Tuesday, January 15, 2008

How to Treat Rhabdomyosarcoma


Rhabdomyosarcoma is a cancer of skeletal muscle and the most common soft tissue cancer in children. Four histologic groups are recognized: embryonal (55 percent of cases), alveolar (20 percent), undifferentiated (20 percent) and botryoid (5 percent). A rhabdomyosarcoma usually occurs on the head, neck and extremities but can occur anywhere in the body except bone. The following steps will show how to treat rhabdomyosarcoma.


Difficulty: Challenging



Step One

Use a multi-mode regimen including chemotherapy, radiation and surgery to treat a rhabdomyosarcoma. Children are usually referred to a pediatric cancer center initially because the treatment is so complicated and prolonged.

Step Two

Categorize the tumor by surgicopathologic group and stage classifications in order to plan the treatment. The surgicopathologic groups are complete removal of the tumor, microscopic residual tumor, gross residual tumor and metastasis. The stage classifications are the extent of the tumor, the degree of regional node involvement and the degree of metastasis present.

Step Three

Perform surgery to promptly remove the tumor without loss of function or disfigurement, if possible. Surgical excision should still be done to maintain local control of the tumor even if it has metastasized because rhabdomyosarcomas are especially prone to recur. The excision should include a 2 cm margin of healthy tissue, if possible.

Step Four

Administer chemotherapy with antineoplastic agents to achieve local control of the tumor. Antineoplastic agents are aimed at killing cells fast enough to keep cancer cells from growing back but slow enough to allow normal cells to recover. Chemotherapy is not effective in treating metastatic rhabdomyosarcoma.

Step Five

Consult with specialists. This is important in the multidisciplinary approach required to treat rhabdomyosarcoma. The most common specialists required are radiotherapists, a psychosocial team, dentists and pediatric therapists.

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