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Childhood Rhabdomyosarcoma

What it is

Childhood Rhabdomyosarcoma is a combination of two types of cancer, sarcoma and Rhabdomyolysis. Sarcoma is found in the body’s support system of soft tissue. This is a fast acting growing type of cancer. It is most commonly found in the blood and lymph vessels, along with any nerves, tendons, joints, and or fat and muscle tissue. Sarcoma builds malignant masses, from the production of fast acting cell growth. Sarcoma is not limited to these parts of the body. However, Sarcoma is very rare and has only been accounted for in 1% of all types of cancer annually. Rhabdomyolysis is the opposite of sarcoma. The break down of fibers in the muscles is the main damage source to the body. The release of muscle fiber myoglobins attacks the kidney and its surrounding cells. The combination of these two diseases creates an attack to premature cell growth that will further turn into muscle. The voluntary muscles such as the facial, and appendage muscles become defined as striated. Striated muscles are the muscles that connect at either or both ends of the joints. This type of malignant cancer is seen most commonly in children and adolescence. This is most commonly seen in the head and neck; however will be seen almost anywhere in the body. ^[1]

Types

Childhood Rhabdomyosarcoma breaks down into three different subgroups. Embryonal, being the most commonly seen type among children and young adults. Alveolar, as well as anaplastic rhabdomyosarcoma, which is rarely documented and if so is only seen within the teenage years. Embryonal rhabdomyosarcoma develops within the first seven weeks of the embryos development. Rapid cell growth causes masses to form along the head and neck, as well as the urinary and genital organs. Alveolar the second most common group is seen further along in life. ^[2] During the teen years large muscle groups become under attack. This includes but is not limited to the torso and large appendages. Aggressive treatment is needed to stop or limit progression of alveolar due to the strength and aggressiveness in comparison to emryonal rhabdomyosarcoma. Anaplastic is almost never seen in children, however may occur in a small percentage. The only way of identifying this type of rhabdomyosarcoma is by precise and intensive lab work.

Risk Factors

Childhood Rhabdomyosarcoma is hard to diagnose. There are limited and rare risk factors that may increase the risk of getting such a cancer. This does not mean however that one will get the cancer if the genetic mapping of previous family members do include the following risk factors: Li-Fraumeni syndrome, type one Neurofibromatosis, Beckwith-Wiedemann syndrome, Costello syndrome, and Noonan syndrome. Each of which contribute to bodily deformations within the bones, tissue, and muscles. ^[3]

Symptoms

Signs and symptoms of Childhood Rhabdomyosarcoma are very visible and prominent. This cancer starts with swollen red lumps where the cancer is starting to develop. The lumps are hard and can progressively get bigger unless treated. This is the most common indicator of this cancer. Other symptoms one may watch for are poor bowel movements, blood in the urine, as well as secreting from the genitals and nose area. Upper body indicators may include painful headaches as well as noticeably large size in the eyeball itself. Varying tests can determine whether or not these related symptoms are indeed Childhood Rhabdomyosarcoma. Several scans such as CT, X-ray, MRI, bone scans, and Ultrasounds may be done to identify where the cancer formed, and where the cell growth has spread the cancer. Biopsies of the lump itself can be taken along with bone marrow biopsies to detect whether or not the cancer has spread within the marrow, the bone itself, and throughout the body’s blood supply. Further determination of how aggressive and large the cancer is relies within these scans. ^[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, as well as the blood. When the cancer spreads from one area to the next the stage level as well as 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 and connecting bile ducts, as well as the male and female genitalia. Once the lump is a distinguishable five centimeters the stage level has increased to a level two. When the lymph nodes become under attack and the cancer has spread to nearby sites classification is considered at a stage three. The size of the lump may still be only up to five centimeters big. Stage three type cancer may be seen anywhere other than the mentioned stage one areas. The most extreme stage, stage 4, includes 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 the bones, marrow, and the lungs. ^{[5] [6]}

Treatment

Determination of treatment options depends on certain factors, some of which affect internal organs and others that affect personal appearance. When determining how to treat this cancer, oncologists consider the location of where the tumor started, whether or not it will potentially deteriorate body functions, how it may further affect their appearance, and how the child will respond to chemotherapy and radiation. Surgery is the least successful of the bunch. The tumor cannot be completely removed in children. Since the tumor develops within the cells, complete removal is impossible. ^[7] Chemotherapy follows surgery to shrink or eliminate the left over cancer cells. Stem cell research is under clinical trial and shows to be a good replacement to lost cells. ^[8] The aggressiveness of this cancer relies on a large team of specialists. The team that follows the patient through the steps of this cancer may include a pediatric surgeon, oncologist, hematologist, specialty nurse, and rehabilitation specialists. This cancer takes a toll on ones self and family. Social workers and psychologist also team up to build a support system in the road of discovery and recovery. Treatment of this cancer is harsh on the body and may create specific side effects. One may go through mood swings, troubles learning, loss of memory, physical deformations or restrictions, and a potential risk of getting a secondary cancers in a different location. ^[3]

Survival Rates

Childhood rhabdomyosarcoma has been fatalChildhood rhabdomyosarcoma has been fatal. Present day recovery has increased by 50 percent since 1975. In children five years of age or younger survival rates are up to 53 to 65 percent out of all diagnosed cases. In adolescence younger then 15 years old the survival rate has increased up to 30 percent. ^[2] This developing cancer becomes more known and treatable with every case.

References