Diagnosis and Treatment

How is rhabdomyosarcoma diagnosed?

The first step in treating your child is forming an accurate and complete diagnosis. A physician may order a number of different tests to diagnose rhabdomyosarcoma. In addition to a medical history and physical exam, these may include:

What are the treatment options for rhabdomyosarcoma?

Treatment for rhabdomyosarcoma requires close coordination between surgeons, pediatric oncologists and radiotherapists. The response of tumors is very much dependent on their site of origin.

A series of studies have been performed by the Intergroup Rhabdomyosarcoma Study (IRS), now a part of the Children’s Oncology Group which has outlined the treatment of rhabdomyosarcoma. Dana-Farber/Boston Children’s plays an active role in this organization.

For treatment of rhabdomyosarcoma, surgery is often a first step — allowing doctors to form a complete diagnosis of the tumor type and providing information on the stage of the disease. Complete surgical removal of a rhabdomyosarcoma is often not possible. Your child's doctor may also recommend radiation therapy and/or chemotherapy. Radiation therapy can help stop the growth of abnormal cells in specific areas of the body using high-energy rays from a specialized machine to damage or kill abnormal cells.

Chemotherapy is systemic treatment, meaning it is introduced to the bloodstream and travels throughout the body to kill or slow the growth of targeted cells. Different groups of chemotherapy drugs work in different ways, and can be taken in a variety of ways including orally or intravenously. While chemotherapy can be quite effective in treating certain cancers, the agents don't completely differentiate normal healthy cells from abnormal cells. Because of this, your child could have adverse side effects during treatment.

Deciding on which of these approaches to use depends largely on the tumor's site. For instance, a sarcoma in the muscles of the arms or legs is often initially treated with surgical removal, which may be followed by chemotherapy with or without radiation. A tumor in the bladder or prostate requires chemotherapy prior to attempts at surgical removal or treatment with radiation. Tumors around the eye are very responsive to chemotherapy and radiation, so they rarely require surgical removal.

What is the long-term outlook for children with rhabdomyosarcoma?

The prognosis for children with rhabdomyosarcoma varies, but more than 70 percent survive five years after diagnosis if they have localized disease and receive combination therapy. After five years of disease-free survival, relapses are rare. Prompt medical attention for and aggressive therapy are critical for the best prognosis.

Your child's outcome will likely depend on a number of factors, including:

  • the extent of the disease
  • the size and location of the tumor
  • the tumor's characteristics when examined under a microscope
  • the presence or absence of metastasis
  • the tumor's response to therapy
  • the age and overall health of your child
  • your child's tolerance of specific medications, procedures, or therapies
  • new developments in treatment