After childhood rhabdomyosarcoma has been diagnosed, treatment is based in part on the stage of the cancer and sometimes it is based on whether all the cancer was removed by surgery.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
Staging of childhood rhabdomyosarcoma is done in three parts.
The staging system is based on the size of the tumor, where it is in the body, and whether it has spread to other parts of the body:
Stage 1
Stage 2
Stage 3
Stage 4
The grouping system is based on whether the cancer has spread and whether all the cancer was removed by surgery:
Group I
Group II
Group III
Group IV
The risk group is based on the staging system and the grouping system.
Low-risk childhood rhabdomyosarcoma
Intermediate-risk childhood rhabdomyosarcoma
High-risk childhood rhabdomyosarcoma
After childhood rhabdomyosarcoma has been diagnosed, treatment is based in part on the stage of the cancer and sometimes it is based on whether all the cancer was removed by surgery.
The process used to find out if cancer
has spread within the tissue
or to other
parts of the body is called staging. It is important to know the stage
in order to plan treatment. The doctor will use results of the diagnostic tests to help find out the stage of the disease.
Treatment for childhood rhabdomyosarcoma
is based in part on the stage and sometimes on the amount of cancer that remains after surgery
to remove the tumor. The pathologist
will use a microscope
to check the tissues removed during surgery, including tissue samples from the edges of the areas where the cancer was removed and the lymph nodes. This is done to see if all the cancer cells
were taken out during the surgery.
There are three ways that cancer spreads in the body.
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels
to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels
to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells
break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor
(metastatic
tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if rhabdomyosarcoma spreads to the lung, the cancer cells in the lung are actually rhabdomyosarcoma cells. The disease is metastatic rhabdomyosarcoma, not lung cancer.
Staging of childhood rhabdomyosarcoma is done in three parts.
Childhood rhabdomyosarcoma is staged by using three different ways to describe the cancer:
Rhabdomyosarcoma
that forms in a "favorable" site has a better prognosis. If the site where cancer occurs is not one of the favorable sites listed above, it is said to be an "unfavorable" site.
Pea, peanut, walnut, and lime show tumor sizes.
Stage 2
In stage
2, cancer
is found in an "unfavorable" site (any one area not described as "favorable" in stage 1). The tumor
is no larger than 5 centimeters
and has not spread to lymph nodes.
Stage 3
In stage
3, cancer
is found in an "unfavorable" site (any one area not described as "favorable" in stage 1) and one of the following is true:
The grouping system is based on whether the cancer has spread and whether all the cancer was removed by surgery:
Group I
Cancer
was found only in the place where it started and it was completely removed by surgery. Tissue
was taken from the edges of where the tumor
was removed. The tissue was checked under a microscope
by a pathologist
and no cancer cells
were found.
Group II
Group II is divided into groups IIA, IIB, and IIC.
There are cancer cells in the fluid
around the brain, spinal cord, or lungs, or in fluid in the abdomen
; or tumors
are found in those areas.
The risk group is based on the staging system and the grouping system.
The risk group describes the chance that rhabdomyosarcoma will recur
(come back). Every child treated for rhabdomyosarcoma should receive chemotherapy
to decrease the chance cancer will recur. The type of anticancer drug, dose, and the number of treatments given depends on whether the child has low-risk, intermediate-risk, or high-risk rhabdomyosarcoma.
An embryonal tumor
of any size that is found in a "favorable" site. There may be tumor
remaining after surgery
that can be seen with or without a microscope. The cancer
may have spread to nearby lymph nodes. The following areas are "favorable" sites:
Eye or area around the eye.
Head or neck (but not in the tissue
near the ear, nose, sinuses, or base of the skull).
An embryonal tumor of any size that is not found in a "favorable" site. There may be tumor remaining after surgery that can be seen only with a microscope. The cancer may have spread to nearby lymph nodes.
Intermediate-risk childhood rhabdomyosarcoma
Intermediate-risk childhood rhabdomyosarcoma
is one of the following:
An embryonal tumor
of any size that is not found in one of the "favorable" sites listed above. There is tumor
remaining after surgery, that can be seen with or without a microscope. The cancer
may have spread to nearby lymph nodes.
An alveolar
tumor of any size in a "favorable" or "unfavorable" site. There may be tumor remaining after surgery that can be seen with or without a microscope. The cancer may have spread to nearby lymph nodes.
