General Information About Childhood Rhabdomyosarcoma
Stages of Childhood Rhabdomyosarcoma
Recurrent Childhood Rhabdomyosarcoma
Treatment Option Overview
Treatment Options for Childhood Rhabdomyosarcoma

Previously Untreated Childhood Rhabdomyosarcoma         Surgery options         Chemotherapy options         Radiation therapy options Recurrent Childhood Rhabdomyosarcoma

To Learn More About Childhood Rhabdomyosarcoma
Get More Information From NCI
Changes to This Summary (11/07/2008)
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General Information About Childhood Rhabdomyosarcoma

Key Points for This Section

Childhood rhabdomyosarcoma is a disease in which malignant (cancer) cells form in muscle tissue. Certain genetic conditions increase the risk of childhood rhabdomyosarcoma. A possible sign of childhood rhabdomyosarcoma is a lump or swelling that keeps getting bigger. Tests that examine the area of the body with symptoms are used to detect (find) and diagnose childhood rhabdomyosarcoma. Certain factors affect prognosis (chance of recovery) and treatment options.

Childhood rhabdomyosarcoma is a disease in which malignant (cancer) cells form in muscle tissue.

Rhabdomyosarcoma is a type of sarcoma. Sarcoma is cancer of soft tissue (such as muscle), connective tissue (such as tendon or cartilage), and bone. Rhabdomyosarcoma usually begins in muscles that are attached to bones and that help the body move. Rhabdomyosarcoma is the most common type of sarcoma found in the soft tissues of children. It can occur in many places in the body.

There are three main types of rhabdomyosarcoma:

• Embryonal: This type occurs most often in the head and neck area or in the genital or urinary organs. It is the most common type.
• Alveolar: This type occurs most often in the arms or legs, chest, abdomen, or genital or anal areas. It usually occurs during the teen years.
• Anaplastic: This type rarely occurs in children.

See the following PDQ treatment summaries for more information about sarcomas:

• Childhood Soft Tissue Sarcoma ¹
• Ewing Family of Tumors ²
• Adult Soft Tissue Sarcoma ³

Certain genetic conditions increase the risk of childhood rhabdomyosarcoma.

Anything that increases the risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Parents who think their child may be at risk should discuss this with the child's doctor. Risk factors for rhabdomyosarcoma include having the following inherited diseases:

• Li-Fraumeni syndrome.
• Neurofibromatosis type 1 (NF1).
• Beckwith-Wiedemann syndrome.
• Costello syndrome.
• Noonan syndrome.

In most cases, the cause of rhabdomyosarcoma is not known.

A possible sign of childhood rhabdomyosarcoma is a lump or swelling that keeps getting bigger.

Lumps and other symptoms may be caused by childhood rhabdomyosarcoma. The symptoms that occur depend on where the cancer forms. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A lump or swelling that keeps getting bigger or does not go away. It may be painful.
• Bulging of the eye.
• Headache.
• Trouble urinating or having bowel movements.
• Blood in the urine.
• Bleeding in the nose, throat, vagina, or rectum.

Tests that examine the area of the body with symptoms are used to detect (find) and diagnose childhood rhabdomyosarcoma.

The following tests and procedures may be used:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• X-ray: An x-ray of the organs and bones inside the body. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen or pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
• Lumbar puncture: A procedure used to collect cerebrospinal fluid (CSF) from the spinal column to check for cancer cells. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
• Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The biopsy is done after imaging tests are done. If rhabdomyosarcoma is found, the pathologist will determine the type. Because treatment depends on the type of rhabdomyosarcoma, patients should ask to have biopsy samples checked by a pathologist who has experience in diagnosing rhabdomyosarcoma.
• Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone. Samples are removed from both hipbones. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
• Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
• Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of study is used to tell the difference between different types of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• Where in the body the tumor started.
• The size of the tumor at the time of diagnosis.
• Whether the tumor can be completely removed by surgery.
• Whether the tumor has spread to lymph nodes or distant parts of the body.
• The type of rhabdomyosarcoma.
• The patient's age and general health.
• Whether the tumor has just been diagnosed or has recurred (come back).

