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How is rhabdomyosarcoma treated?

The types of treatment used for rhabdomyosarcoma (RMS) include:

Common treatment approaches

RMS is almost always treated with both local therapy (surgery and/or radiation therapy) as well as chemotherapy. But the details of treatment can vary based on a number of factors, including the location and extent of the tumor and which?risk group?the patient falls into.

All children and adults with RMS will be treated with surgery to remove the tumor if it can be done without causing major damage or disfigurement. If this isn¡¯t possible, chemotherapy and/or radiation therapy may be used first to try to shrink the tumor. If it shrinks enough, surgery can be done at this point. The goal of surgery is to remove the tumor completely, but this isn¡¯t always possible.

Even if the tumor appears to have been removed completely, all patients with RMS need chemotherapy. Without it, it¡¯s very likely that the cancer will come back in distant parts in the body because small amounts of cancer have almost always reached other parts of the body when the cancer is first found (even thought they can't be seen on imaging tests).

If cancer is left behind after surgery or if the cancer has some less favorable traits and it hasn¡¯t spread to distant sites (as is the case most of the time), radiation therapy will also be given.

Many of these treatments can be used again if the cancer?continues to grow or if it comes back later on.

Who treats rhabdomyosarcoma?

RMS is not common, and treating it can be complex, so it¡¯s very important for patients to be diagnosed and treated by a team of doctors who have experience with RMS.

For children and teens, treatment is best done at a children¡¯s cancer center. For adults with RMS, treatment is typically done at a major cancer center. Doctors on the treatment team might include:

• An?orthopedic surgeon?(a surgeon who specializes in muscles and bones) who is experienced in treating RMS
• A?medical or pediatric oncologist?(a doctor who treats cancer with chemotherapy and other drugs)
• A?radiation oncologist?(a doctor who treats cancer with radiation therapy)
• A?pathologist?(a doctor specializing in using lab tests to diagnose and classify diseases)
• A?physiatrist?(a doctor who directs a person¡¯s rehabilitation and physical therapy after treatment)

For both children and adults, the team might also include other doctors, as well as physician assistants (PAs), nurse practitioners (NPs), nurses, psychologists, social workers, physical therapists and other rehabilitation specialists, and other health professionals.?

Making treatment decisions

The treatment for RMS can often be effective, but it can also cause serious side effects. It¡¯s important to discuss all treatment options as well as their possible side effects with the cancer care team so you can make an informed decision. It¡¯s also very important to ask questions if you¡¯re not sure about anything.?

If time allows,?getting a second opinion?from another doctor experienced with your child¡¯s type of tumor is often a good idea. This can give you more information and help you feel more confident about the treatment plan you choose. If you aren¡¯t sure where to go for a second opinion, ask your doctor for help.

The treatment team will also help you take care of side effects and can help you work closely with nutritionists, psychologists, social workers, and other professionals to understand and deal with medical problems, stress, and other issues related to the treatment.

For cancer in children and teens, many of these issues can be more complex. As a parent, taking care of a child with cancer can be a big job. It¡¯s important to remember that you will have a lot of help. Many people will be involved in your child¡¯s overall care. It¡¯s also important to know that the health professionals who treat children with RMS are using the experience and knowledge gained from many decades of studying the treatment of this disease.?