it is used when radiotherapy is not an option due to the location of the tumor. This is also performed even if the tumor has metastasized because the removal of the tumor is our best chance to help the patient get rid of Rhabdomyosarcoma.
This method will kill the cancer cells that are causing Rhabdomyosarcoma. However, this can also kill our normal cells in the body and cause systemic side-effects like nausea and vomiting, loss of appetite, hair loss, etc.
Because solo therapy is not producing good results, a combined therapy is developed and it produced an opportunity to cure this type of cancer. The combined therapy is a combination of chemotherapy and surgery (radiation therapy can be also used too).
Prognosis and Survival Rate
The basic location of the tumor will affect the patient’s prognosis. According to a research study, rhabdomyosarcoma that occurred in the genitourinary tract (GUT) or in the eye area has the highest prognosis rate. Also, embryonal rhabdomyosarcoma is the easiest to treat among the rhabdomyosarcoma types.
The total survival rate for children is 72%. However, if the tumor is malignant, the doctors and the medical team will have difficulty in treating the condition and it decreases the survival rate down to 30%. The patient’s tolerance of the medications that are given will be a general factor that will affect the prognosis of the patient because if a patient cannot tolerate certain medications that are necessary for the treatment, treatment results will be decreased. Below are the list of common factors that will affect the prognosis of a child with rhabdomyosarcoma.
- Tumor’s Response to Medical Intervention
- Extent of the Condition
The prognosis and the survival rate will depend on the stage of the tumor. The staging is the most important part of the diagnostic process because it is the deciding factor for the treatment and for the survival of the patient. And just like any other cancer condition, the survival and the prognosis vary from child to child or person to person. A very important factor for the prognosis is prompt medical intervention and intensive medical therapy.
However, to monitor the signs of any remissions or to know if the cancer has spread to other parts of the body, continuous follow-up is necessary. The patient’s family needs to monitor the signs and symptoms of a second malignancy.
Rhabdomyosarcoma in the Arms showing an Enlarged Mass
Post-Removal of Rhabdomyosarcoma in the Eyes
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