By Andrea Liu A child, no older than five, walks into the doctor’s office with his mother behind him. She has recently noticed something strange about her son: he has crossed eyes, bad vision, frequent headaches, and a strange lump that has recently appeared on his back. She doesn’t know it yet, but the doctor is about to diagnose her son with Rhabdomyosarcoma. ![]() Rhabdomyosarcoma (RMS) is a cancer common in children that begins its development in the embryo. About 7 weeks into embryonic development, cells called rhabdomyoblasts (which eventually will form the body’s skeletal muscles) begin to form. These are the cells that might develop into RMS. This is a cancer of embryonal cells, therefore it is much more common in children and is the most common type of soft-tissue cancer in children. There are two main types of RMS: Embryonal and Alveolar. Embryonal RMS (ERMS) typically affects children of around 5 years old, like the boy mentioned above, and is most common type of RMS. The cells look like the developing muscle cells of a 6 to 8-week-old embryo, typically occurring in the head and neck area, bladder, vagina, or in or around the prostate and testicles. This type of RMS has two subtypes (botryoid and spindle cell) that tend to result in a better prognosis (a forecast of the likely outcome of a situation), meaning that the children who have those two subtypes are more likely to make a full recovery. The second main type of RMS is Alveolar RMS (ARMS) which affects all age groups equally, though it makes up a larger portion of the RMS cases in older children and teens. ARMS typically occurs in large muscles of the torso, arms, and legs. These cells resemble muscle cells in a 10-week-old fetus. These cancerous cells tend to grow faster than ERMS and require more intense treatment. ![]() Another type of RMS is Anaplastic RMS (formerly called pleomorphic RMS), which is an uncommon form of the cancer that is found in adults but is very rare in children. The causes of RMS is not fully understood, but scientists are sure that the lifestyle causes of other cancers (diet, weight, physical activity, tobacco use) do not cause RMS, as they require many years to influence the patient’s cancer development. The disease is slightly more common in boys than in girls, and it is found mostly in children under or around 10 years old, though older children and adults have been known to have RMS as well. Though there is no established cause for RMS, there are several genetic conditions that make RMS more likely in a child. These genetic conditions include:
More research is still necessary to determine any other causes for the development of the cancer, as well as to determine the early onsets of RMS. Treatment for RMS will vary depending on the tumor type, aggression, and size. Almost all patients will be treated with both surgery and chemotherapy. Surgery is used to remove the whole tumor without causing major damage. If this isn’t possible, chemotherapy or radiation therapy might be used to shrink the tumor, making it easier to surgically remove. After the tumor removal surgery, all patients will receive chemotherapy. Without chemotherapy, the cancer will very likely continue to grow in different parts of the body (metastasize), since cancer usually reaches other parts of the body upon its initial diagnosis. Radiation therapy may also be used in cases where cancer is left behind after surgery or if the cancer has some unwanted traits and has not yet spread to distant sites. The boy who walked into the doctor’s office with his mom at the beginning of this article is now about to go through surgery, then chemotherapy to rid his body of the cancerous tumor we call Rhabdomyosarcoma. Citations“About Rhabdomyosarcoma.” American Cancer Society, www.cancer.org/cancer/rhabdomyosarcoma/about.html. “Rhabdomyosarcoma (RMS).” Edited by Scott M. Bradfield, KidsHealth, The Nemours Foundation, Sept. 2016, kidshealth.org/en/parents/rms.html. ALL IMAGES BELONG TO THEIR RESPECTIVE OWNERS (cancer.net). SUGGESTED READINGSSuggested Reading:
“Rhabdomyosarcoma.” St. Jude Children's Research Hospital, www.stjude.org/disease/rhabdomyosarcoma.html. “Rhabdomyosarcoma.” Liddy Shriver Sarcoma Initiative, sarcomahelp.org/rhabdomyosarcoma.html. “Rhabdomyosarcoma - Childhood: Symptoms and Signs.” Cancer.net, 29 Aug. 2016, www.cancer.net/cancer-types/rhabdomyosarcoma-childhood/symptoms-and-signs.
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