ABSTRACT
Rhabdomyosarcoma Rhabdomyosarcoma1 is a highly malignant soft tissue tumour that requires aggressive multimodal therapy. It has often metastasised by the time of diagnosis.
Setting the scene: Part 1 Adam is 15 years old and has suffered from an orbital rhabdomyosarcoma for the past 2 years. He now has spinal secondaries and has been in severe and poorly controlled pain. He is receiving palliative care at home. A subcutaneous syringe driver with morphine sulphate and cyclizine was commenced 1 week ago, as well as an oral antidepressant, a muscle relaxant and an anticonvulsant. Adam is now much more comfortable. He has short bouts of energy, when he is able to be up in his electric wheelchair, which alternate with prolonged periods of exhaustion and very low mood. He feels that he has a lot of unfinished business to attend to, and he gets frustrated at the short time he has left. He is very keen on planning his own funeral and wants his friends from school to be involved. He has requested that his corneas be donated, but this request has been rejected emphatically by his adoptive parents.