Stages of Childhood Rhabdomyosarcoma

Key Points for This Section

After childhood rhabdomyosarcoma has been diagnosed, treatment is based on the stage of the cancer and whether cancer remains after surgery to remove the tumor. There are three ways that cancer spreads in the body. Staging of childhood rhabdomyosarcoma is done in three related steps. The grouping system is based on whether the cancer has spread and how much cancer remains after surgery to remove the tumor: Group I Group II Group III Group IV The staging system is based on tumor location and size, and whether it has spread to lymph nodes or distant parts of the body: Stage 1 Stage 2 Stage 3 Stage 4 The risk group is based on both the grouping system and the staging system and is used to plan treatment. Low-risk childhood rhabdomyosarcoma Intermediate-risk childhood rhabdomyosarcoma High-risk childhood rhabdomyosarcoma

After childhood rhabdomyosarcoma has been diagnosed, treatment is based on the stage of the cancer and whether cancer remains after surgery to remove the tumor.

The process used to find out if cancer has spread within the muscle 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 ⁴ to help determine the stage of the disease.

Treatment for childhood rhabdomyosarcoma is based on the stage and the amount of cancer that remains after surgery to remove the tumor. The pathologist will use a microscope to check the tissues, including lymph nodes, removed during surgery, and the edges of the areas where the cancer was removed. 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.

The three ways that cancer spreads in the body are:

• Through tissue. Cancer invades the surrounding normal tissue.
• Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
• Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Staging of childhood rhabdomyosarcoma is done in three related steps.

Childhood rhabdomyosarcoma is staged by using three different ways to describe the cancer:

• A grouping system.
• A staging system.
• A risk group.

The grouping system is based on whether the cancer has spread and how much cancer remains after surgery to remove the tumor:

Group I

Cancer was only in the place where it started and it was completely removed by surgery. No cancer cells are seen when tissue taken from the edges of where the tumor was removed is viewed under a microscope by a pathologist.

Group II

Group II is divided into groups IIA, IIB, and IIC.

• IIA: Cancer was removed by surgery but there are cancer cells remaining that can be seen only with a microscope.
• IIB: Cancer had spread to nearby lymph nodes and the cancer and lymph nodes were removed by surgery.
• IIC: Cancer had spread to nearby lymph nodes and the cancer and lymph nodes were removed by surgery. There are cancer cells remaining that can be seen only with a microscope.

Group III

Cancer was removed by surgery and there are cancer cells remaining that can be seen without a microscope. Cancer did not spread to distant parts of the body.

Group IV

Cancer had spread to distant parts of the body at the time of diagnosis.

The staging system is based on tumor location and size, and whether it has spread to lymph nodes or distant parts of the body:

Stage 1

In stage 1, cancer is any size, has not spread to lymph nodes, and is found in only one of the following "favorable" sites:

• Eye or area around the eye.
• Head and neck (but not in the tissue covering the brain and spinal cord).
• Gallbladder and bile ducts.
• Near the testes or vagina (but not in the kidney, bladder, or prostate).

Rhabdomyosarcoma that occurs 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 considered an "unfavorable" site.

Enlarge

Pea, peanut, walnut, and lime show tumor sizes.

Stage 2

In stage 2, cancer is found in any one area not included in stage 1. The tumor is 5 centimeters or smaller and has not spread to lymph nodes.

Stage 3

In stage 3, cancer is found in any one area not included in stage 1 and one of the following is true:

• The tumor is 5 centimeters or smaller and cancer has spread to nearby lymph nodes.
• The tumor is larger than 5 centimeters and cancer may have spread to nearby lymph nodes.

Stage 4

In stage 4, the tumor may be any size and cancer may have spread to nearby lymph nodes. Cancer has spread to distant parts of the body such as the lung, bone marrow, or bone.

The risk group is based on both the grouping system and the staging system and is used to plan treatment.

