Rhabdomyosarcoma is a cancer that grows in skeletal muscle. This type of cancer is rare and more often affects children. Rhabdomyosarcoma can attack all parts of the body that have skeletal muscles , including the neck, chest, abdomen, the area around the eyes, and limbs.
Rhabdomyosarcoma starts from rhabdomyoblast cells, which are cells that are formed at the beginning of pregnancy and then develop into skeletal muscle . In rhabdomyosarcoma, the cells grow rapidly and uncontrollably, and damage the surrounding healthy tissue.
Rhabdomyosarcoma can not only grow in the limbs, but can also grow in the bladder, vagina, uterus, or testicles. This cancer treatment method depends on the organ of origin, the size of the tumor, and the level of spread of cancer cells.
Types of Rhabdomyosarcoma
Rhabdomyosarcoma is a rare type of cancer. In general, rhabdomyosarcoma is divided into three, namely:
Embryonal rhabdomyosarcoma is the type of rhabdomyosarcoma that most often affects children under the age of 6. Generally, embryonal rhabdomyosarcoma grows in the head and neck, bladder, and genitals.
This type of rhabdomyosarcoma spreads quickly, but responds well to treatment so it is easier to cure.
Alveolar rhabdomyosarcoma is a type of rhabdomyosarcoma that often occurs in teenagers. This type of rhabdomyosarcoma tends to attack the legs, chest, and abdomen.
Alveolar rhabdomyosarcoma spreads quickly and is more difficult to treat than embryonal rhabdomyosarcoma. Therefore, patients with this tumor should be treated intensively.
Pleomorphic rhabdomyosarcoma or anaplastic rhabdomyosarcoma is a rare type of rhabdomyosarcoma. This type of tumor is more common in adults.
Unlike other types of rhabdomyosarcoma, anaplastic rhabdomyosarcoma is less responsive to treatment so it is more difficult to cure.
Causes of Rhabdomyosarcoma
Rhabdomyosarcoma occurs when rhabdomyoblast cells grow abnormally and out of control. These cells then form tumors that can damage healthy body tissue and spread throughout the body.
Risk factors for rhabdomyosarcoma
Although the cause is not yet known, the factors below can increase a person's risk of developing rhabdomyosarcoma:
- Male gender
- Under 10 years old
- Suffering from genetic disorders, such as neurofibromatosis type 1 , Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, Costello syndrome, and Noonan syndrome
- Having a history of rhabdomyosarcoma in the family
- Exposure to X-Ray radiation while still in the womb
- Having a mother with a history of NAPZA abuse and alcohol addiction , especially during pregnancy
Symptoms of Rhabdomyosarcoma
The symptoms of rhabdomyosarcoma can vary, depending on the size and location of the tumor , as well as the severity of the patient.
The appearance of lumps or swelling in some parts of the body can be an early sign of rhabdomyosarcoma. The complaint is generally accompanied by the appearance of other symptoms according to the area and location of tumor growth.
Signs and symptoms of rhabdomyosarcoma in the head and neck area are:
- Nasal congestion
- Swollen eyes
- Eyes protrude
- Drooping eyelids
- Blood coming out of the ear
While the symptoms of rhabdomyosarcoma in the stomach include:
- Stomach pain
Meanwhile, symptoms of rhabdomyosarcoma in the urinary tract and reproductive system include:
- Difficulty urinating or defecating
- There is blood in the urine or stool
- Lumps or bleeding in the vagina and rectum
The symptoms of rhabdomyosarcoma in the arm or leg include:
- Swelling in the legs
- Pain or numbness in the tumor growth area
When should you go to the doctor?
Immediately check with a doctor if you or your child experiences the symptoms above, especially if the complaint has been going on for a long time. Early detection and treatment is expected to prevent the spread of rhabdomyosarcoma to other organs.
Diagnosis of Rhabdomyosarcoma
First of all, the doctor will ask about the symptoms and medical history of the patient and his family, followed by a thorough physical examination, including checking for lumps or swellings that grow.
To confirm the diagnosis, the doctor will perform further examinations with the following methods:
- Blood tests, including genetic tests, complete blood count, liver function tests, and blood chemistry tests
- Image scanning with USG, X-ray photo, CT scan , PET scan, MRI , and bone scan (bone scan), to detect the location of the tumor and whether the tumor has spread
- Biopsy (tissue sampling) in the bone marrow, to determine if the tumor is cancerous and to determine the type of rhabdomyosarcoma
If the patient is diagnosed with rhabdomyosarcoma, the doctor will determine the stage or severity level to determine the appropriate treatment method. The stage of cancer is determined based on the size and whether the tumor has spread to the lymph nodes or other parts of the body.
In stage 1 rhabdomyosarcoma, the size of the tumor can vary and can invade the surrounding tissue. Stage 1 tumors usually begin to grow in the following areas:
- Area around the eyes
- Head and neck, except for the area near the brain membrane
- Urinary tract and genitals, except bladder and prostate
- Bile ducts
Rhabdomyosarcoma stage 2 is characterized by tumors that are less than 5 cm in size, but have not spread to lymph nodes or other organs. At this stage, the tumor usually begins to grow in:
- Bladder and prostate
- Arms and legs
- Muscles near the meninges
- Other body parts not mentioned in stadium 1
Stage 3 is marked by a tumor measuring less than or more than 5 cm that begins to grow in the same area as stage 2 rhabdomyosarcoma. The difference is that stage 3 tumors have spread to the nearest lymph nodes and other parts of the body.
In stage 4, the cancer has spread to the lymph nodes and other organs of the body, such as the liver, lungs, and bone marrow.
Treatment of Rhabdomyosarcoma
Rhabdomyosarcoma treatment is usually done by combining two or more treatment methods. Here is the explanation:
The operation aims to remove all cancer cells. If the cancer cannot be completely removed, the doctor will combine the operation with other treatments, such as chemotherapy or radiotherapy, to remove the remaining cancer cells.
Chemotherapy aims to shrink the size of the tumor before surgery so that tumor handling is more effective. Some drugs used in rhabdomyosarcoma chemotherapy are doxorubicin, vincristine , cyclophosphamide, and etoposide.
Radiotherapy aims to kill cancer cells using high intensity radiation. Radiotherapy is usually combined with chemotherapy and is done over several weeks.
Radiation therapy is generally performed 5 days a week, with each session lasting around 15-30 minutes.
Complications of Rhabdomyosarcoma
Rhabdomyosarcoma that is not treated properly can spread to other body organs, such as bones, lymph nodes, and lungs.
In addition, rhabdomyosarcoma patients can also experience other complications due to the side effects of treatment including:
- Hearing impairment
- Growth disorders
- Fertility disorders
- Kidney and heart disorders
- Another cancer appeared
Prevention of Rhabdomyosarcoma
Rhabdomyosarcoma cannot be prevented, because the cause is not yet known. However, to reduce the risk of this condition occurring, do genetic screening and consult with a doctor routinely if planning pregnancy. Expectant mothers also need to adopt a healthy lifestyle, both before and after giving birth.
Examination also needs to be done if there is a history of rhabdomyosarcoma in the family. That way, the child's risk of getting rhabdomyosarcoma will decrease.