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Childhood rhabdomyosarcoma


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is rhabdomyosarcoma?
STAGE EXPLANATION
Stages of childhood rhabdomyosarcoma
Stage 1
Stage 2
Stage 3
Stage 4
Recurrent
TREATMENT OPTION OVERVIEW
How childhood rhabdomyosarcoma is treated
Treatment by stage
PREVIOUSLY UNTREATED (STAGES 1-4) CHILDHOOD RHABDOMYOSARCOMA
RECURRENT CHILDHOOD RHABDOMYOSARCOMA
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that provides up-to-date information on cancer and its prevention, detection, treatment, and supportive care. PDQ is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

Cancer in children and adolescents is rare. The majority of children with cancer are treated at cancer centers with special facilities to treat childhood cancers. There are organized groups of doctors and other health care professionals who work together by doing clinical trials to improve treatments for children with cancer.

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your child's doctor, who knows your child and has the facts about your child's disease. PDQ can also provide the names of additional health care professionals and hospitals that specialize in treating children who have cancer.

Before your child begins treatment, you may want to consider entering your child in a clinical trial. PDQ can be used to learn more about the trials. A clinical trial is a research study that attempts to improve current treatments or find new treatments for people with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers specific scientific questions in order to find new and better ways to help people with cancer. During clinical trials, information is collected about new treatments, their risks, and how well they do or do not work. When a clinical trial shows that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the "standard" treatment. Children who are treated in clinical trials have the advantage of getting the best available therapy. In the United States, about two thirds of children with cancer are treated in a clinical trial at some point in their illness.

Listings of current clinical trials are available on PDQ. In the United States, there are two major groups (called cooperative groups) that organize clinical trials for childhood cancers: the Childrens Cancer Group (CCG) and the Pediatric Oncology Group (POG). Doctors who belong to these groups or who take part in other clinical trials are listed in PDQ.

To learn more about cancer and how it is treated or to learn more about clinical trials for your child's kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer your cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is rhabdomyosarcoma?

Rhabdomyosarcoma is a disease in which cancer (malignant) cells begin growing in muscle tissue somewhere in the body. Rhabdomyosarcoma is a type of a sarcoma, which means a cancer of the bone, soft tissues, or connective tissue (e.g., tendon or cartilage). Rhabdomyosarcoma begins in the soft tissues in a type of muscle called striated muscle. It can occur anywhere in the body.

There are several types of sarcoma that are found in children and young adults. The cancer cells must be looked at under a microscope to tell which type of sarcoma it is. Rhabdomyosarcoma is the most common type of sarcoma found in the soft tissues of children. Other types of soft tissue sarcoma are covered in the PDQ patient information summary on childhood soft tissue sarcoma, non-rhabdomyosarcoma. Sarcomas occurring in the bone are usually called osteosarcoma or Ewing's sarcoma; see the separate patient information summaries on these diseases for more information. Soft tissue sarcoma in adults is covered in the patient information summary on adult soft tissue sarcoma.

If your child has symptoms of a sarcoma, your child's doctor may order x-rays and other tests. Your child's doctor may also cut out a small piece of tissue and have it looked at under the microscope to see if there are any cancer cells. This is called a biopsy.

Your child's chance of recovery (prognosis) and choice of treatment depend on where the cancer is located, how far it has spread, how the cells look under the microscope (histology), the type of therapy administered, and how much of the cancer can be removed by surgery.


STAGE EXPLANATION


Stages of childhood rhabdomyosarcoma

Once childhood rhabdomyosarcoma is found, more tests will be done to find out if the cancer cells have spread to other parts of the body. This is called staging. Your doctor needs to know how far the cancer has spread to plan treatment.

There are several staging systems for childhood rhabdomyosarcoma. The treatment options in this summary are based on size, location, and how far and where the cancer has spread.


Stage 1

Cancer is found in the eye, head and/or neck, or near your sex organs and bladder.


Stage 2

Cancer is located in only one area (but in none of the areas in Stage 1), is smaller than 2 inches across (5 cm) in size, and has not spread to the lymph nodes.


Stage 3

Cancer is located in one area (but not one of the areas in Stage 1), is greater than 2 inches across (5 cm) in size, and may have spread to the lymph nodes found nearby the cancer.


Stage 4

Cancer has spread and is found in more than one place at the time of diagnosis.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the area where it started or in another part of the body.


TREATMENT OPTION OVERVIEW


How childhood rhabdomyosarcoma is treated

There are treatments for all patients with childhood rhabdomyosarcoma. Three types of treatment are used, most often in combination with each other:

Surgery is a common treatment for rhabdomyosarcoma. Depending on where the cancer is, your child's doctor will take out as much of the cancer as possible, along with some of the normal tissue around it. If the cancer is in a place where it cannot be removed, surgery may be limited to taking out only a small piece of the cancer (biopsy). Surgery is usually followed by chemotherapy and radiation therapy.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). Clinical trials are testing radiation given in several small doses per day (hyperfractionated radiation therapy).

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by mouth in the form of a pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body.

Bone marrow transplantation is a treatment being studied for recurrent rhabdomyosarcoma. Sometimes rhabdomyosarcoma becomes resistant to treatment with standard doses of radiation therapy or chemotherapy. Very high doses of chemotherapy may then be used to treat the cancer. Because the high doses of chemotherapy can destroy the bone marrow, marrow is taken from the bones before treatment. The marrow is then frozen and high-dose chemotherapy with or without radiation therapy is given to treat the cancer. The marrow that was taken out is then thawed and given back through a needle in a vein to replace the marrow that was destroyed. This type of transplant is called an autologous transplant.


Treatment by stage

Treatment for childhood rhabdomyosarcoma depends on where the cancer is and how far it has spread and what the cancer cells look like under the microscope.

Your child may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to have your child go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to test new treatments and to find better ways to treat cancer patients. A large cooperative group clinical trial comparing new treatments with standard treatments is ongoing in most parts of the country for all stages of rhabdomyosarcoma. If you want more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


PREVIOUSLY UNTREATED (STAGES 1-4) CHILDHOOD RHABDOMYOSARCOMA

If the cancer can be removed, your child's treatment will probably be surgery followed by chemotherapy. Radiation therapy may also be given if there is cancer left following surgery. If the cancer cannot be removed with surgery or if it is near an important organ (e.g., the eye or bladder), your child's treatment will probably be chemotherapy plus radiation therapy, followed, if needed, by surgery. Clinical trials are testing new chemotherapy drugs, new ways of giving radiation therapy, and autologous bone marrow transplantation following high-dose chemotherapy (for patients whose cancer has spread to other parts of the body).


RECURRENT CHILDHOOD RHABDOMYOSARCOMA

Your child's treatment depends on how much of the cancer can be removed by surgery, where the cancer came back, and the treatment your child received before. Your child's treatment may be chemotherapy. Clinical trials are testing new chemotherapy agents and autologous bone marrow transplantation.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about childhood rhabdomyosarcoma, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is toll-free and a trained information specialist can answer your questions.

The Cancer Information Service can also send you booklets. The following booklets on childhood cancer may be helpful to you:

Young People with Cancer: A Handbook for Parents
Talking with Your Child About Cancer
Managing Your Child's Eating Problems During Cancer Treatment
When Someone in Your Family Has Cancer

The following general booklets on questions related to cancer may also be helpful:

Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
What You Need To Know About Cancer

There are many other places where material about cancer treatment and information about services are available. Check the hospital social service office for local and national agencies that help with finances, getting to and from treatment, care at home, and dealing with other problems.

Write to the National Cancer Institute at this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 09/1999


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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