The following risk groups are used:

Low-risk childhood rhabdomyosarcoma

Low-risk childhood rhabdomyosarcoma is one of the following:

• An embryonal tumor of any size that is found in a "favorable" site. There may be tumor remaining after surgery that can be seen without a microscope. The cancer may have spread to lymph nodes. The following areas are "favorable" sites:
  • Eye or area around the eye.
  • Head and neck (but not in the tissue covering the brain and spinal cord).
  • Gallbladder and bile ducts.
  • Near the testes or vagina (but not in the kidney, bladder, or prostate).
• An embryonal tumor of any size that is not found in one of the "favorable" sites listed above. There may be tumor remaining after surgery that can be seen only with a microscope. The cancer may have spread to 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.

High-risk childhood rhabdomyosarcoma

High-risk childhood rhabdomyosarcoma may be the embryonal type, alveolar type, or anaplastic type. It may have spread to nearby lymph nodes and has spread to distant parts of the body.

Recurrent Childhood Rhabdomyosarcoma

Recurrent childhood rhabdomyosarcoma is cancer that has recurred (come back) after it has been treated. The cancer may come back in the same place or in other parts of the body.

Treatment Option Overview

Key Points for This Section

There are different types of treatment for patients with childhood rhabdomyosarcoma. Children with rhabdomyosarcoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children. Some cancer treatments cause side effects months or years after treatment has ended. Three types of standard treatment are used: Surgery Radiation therapy Chemotherapy New types of treatment are being tested in clinical trials. High-dose chemotherapy with stem cell transplant Patients may want to think about taking part in a clinical trial. Patients can enter clinical trials before, during, or after starting their cancer treatment. Follow-up tests may be needed.

There are different types of treatment for patients with childhood rhabdomyosarcoma.

Different types of treatments are available for children with rhabdomyosarcoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.

Children with rhabdomyosarcoma should have their treatment planned by a team of health care providers who are experts in treating cancer in children.

Because rhabdomyosarcoma can form in many different parts of the body, many different kinds of treatments are used. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with rhabdomyosarcoma and who specialize in certain areas of medicine. These may include the following specialists:

• Pediatric surgeon.
• Radiation oncologist.
• Pediatric hematologist.
• Pediatric nurse specialist.
• Geneticist or cancer genetics risk counselor.
• Social worker.
• Rehabilitation specialist.
• Psychologist.

Some cancer treatments cause side effects months or years after treatment has ended.

Side effects from cancer treatment that begin during or after treatment and continue for months or years are called late effects. Late effects of cancer treatment for rhabdomyosarcoma may include:

• Physical problems.
• Changes in mood, feelings, thinking, learning, or memory.
• Second cancers (new types of cancer).

Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer ⁵ for more information.)

Three types of standard treatment are used:

Surgery

Surgery (removing the cancer in an operation) is used to treat childhood rhabdomyosarcoma. Surgery is usually wide local excision, which is removal of the tumor and some of the normal tissue around it, including lymph nodes. When an extra amount of normal tissue is removed from around the tumor, it is called an en bloc removal of a cuff of normal tissue. A second surgery may be needed to remove all the cancer. Whether surgery is done and the type of surgery done depends on the following:

• Where in the body the tumor started.
• The effect the surgery will have on the child's appearance.
• The effect the surgery will have on the child's important body functions.
• How the tumor responded to chemotherapy or radiation therapy that may have been given first.

Rhabdomyosarcoma can form in many different places in the body and the surgery will be different for each site. Surgery to treat rhabdomyosarcoma of the eye or genital areas is usually a biopsy. Chemotherapy or radiation therapy may be given before surgery to shrink large tumors.

For most children with rhabdomyosarcoma, complete removal of the tumor by surgery is not possible. Even if the doctor removes all the cancer that can be seen at the time of the surgery, patients will be given chemotherapy, with or without radiation therapy, after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or stop them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. The type and amount of radiation therapy and when it is given depend on where in the body the tumor started, how much tumor remained after surgery, and the age of the child.

