Childhood rhabdomyosarcoma

Childhood rhabdomyosarcoma is a cancer that develops out of the cells that form skeletal muscles. These cells are called rhabdomyoblasts.

This type of malignant cancer is seen most commonly in children and adolescents. This is most commonly seen in the head and neck; however, it can be found almost anywhere in the body.^[1]

Types

Childhood rhabdomyosarcoma consists of three subgroups. Embryonal is the most common among children and young adults. Alveolar and anaplastic rhabdomyosarcoma occur in the teenage years.

• Embryonal rhabdomyosarcoma develops within the first seven weeks of the embryo's development. Rapid cell growth causes masses to form along the head, neck, urinary tract, and genital organs.
• Alveolar, the second most common group, is seen later in life.^[2] During the teen years, large muscle groups come under attack, including the torso and large appendages. Aggressive treatment is needed to stop or limit progression of alveolar rhabdomyosarcoma.
• Anaplastic rhabdomyosarcoma is rarely seen in children and only precise intensive lab work can identify it.

Risk Factors

Childhood rhabdomyosarcoma is difficult to diagnose. Factors that increase the likelihood of this cancer include Li-Fraumeni syndrome, type one Neurofibromatosis, Beckwith-Wiedemann syndrome, Costello syndrome, and Noonan syndrome. Each contribute to deformations of bones, tissue, and muscles.

Symptoms

The symptoms of childhood rhabdomyosarcoma are visible and prominent and include swollen red lumps where the cancer starts developing. The lumps are hard and can grow in size unless treated. Other symptoms include poor bowel movements, blood in the urine, secretions from the genitals and nose, and headaches. Various tests can determine whether these related symptoms indicate childhood rhabdomyosarcoma. CT, X-ray, MRI, bone scans, and Ultrasounds may be performed to identify the location and size of the cancer. Biopsies of the lump can be taken along with bone marrow biopsies to detect whether the cancer has spread within the marrow, the bone, and the blood supply. Further determination of how aggressive and large the cancer is requires these scans.^[3][4]

Stages

Childhood Rhabdomyosarcoma can be classified under four developing stages, each of which have their own indications and characteristics. Cancer can be spread through tissue, lymph nodes, and the blood. When it spreads, the stage level and the seriousness of the illness increases. Stage one is limited to one area and has no specific size.^[4] Stage one rhabdomyosarcoma is seen in the eye and area surrounding it, the gallbladder, connecting bile ducts, and male and female genitalia. Stage two is characterized by a lump size of five centimeters. Stage three is characterized by the spread to the lymph nodes and the cancer has spread to nearby sites. The size of the lump may still be only up to five centimeters. Stage three cancer may be seen anywhere other than the mentioned stage one areas. Stage 4 is characterized by a tumor of any size that has also spread to nearby lymph nodes. However, the cancer is not strictly limited to this area and may be seen within bones, marrow, and lungs.^[5]

Treatment

Determination of treatment options depends on certain factors, some of which affect internal organs and others that affect personal appearance. When determining treatment, oncologists consider the initial location the tumor, the likelihood of body function deterioration, the effect on appearance, and the patient's potential response to chemotherapy and radiation. Surgery is the least successful of the treatment options; the tumor cannot be completely removed because it develops within the cells.^[6] Chemotherapy follows surgery to shrink or eliminate the remaining cancer cells.

Stem cell research under clinical trial shows promise to replace lost cells.

The aggressiveness of this cancer requires the response of a large team of specialists, possibly including a pediatric surgeon, oncologist, hematologist, specialty nurse, and rehabilitation specialists. Social workers and psychologists aid recovery by building a system of emotional support. Treatment is harsh on the body and may result in side effects including mood swings, learning difficulties, memory loss, physical deformations or restrictions, and potential risk of secondary cancers.

Survival rates

Childhood rhabdomyosarcoma has been fatal. Recovery rates have increased by 50 percent since 1975. In children five years of age or younger survival rates are up to 65 percent. In adolescents younger than 15 years old, the survival rate has increased up to 30 percent.^[2]

References

1. American Cancer Organization. "What Is Cancer". ACS. Retrieved June 4, 2013.
2. Drake, Amelia; MD Steve C Lee (13 April 2012). "Pathology - Rhabdomyosarcoma". Medscape: 1–4.
3. Childhood Rhabdomyosarcoma Treatment
4. Bethesda, MD. "Childhood Rhabdomyosarcoma Treatment". PDQ (NCI).
5. Witmore, Ralph (2000). Pediatric Otolaryngology. New York, NY: Theme Medical Publishers Inc. pp. 103–111. ISBN 9780865778351.
6. Pratt, Charles; Hustu Omar; Fleming Irvin (March 1972). "Coordinated treatment of childhood rhabdomyosarcoma with surgery, radiotherapy, and combination chemotherapy". Cancer Research. 32: 606–607.