Rhabdomyosarcoma

Rhabdomyosarcoma is a type of soft tissue sarcoma. It develops from skeletal (striated) muscle cells. This is the type of muscle that you can control (voluntary muscle). A soft tissue sarcoma is a type of cancer.

Rhabdomyosarcomas are more common in children and adolescents, and rare in adults.

There are 3 distinct types of rhabdomyosarcoma. These are:

  • embryonal rhabdomyosarcoma
  • alveolar rhabdomyosarcoma 
  • pleomorphic rhabdomyosarcoma

Knowing the type of rhabdomyosarcoma helps your specialist decide on the best treatment for you. 

Treatment overview

Level of risk

The type of treatment you might have depends on the level of risk of your cancer. Your doctor will look at several factors to decide what the risk of your rhabdomyosarcoma is. These factors include:

  • the stage of your rhabdomyosarcoma
  • your age
  • the size of the tumour
  • the type of rhabdomyosarcoma 
  •  whether you have a gene Open a glossary item made up by joining parts of two different genes (fusion gene)
  • where the tumour is in your body
  • whether the cancer has spread to any lymph nodes

So, depending on the level of risk, you will have:

  • chemotherapy on its own
  • chemotherapy, as well as radiotherapy and surgery

Surgery

You are likely to have surgery if it is possible to remove the sarcoma. The surgeon removes the cancer along with a border of healthy looking tissue around it. After the operation, they send the tumour to the laboratory. A pathologist examines the border of healthy tissue for cancer cells.

Chemotherapy 

The chemotherapy drugs most commonly used are:

When surgery is not possible 

If surgery is not possible you might have radiotherapy to the sarcoma. Sometimes surgery to remove rhabdomyosarcoma may have a large effect on the way you look. In situations where surgery would be very disfiguring, your doctor may offer you radiotherapy instead of surgery. 

Types and treatment

Embryonal rhabdomyosarcoma is more common in children. It usually occurs in the head and neck region, the bladder or genital area. 

Your treatment depends on where in the body the rhabdomyosarcoma is. Surgery is usually part of the treatment. Chemotherapy tends to work well with this type of sarcoma. You might have chemotherapy before surgery to shrink the cancer. This makes it easier to remove. This is called neoadjuvant treatment. 

Chemotherapy after surgery aims to help stop the cancer from coming back. This is called adjuvant treatment. 

If you can't have surgery 

Some people might not be able to have surgery. This is because the sarcoma is in a place where it is not possible to completely remove it. For example, it might be behind the nose or in the eye socket. In this situation, you might have a combination of radiotherapy and chemotherapy.

This occurs in the arms or legs of older children and young people but can also occur in the muscles of the trunk.

Alveolar rhabdomyosarcoma is usually treated with surgery. Then you have radiotherapy to the area where the sarcoma was.

Radiotherapy aims to reduce the chance of the tumour coming back in the same place. Chemotherapy is usually given before or after surgery.

This type of rhabdomyosarcoma usually occurs in adults, in the arms or legs.

The main treatment is surgery. After surgery you usually have radiotherapy. This aims to lower the risk of sarcoma coming back. 

Research has shown that chemotherapy does not work very well with pleomorphic rhabdomyosarcoma. Chemotherapy is not part of standard treatment for this type of sarcoma. 

Coping

Coping with a diagnosis of a rare cancer can be especially difficult. Knowing more about your sarcoma and its treatment can make it easier. It can help you to make decisions and cope with what happens.

Sarcoma UK has support and information for people affected by soft tissue and bone sarcoma.

The Rare Cancer Alliance offer support and information to people with rare cancers.

Talking to other people who have the same thing can also help.

Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.

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    Clinical sarcoma research, 2016. Volume 6, number 20 

  • Rhabdomyosarcoma

    R Yechieli and others

    Pediatric Blood and Cancer, Volume 68, Issue S2, May 2021

  • Fusion status in patients with lymph node-positive (N1) alveolar rhabdomyosarcoma is a powerful predictor of prognosis: Experience of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG)

    S Gallego and others

    Cancer, Volume124, Issue15, August 1, 2018, Pages 3201 to 3209

  • Rhabdomyosarcoma in childhood, adolescence, and adulthood: Treatment

    M Okcu and others

    UpToDate website

    Accessed June 2021

Last reviewed: 
09 Jun 2021
Next review due: 
10 Jun 2024

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