Types of external radiation therapy include the following:

• Conformal radiation uses a computer to create a 3-dimensional picture of the tumor. The radiation beams are shaped to fit the tumor.
• Intensity-modulated radiation therapy (IMRT) uses images created by a computer that show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles.
• Fractionated stereotactic radiation therapy uses a rigid head frame attached to the skull to aim radiation directly to a tumor, causing less damage to nearby healthy tissue. The total dose of radiation is divided into several small doses given over several days. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy. It may be used for rhabdomyosarcomas of the head and neck.
• Proton-beam therapy is a type of high-energy, external radiation therapy that uses streams of protons (small, positively-charged particles of matter) to make radiation.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site ⁶.

High-dose chemotherapy with stem cell transplant

High-dose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Treatment Options for Childhood Rhabdomyosarcoma

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Childhood rhabdomyosarcoma may be treated with chemotherapy and/or radiation therapy before or after surgery. Treatment with surgery may include the following:

Rhabdomyosarcoma of the head and neck

• For tumors of the head and neck that are close to the skin and not in or near the eye: Treatment may include surgery (wide local excision). Some lymph nodes may be removed from the same side of the neck as the tumor. Surgery will be followed by chemotherapy with or without radiation therapy.
• For tumors of the head and neck that are in or near the eye: A biopsy of the tumor is followed by chemotherapy and radiation therapy. If the tumor remains or comes back after treatment with chemotherapy and radiation therapy, surgery to remove the eye and some tissues around the eye may be needed.
• For tumors of the head and neck that cannot be removed by surgery: Chemotherapy and radiation therapy are given.

Rhabdomyosarcoma of the arms or legs

• For tumors of the arms or legs: Surgery (wide local excision and en bloc removal of a cuff of normal tissue) may be done. For tumors in the arms, lymph nodes near the tumor and in the armpit area may be removed. For tumors in the legs, lymph nodes near the tumor and in the groin area may be removed. A second surgery may be done to remove any remaining tumor cells.

Rhabdomyosarcoma of the chest or abdomen

• For tumors in the chest wall or abdominal wall: Surgery (wide local excision) may be done. A second surgery may be done to remove any remaining tumor cells.
• For tumors of the chest or abdomen: Surgery alone or chemotherapy and radiation therapy, followed by surgery to remove the tumor.
• For large tumors of the chest or abdomen: Chemotherapy and/or radiation therapy is given to shrink the tumor first, followed by surgery (wide local excision) to remove the remaining tumor.
• For tumors of the muscles or tissues around the anus or between the vulva and the anus or the scrotum and the anus: Surgery is done to remove as much of the tumor as possible and some nearby lymph nodes, followed by chemotherapy.
• For tumors of the gallbladder or bile ducts: Surgery is done to remove as much of the tumor as possible, followed by chemotherapy.

Rhabdomyosarcoma of the area near the testicles

• Rhabdomyosarcoma of the testicular area is usually treated with surgery to remove the testicle and spermatic cord. Sometimes the lymph nodes in the back of the abdomen are removed, especially if the child is older than 9 years. CT scans may be done every 3 months after surgery to see if the cancer is growing in nearby lymph nodes.

Rhabdomyosarcoma of the prostate or bladder

• For tumors that are only at the top of the bladder: Surgery (wide local excision) is done.
• For tumors of the prostate or other parts of the bladder: Chemotherapy and radiation therapy are given first to shrink the tumor. A biopsy is done and if cancer cells remain, surgery to remove the tumor is done. Surgery may include removal of the prostate, part of the bladder, or pelvic exenteration without removal of the rectum. (This may include removal of the lower colon and bladder. In girls, the cervix, vagina, ovaries, and nearby lymph nodes may be removed).

Rhabdomyosarcoma of the vagina, vulva, or uterus

• Rhabdomyosarcoma of the vagina, vulva, or uterus is usually treated with a biopsy followed by chemotherapy.
• For tumors of the vagina, vulva, or uterus: Chemotherapy is given first to shrink the tumor, followed by surgery. Radiation therapy may be given after surgery.

