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Treating Rhabdomyosarcoma

If you or your child has been diagnosed with rhabdomyosarcoma (RMS), your treatment team will discuss the options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects.

How is rhabdomyosarcoma treated?

The types of treatment used for rhabdomyosarcoma (RMS) include:

Common treatment approaches

RMS is almost always treated with both local therapy (surgery and/or radiation therapy) as well as chemotherapy. But the details of treatment can vary based on a number of factors, including the location and extent of the tumor and which risk group the patient falls into.

All children and adults with RMS will be treated with surgery to remove the tumor if it can be done without causing major damage or disfigurement. If this isn’t possible, chemotherapy and/or radiation therapy may be used first to try to shrink the tumor. If it shrinks enough, surgery can be done at this point. The goal of surgery is to remove the tumor completely, but this isn’t always possible.

Even if the tumor appears to have been removed completely, all patients with RMS need chemotherapy. Without it, it’s very likely that the cancer will come back in distant parts in the body because small amounts of cancer have almost always reached other parts of the body when the cancer is first found (even thought they can't be seen on imaging tests).

If cancer is left behind after surgery or if the cancer has some less favorable traits and it hasn’t spread to distant sites (as is the case most of the time), radiation therapy will also be given.

Many of these treatments can be used again if the cancer continues to grow or if it comes back later on.

Who treats rhabdomyosarcoma?

RMS is not common, and treating it can be complex, so it’s very important for patients to be diagnosed and treated by a team of doctors who have experience with RMS.

For children and teens, treatment is best done at a children’s cancer center. For adults with RMS, treatment is typically done at a major cancer center. Doctors on the treatment team might include:

  • An orthopedic surgeon (a surgeon who specializes in muscles and bones) who is experienced in treating RMS
  • A medical or pediatric oncologist (a doctor who treats cancer with chemotherapy and other drugs)
  • A radiation oncologist (a doctor who treats cancer with radiation therapy)
  • A pathologist (a doctor specializing in using lab tests to diagnose and classify diseases)
  • A physiatrist (a doctor who directs a person’s rehabilitation and physical therapy after treatment)

For both children and adults, the team might also include other doctors, as well as physician assistants (PAs), nurse practitioners (NPs), nurses, psychologists, social workers, physical therapists and other rehabilitation specialists, and other health professionals. 

Making treatment decisions

The treatment for RMS can often be effective, but it can also cause serious side effects. It’s important to discuss all treatment options as well as their possible side effects with the cancer care team so you can make an informed decision. It’s also very important to ask questions if you’re not sure about anything. 

If time allows, getting a second opinion from another doctor experienced with your child’s type of tumor is often a good idea. This can give you more information and help you feel more confident about the treatment plan you choose. If you aren’t sure where to go for a second opinion, ask your doctor for help.

The treatment team will also help you take care of side effects and can help you work closely with nutritionists, psychologists, social workers, and other professionals to understand and deal with medical problems, stress, and other issues related to the treatment.

For cancer in children and teens, many of these issues can be more complex. As a parent, taking care of a child with cancer can be a big job. It’s important to remember that you will have a lot of help. Many people will be involved in your child’s overall care. It’s also important to know that the health professionals who treat children with RMS are using the experience and knowledge gained from many decades of studying the treatment of this disease. 

Thinking about taking part in a clinical trial

Today, most children and teens with cancer are treated at specialized children’s cancer centers. These centers offer the most up-to-date-treatment by conducting clinical trials (studies of promising new therapies). Children’s cancer centers often conduct many clinical trials at any one time, and in fact most children treated at these centers take part in a clinical trial as part of their treatment.

Adults with cancer also typically have the option to participate in clinical trials as a way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they might not be right for everyone. Talk to your treatment team if you're interested in learning more about clinical trials, and ask about the pros and cons of enrolling in one of them.

If you would like to learn more about clinical trials, start by asking the treatment team if your clinic or hospital conducts clinical trials. 

Considering complementary and alternative methods

You may hear about alternative or complementary methods that the doctor hasn’t mentioned. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of standard medical treatment. Although some of these methods might be helpful in relieving symptoms or helping people feel better, many have not been proven to work. Some might even be harmful.

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. 

Preparing for treatment

Before treatment, the doctors and other members of the team will help you understand the tests that will need to be done. The team’s social worker will also counsel you about some of the issues that might come up during and after treatment, and might be able to help you find housing and financial aid if needed.

Help getting through cancer treatment

Your cancer care team will be your first source of information and support, but there are other resources for help when you need it. Hospital- or clinic-based support services can also be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. For children and teens with cancer and their families, other specialists can be an important part of care as well. 

The American Cancer Society also has programs and services – including rides to treatment, lodging, and more – to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.

The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask your cancer care team any questions you may have about your treatment options.

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