Sourasky Medical Center (Ichilov)
Rhabdomyosarcoma treatment in Israel
Rhabdomyosarcoma develops from a transversely striated (skeletal) muscle and is a colony of modified muscle cells (myocytes). In a result of a number of successive divisions, tumor elements are simplified and become similar to embryonic cells (precursors of muscles) that are rabdomioblasts. The longer the tumor does not being treat, the worse the prognosis for life is as there is the higher risk of metastasing and organ damage around tumors.
In two-thirds of cases, rhabdomyosarcoma affects the children up to 10 years, mainly boys (girls’ rate is in 2 times lower). Overwhelming majority of the illness cases (90%) is up to the age of 25 years.
Types of rhabdomyosarcoma:
- embryonic rhabdomyosarcoma is typical for children and it affects the head and neck;
- alveolar rhabdomyosarcoma develops mainly in adolescents. It affects the large skeletal muscles (quadriceps, triceps, back muscles);
- botryoid rhabdomyosarcoma affects the muscle wall of the internal organs (vagina, urine bladder).
Only in Israel
- assistance is provided by experts of global renown;
- there are specialized clinics for the treatment of various types of sarcomas; Diagnosticians and oncologists of Israel know all the peculiarities of this type of tumors;
- they use the most up-to-date diagnostic equipment;
- excellent survival rates and curability of patients;
- all-day care, patient and family support programs.
70% is an average survival index.
Causes of rhabdomyosarcoma
Major risk factors contributing to the development of rhabdomyosarcoma:
- the irradiation of a mother or a child, especially during pregnancy;
- concomitant genetic abnormalities as Li-Fraumeni syndrome, albinism or neurofibromatosis. The process is more common for children with a giant melanocytic nevus;
- constant contact with carcinogens (including food) and toxic substances.
Rhabdomyosarcoma usually develops in people with immunodeficiency. People infected with HIV, TB, children with any form of anemia are the most vulnerable. It is necessary to pay attention to the children previously treated with chemotherapy. In some cases, rhabdomyosarcoma develops after leukemia.
Symptoms of rhabdomyosarcoma
- some tumors above the skin surface. They are painless and aren’t red; subdermal formation is dense and elastic;
- after a while, there is some pain due to compression of the nerve endings by growing tumor;
- bleeding and ulceration of sarcoma may occur;
- regional lymph nodes are increased;
- weakness is developing, the body weight is decreasing. There may be some intestinal dysmotility, nausea, loss of appetite.
Depending on the location of the main tumor, the disease manifests itself as follows:
- unilateral exophthalmos (proptotic eyes) due to the location of rhabdomyosarcoma in the orbit;
- blood-tinged discharges from the ear canal when the tumor is in the middle ear;
- nose bleedings, nasal congestion when the tumor is in the nasal passages;
- scrotal edema, blood in semen;
- blood in the urine, the symptoms of cystitis (painful urination, pain шт lower abdomen) when the urine bladder wall is affected.
The symptoms at different stages of rhabdomyosarcoma:
|
Stage 1 |
Stage 2 |
|
nearly invisible tumor, no local reactions |
visible (subdermal) tumor, some pain, redding |
|
Stage 3 |
Stage 4 |
|
intense pain, enlarged lymph nodes |
damage and dysfunction of organs, metastasing |
Rhabdomyosarcoma diagnostics in Israel
- the main method of rhabdomyosarcoma diagnostics is an MRI. The method allows to precisely localize the process, its relationship with the surrounding structures. Tumor is located deeply in the soft tissues and is not very different from the structure, so radiographic techniques are less effective;
- MSCT for metastases screening and localization;
- PET-CT for the determination of small foci of metastasis;
- Ultrasound is used as a preliminary screening. As a rule, ultrasound is used with Doppler sonography;
- scintigraphy is used for the diagnostics of bone metastases;
- biopsy is used to determine the type of tumor. it does not only confirms the diagnosis, but also affects the intensity and duration of chemotherapy (it determines the invasiveness of the process and makes prognosis);
- searching for tumor markers in the blood helps to confirm the ongoing process if there are difficulties in finding the primary focus.
Methods of rhabdomyosarcoma treatment in Israel
Israeli oncologists achieve excellent results even with common processes (3A-B stage):
- surgical treatment. The entire tumor or most of it is removed (if the complete excision is not possible), as well as regional lymph nodes, and concerned tissues and organs;
- chemotherapy of rhabdomyosarcoma. Israeli chemotherapists use innovative combinations of cytostatics and hormones, that increases the sensitivity of the tumor to treatment. On the 4th stage of the disease it is the main method. Targeted chemotherapy helps to achieve the maximum concentration of drug in the tumor body;
- radiation therapy is applying in 2 months after chemotherapy. The impact is produced on the operated area of the body. With rhabdomyosarcoma of the central nervous system, radiation therapy is applied before chemotherapy;
- transplantation of bone marrow stem cells. It is used due to destroying own stem cells by the necessary for the treatment doses of chemotherapy. When transplantation is possible, your doctor may significantly increase the dosage of chemotherapy drugs with no hesitating of subsequent complications such as aplastic anemia.
Review: a four-month-old infant with rhabdomyosarcoma
When my son was 4 months, doctors have found rhabdomyosarcoma. We had conducted 4 courses of chemotherapy and two surgeries, then aplastic anemia began. The doctor said that haemopoiesis was disrupted and we needed a bone marrow transplantation.
After the examination of relatives, it turned out that my brother can be a bone marrow donor. We have conducted stem cell transplantation.
Now the boy is 2 years old, he is often sick, but there are no tumor signs anymore. We take drugs (necessary for normal functioning of the transplanted bone marrow).”
Valentina, Turkmenistan
Rehabilitation after rhabdomyosarcoma removal, prevention of recurrence
Prediction for patients depends on the process stage. Even at the 4th stage, the five-year survival rate exceeds 30% (alveolar form of the disease). Careful attention to a patient after surgery and intensive chemotherapy allows to achieve full cure in 70% of all patients with rhabdomyosarcoma.
It is recommended to make regular visits to the oncologist (every 2 months during the first year after surgery) and periodic screening of tissues:
- in the area of the removed tumor;
- plain radiography of thoracic organs;
- liver ultrasound.
Two recent studies allow quick identifying metastases in the process expansion.
Cost of rhabdomyosarcoma treatment in Israel
- Prices for cancer center services in Israel are controlled by the state. This allows you to plan ahead the medical tour and optimize costs;
- The cost of treatment is 20% lower than in Switzerland, the USA and Germany (the national average);
- Bookimed company helps to avoid payment of intermediaries, that significantly reduce the overall cost of treatment;
- High level of service due to which the patient and his/her family receive all the necessary support during treatment and the rehabilitation period.