Rhabdomyosarcoma in unusual areas

• For tumors of the diaphragm: A biopsy of the tumor is followed by chemotherapy to shrink the tumor. Surgery may be done later to remove any remaining cancer cells.
• For tumors of the larynx (voice box): A biopsy of the tumor is followed by chemotherapy and radiation therapy. Surgery is usually not done, so that the voice can be saved.

Metastatic rhabdomyosarcoma

• Metastatic rhabdomyosarcoma is not usually treated with surgery. However, if the cancer has spread to the lungs, chemotherapy and radiation therapy are given to shrink the tumor, followed by surgery to remove any remaining cancer cells in the lung.

Every child treated for rhabdomyosarcoma should receive chemotherapy. The dose of the chemotherapy and the number of treatments given depend on the child's risk group ⁷, as follows:

Low-risk patients

• Combination chemotherapy, with or without radiation therapy.
• A clinical trial of different doses and schedules of combination chemotherapy, with or without radiation therapy.

Intermediate-risk patients

• Combination chemotherapy.
• A clinical trial of combination chemotherapy with radiation therapy.

High-risk patients

• Combination chemotherapy.
• A clinical trial of different doses and schedules of combination chemotherapy, with or without radiation therapy.
• A clinical trial of high-dose chemotherapy with stem cell transplant for high-risk childhood rhabdomyosarcoma.
• A clinical trial of anticancer drugs taken by mouth.

Radiation therapy may be used if childhood rhabdomyosarcoma tumor cells remain after surgery, after chemotherapy, or if the tumor is the alveolar type.

Treatment may include certain kinds of radiation therapy that cause less damage to normal tissue and lessen late effects of treatment. These include:

• Conformal radiation therapy.
• Intensity-modulated radiation therapy.
• Fractionated stereotactic radiation therapy.
• Proton-beam therapy.
• A clinical trial of brachytherapy (also called internal radiation therapy) for cancer in areas such as the vagina, vulva, head, or neck.
• A clinical trial of second-look surgery after chemotherapy to reduce the need for radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with previously untreated childhood rhabdomyosarcoma ⁸. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁹.

Treatment options for recurrent childhood rhabdomyosarcoma are based on many factors, including where in the body the cancer has come back, what type of treatment the patient had before, and the needs of the individual child. Treatment may include one or more of the following:

• Chemotherapy with one or more anticancer agents.
• Surgery.
• Radiation therapy.
• A clinical trial of different schedules and combinations of chemotherapy.
• A clinical trial of new chemotherapy regimens.
• A clinical trial of new anticancer drugs.
• A clinical trial of high-dose chemotherapy followed by stem cell transplant using the patient's own stem cells.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood rhabdomyosarcoma ¹⁰. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ⁹.

To Learn More About Childhood Rhabdomyosarcoma

For more information from the National Cancer Institute about childhood rhabdomyosarcoma, see Soft Tissue Sarcomas: Questions and Answers ¹¹.

For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:

• What You Need to Know About™ Cancer - An Overview ¹²
• Childhood Cancers ¹³
• CureSearch - National Childhood Cancer Foundation Children’s Oncology Group ¹⁴
• Late Effects of Treatment for Childhood Cancer ⁵
• Young People with Cancer: A Handbook for Parents ¹⁵
• Care for Children and Adolescents with Cancer: Questions and Answers ¹⁶
• Understanding Cancer Series: Cancer ¹⁷
• Staging: Questions and Answers ¹⁸
• Coping with Cancer ¹⁹
• Support and Resources ²⁰
• Cancer Library ²¹
• Information for Survivors/Caregivers/Advocates ²²

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Changes to This Summary (11/07/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ²⁴. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." In the United States, about two-thirds of children with cancer are treated in a clinical trial at some point in their illness.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site ²⁶. Descriptions of the trials are available in health professional and patient versions. For additional help in locating a childhood cancer clinical trial, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of groups specializing in clinical trials.

