Local Control Management: Surgery
In recent years, the predominant site of treatment failure in patients with initially localized rhabdomyosarcoma has been local recurrence. Both surgery and radiation therapy are primarily measures taken to produce local control, but each has risks, as well as benefits. Surgical removal of the entire tumor should be considered initially, but only if major functional/cosmetic impairment will not result. With that proviso, complete resection of the primary...
Radiation therapy can stop or slow the growth of bone. The type of bone and joint late effect depends on the part of the body that received radiation therapy. Radiation therapy may cause any of the following:
Changes in the way the face or skull form, especially when treatment is given to children before age 5 or when high-dose radiation is given.
Amputation or limb-sparing surgery to remove the cancer and prevent it from coming back may cause late effects depending on where the tumor was, age of the patient, and type of surgery. Health problems after amputation or limb-sparing surgery may include:
Having problems with activities of daily living.
Not being able to be as active as normal.
Chronic pain or infection.
Problems with the way prosthetics fit or work.
One arm or leg is shorter than the other.
Studies show no difference in quality of life in childhood cancer survivors who had amputation compared to those who had limb-sparing surgery.
Chemotherapy and other drug therapy
Risk may be increased in childhood cancer survivors who receive anticancer therapy that includes methotrexate or corticosteroids or glucocorticoids such as dexamethasone. Drug therapy may cause any of the following:
Osteoporosis (weak or thin bones that can break easily).
Osteonecrosis (one or more parts of a bone dies from a lack of blood flow), especially in the hip or knee.
Stem cell transplant
A stem cell transplant can affect the bone and joints in different ways:
Total-body irradiation (TBI) given as part of a stem cell transplant may affect the body's ability to make growth hormone and cause short stature (being shorter than normal).