Childhood cancers

Rhabdomyosarcoma

Rhabdomyosarcoma is a type of soft tissue cancer that occurs in striated muscle tissue. Nine in 10 cases occur in people age 25 and younger. Of these, 60 percent occur in children younger than 10. The incidence is highest in the first year of life.

There are two types of rhabdomyosarcoma. Embryonal occurs in the head and neck, urinary areas, and in or around the prostate and testes. It usually affects infants and young children. Alveolar accounts for a quarter of cases of rhabdomyosarcomas and occurs more often in the large muscles of the trunk, arms and legs. It usually affects older children or teenagers. Two-thirds of children with rhabdomyosarcoma survive.

Risk factors
Most children who develop rhabdomyosarcoma have no known risk factors for the disease, so most of these cancers develop sporadically. Genetic research is yielding more clues to the causes of this disease. Scientists studying the patterns of occurrence have noted certain risk factors, including:

	Having Li-Fraumeni syndrome or other syndromes that increase the risk of rhabdomyosarcoma and other types of cancers.
	Being male. The disease affects boys 1.5 times more than girls.

Symptoms
Because rhabdomyosarcoma can occur in a variety of locations, symptoms vary widely. Some cases of rhabdomyosarcoma are detected early when children or parents notice tumors on the arms or legs or upper neck. Tumors in the urinary tract can cause blood in the urine. Tumors behind the eyes can cause the eyes to bulge. If in the abdomen, there can be vomiting and pain. Teenagers may be very reluctant to discuss tumors in the genital area.

Questions to ask your child's doctor

Diagnosis
A medical history and physical exam can help determine if the child needs further evaluation. One or more types of biopsy can be used to determine if cancer is present. Imaging studies, such as X-rays, MRI and CT and bone scans are also used in diagnosing and evaluating rhabdomyosarcoma. Diagnosing cancer

Treatment
Before cancer is treated, it has to be staged. Staging involves finding out where the cancer is located, the extent of the cancer and whether it has spread.

Rhabdomyosarcoma is classified into four groups: group 1 or localized cancer; group 2 with evidence of lymph node involvement; group 3 with some tumor remaining after surgery; and group 4 with spread to distant areas at time of diagnosis.

The cancer team at Yale-New Haven Children's Hospital includes the child's pediatrician as well as specialists (such as pediatric oncologists and surgeons) at the Yale Cancer Center. Once the cancer is staged, the cancer care team will suggest a treatment plan. This is an important decision and it is good to take time and think about all of the choices.

Children with rhabdomyosarcoma usually undergo some form of surgery along with chemotherapy. Radiation therapy is also sometimes used. Chemotherapy can cause side effects. Be sure to discuss side effects of treatment with the pediatric oncologist before your child begins therapy.

Clinical trials, protocols and research

Learn more
• YNHH Health Library: Rhabdomyosarcoma

Last revised: Jan. 8, 2008 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.