The Children's Oncology Group (COG) is the major group that organizes clinical trials for childhood cancers in the United States. Information about contacting COG is available on the NCI Web site ²⁴ or from the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

The PDQ database contains listings of cancer health professionals and hospitals with cancer programs.

Because cancer in children and adolescents is rare, the majority of children with cancer are treated by health professionals specializing in childhood cancers, at hospitals or cancer centers with special facilities to treat them. The PDQ database contains listings of health professionals who specialize in childhood cancer and listings of hospitals with cancer programs. For help locating childhood cancer health professionals or a hospital with cancer programs, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

Glossary Terms

A graphic display of depth, width, and height. Also called 3-D.

A procedure that uses a computer to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. Also called 3-dimensional radiation therapy.

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.

Having to do with the anus. The anus is the opening of the rectum (last part of the large intestine) to the outside of the body.

A term used to describe cancer cells that divide rapidly and have little or no resemblance to normal cells.

A type of protein made by plasma cells (a type of white blood cell) in response to an antigen (foreign substance). Each antibody can bind to only one specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen.

A substance that causes the immune system to make a specific immune response.

The opening of the rectum to the outside of the body.

A rare, overgrowth disorder in which babies are large at birth and may develop low blood sugar. Other common symptoms are a large tongue, large internal organs, and defects of the abdominal wall near the navel. Beckwith-Wiedemann syndrome increases the risk of developing certain cancers, especially Wilms tumor.

A tube through which bile passes in and out of the liver.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

Tissue removed from the body and examined under a microscope to determine whether disease is present.

The organ that stores urine.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.

The removal of a small sample of bone marrow (usually from the hip) through a needle for examination under a microscope.

The removal of a sample of tissue from the bone marrow with a needle for examination under a microscope.

A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.

The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel. Also called intestine.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called implant radiation therapy, internal radiation therapy, and radiation brachytherapy.

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.

A tough, flexible tissue that lines joints and gives structure to the nose, ears, larynx, and other parts of the body.

A flexible tube used to deliver fluids into or withdraw fluids from the body.

A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between two of the meninges (the thin layers of tissue that cover and protect the brain and spinal cord). Cerebrospinal fluid is made by tissue called the choroid plexus in the ventricles (hollow spaces) in the brain. Also called CSF.

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

Treatment with drugs that kill cancer cells.

The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

Treatment using more than one anticancer drug.

Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.

A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.

To heal or restore health; a treatment to restore health.

The process of identifying a disease, such as cancer, from its signs and symptoms.

The thin muscle below the lungs and heart that separates the chest from the abdomen.

Refers to cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes. Also known as distant cancer.

The amount of medicine taken, or radiation given, at one time.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscope shows tiny details better than any other type of microscope.

A soft-tissue tumor that affects children. It begins in muscle cells, and usually occurs in the head, neck, arms, legs, or genitourinary tract.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days.

The pear-shaped organ found below the liver. Bile is concentrated and stored in the gallbladder.

A communication process between a specially trained health professional and a person concerned about the genetic risk of disease. The person's family and personal medical history may be discussed, and counseling may lead to genetic testing.

Refers to the genitalia (external and internal sex organs and glands).

The area where the thigh meets the abdomen.

An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.

In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as x-rays (high-energy radiation), ultrasound (high-energy sound waves), and radio waves.

A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.

Transmitted through genes that have been passed from parents to their offspring (children).

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor. Also called IMRT.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.

Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

A medical procedure that involves testing a sample of blood, urine, or other substance from the body. Tests can help determine a diagnosis, plan treatment, check to see if treatment is working, or monitor the disease over time.

The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

A rare, inherited predisposition to multiple cancers, caused by an alteration in the p53 tumor suppressor gene.

A microscope (device to magnify small objects) in which objects are lit directly by white light.

A procedure in which a thin needle called a spinal needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give drugs. Also called spinal tap.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.

The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).

Having to do with metastasis, which is the spread of cancer from one part of the body to another.

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.

The National Cancer Institute, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. The National Cancer Institute conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the National Cancer Institute Web site at http://www.cancer.gov. Also called NCI.

NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.

A rare genetic condition that causes brown spots and tumors on the skin, freckling in skin areas not exposed to the sun, tumors on the nerves, and developmental changes in the nervous system, muscles, bone, and skin. Also called NF1.

A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

A part of the body that performs a specific function. For example, the heart is an organ.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

A doctor who identifies diseases by studying cells and tissues under a microscope.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

Having to do with children.

A doctor who specializes in treating blood disorders in children.

A registered nurse with an advanced degree in nursing who specializes in the care of children.

A surgeon who specializes in the treatment of children. A surgeon removes or repairs a part of the body by operating on the patient.

Surgery to remove the lower colon, rectum, and bladder, and create stomata (openings) through which urine and stool are passed out of the body. In women, the cervix, vagina, ovaries, and nearby lymph nodes are also removed.

The lower part of the abdomen, located between the hip bones.

An exam of the body to check for general signs of disease.

The original tumor.

The likely outcome or course of a disease; the chance of recovery or recurrence.

A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

A small, positively charged particle of matter found in the atoms of all elements. Streams of protons generated by special equipment can be used for radiation treatment.

A type of high-energy, external radiation therapy that uses streams of protons (small, positively charged particles) that come from a special machine. Proton beam radiation is different from x-ray radiation.

A specialist who can talk with patients and their families about emotional and personal matters, and can help them make decisions.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

A doctor who specializes in using radiation to treat cancer.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Giving off radiation.

A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.

An unstable form of a chemical element that releases radiation as it breaks down and becomes more stable. Radioisotopes may occur in nature or be made in a laboratory. In medicine, they are used in imaging tests and in treatment. Also called radionuclide.

The last several inches of the large intestine closest to the anus.

To come back or to return.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

A treatment plan that specifies the dosage, the schedule, and the duration of treatment.

Treatment with anticancer drugs directed to a specific area of the body.

A healthcare professional who helps people recover from an illness or injury and return to daily life. Examples of rehabilitation specialists are physical therapists and occupational therapists.

Cancer that forms in the soft tissues in a type of muscle called striated muscle. Rhabdomyosarcoma can occur anywhere in the body.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

In medicine, an instrument that takes pictures of the inside of the body.

In clinical trials, the step-by-step plan for how patients are to be treated; for example, the drug or type of radiation therapy that is to be given, the method by which it is to be given, the amount of time between courses, and the total length of treatment.

In males, the external sac that contains the testicles.

Refers to a new primary cancer in a person with a history of cancer.

Surgery performed after primary treatment to determine whether tumor cells remain.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.

Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body.

A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called ultrasonogram.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spinal column encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spine, and vertebral column.

A column of nerve tissue that runs from the base of the skull down the back. It is surrounded by three protective membranes, and is enclosed within the vertebrae (back bones). The spinal cord and the brain make up the central nervous system, and spinal cord nerves carry most messages between the brain and the rest of the body.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with the standard of care. Also called best practice and standard therapy.

A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

A type of external radiation therapy that uses special equipment to position the patient and precisely deliver radiation to a tumor. The total dose of radiation is divided into several smaller doses given over several days. Stereotactic radiation therapy is used to treat brain tumors and other brain disorders. It is also being studied in the treatment of other types of cancer, such as lung cancer. Also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

Tough, fibrous, cord-like tissue that connects muscle to bone or another structure, such as an eyeball. Tendons help the bone or structure to move.

One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testis.

One of two egg-shaped glands inside the scrotum that produce sperm and male hormones. Also called testicle.

The hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The throat is about 5 inches long, depending on body size. Also called pharynx.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

Having to do with urine or the organs of the body that produce and get rid of urine.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a baby grows. Also called womb.

The muscular canal extending from the uterus to the exterior of the body. Also called birth canal.

A blood vessel that carries blood to the heart from tissues and organs in the body.

The external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina.

Surgery to cut out the cancer and some healthy tissue around it.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.