Neuroblastoma is a type of cancer of the nerve tissues and is uncommon. Neuroblastoma mostly affects children below 5 years. Common symptoms of this cancer include a lump in the belly, chest, or neck, decreased appetite, and fatigue.
Neuroblastoma is treated using surgery, radiation, and chemotherapy. The outlook depends on the age of the child, the stage of cancer, and the risk category. Neuroblastoma can be described as pediatric cancer that affects the nervous system and mostly grows in immature nerve tissues known as neuroblasts.
Neuroblastoma usually affects neuroblasts found in the adrenal glands found on top of the kidneys. Adrenal glands are responsible for producing hormones that are responsible for controlling automatic body functions like heart rate, digestion, breathing, and blood pressure.
In some cases, neuroblastoma can also develop in nerve tissue found in the abdomen, spinal cord, neck, or chest and may spread to other body parts. The outlook for children with this cancer depends on the stage of cancer, the location of the tumor, and the age of the child.
How common is Neuroblastoma?
Neuroblastoma is the most common cancer among children although it is very rare. In the United States, for instance, around 800 children are diagnosed with it every year. In most cases, neuroblastoma will occur in children below 5 years although it can also occur in unborn babies. This cancer is very rare in children who are 10 years or older.
Neuroblastoma is classified based on how advanced the cancer is and how quickly it is growing and spreading. During classification, healthcare providers also consider if cancer has metastasized or spread to other parts of the body.
Healthcare providers will use such information to determine the risk level of cancer. Thereafter, they can be able to choose the appropriate treatment. In the past, healthcare providers determined the stage of cancer by finding out how much of it was found in the body after surgery.
Currently, the stage of neuroblastoma is determined using the International Neuroblastoma Risk Group Staging System. This method determines the stage of the cancer by focusing on how much it has spread in the initial imaging studies known as image-defined risk factors. These images can be either on MRI or Ct scan.
The International Neuroblastoma Risk Group Staging System stages of neuroblastoma include:
Neuroblastoma occurs when neuroblasts which are immature nerve tissues grow out of control. Cells of these tissues become abnormal and continue to grow and divide to form a tumor.
These cells grow and divide uncontrollably due to a genetic mutation or a change in the genes of the neuroblast. It is unclear what causes this genetic mutation. However, children with a family history of this cancer are more likely to develop this cancer compared to those with no history of it.
However, it is important to note that almost 99% of the time, cases of neuroblastoma are not inherited. Children who are born with congenital anomalies also known as birth defects are more likely to develop neuroblastoma.
Symptoms of neuroblastoma range from mild to severe. Symptoms of neuroblastoma vary depending on the stage of the disease and the location of the tumor. By the time the symptoms appear, cancer will have spread to other parts of the body.
Symptoms of neuroblastoma include:
Symptoms of neuroblastoma that are likely to appear as the disease progresses include:
Most children with neuroblastoma will receive a diagnosis before they celebrate their 5th birthday. Neuroblastoma is the most common cancer in infants. In some cases, neuroblastoma can be diagnosed during a prenatal ultrasound.
During diagnosis, the healthcare provider will conduct a neurological and physical examination. A neurological exam will help check the child’s reflexes, coordination, and nerve function.
Additionally, the doctor may order additional tests to confirm the diagnosis and to determine if cancer has metastasized. Additional tests done include;
This compound is very specific for neuroblastoma cells. The radiotracer goes to any area where neuroblastoma is. This nuclear medicine helps the doctor determine if the neuroblastoma has spread or not.
However, neuroblastoma tumors in some patients do not take up this compound. In such cases, a PET scan is done to locate all areas of active neuroblastoma cells.
Treatment for neuroblastoma will depend on the age of the child, the location of the tumor and the stage of the disease, and its category. Parents and doctors work together to determine the most appropriate treatment plan for the child based on the risk category.
Risk categories for neuroblastoma include:
other children in this category may need chemotherapy or surgery to remove the tumor or both. The health of the child will be monitored closely.
In some cases, however, chemotherapy is done before surgery to shrink the tumor to improve the chances of the surgery being successful. The number of chemotherapy sessions done depends on the tumor’s response to treatment and certain risk factors.
Those with extra copies of the MYCN gene will need high-risk neuroblastoma treatment no matter the stage they are in. Children who have more of this gene will be treated using the most aggressive treatment because the MYCN gene promotes the abnormal growth of cells. This means that it can cause tumors to grow and spread throughout the body very fast.
The treatment option recommended by the doctor will depend on several factors. Doctors may recommend radiation, chemotherapy, surgery and other treatments to treat neuroblastoma.
Treatments for neuroblastoma include:
Is it possible to prevent neuroblastoma?
It is not possible to prevent neuroblastoma. Parents who have a family history of neuroblastoma or have had neuroblastoma as children should talk to the doctor. It is recommended that genetic counseling is done for all children who have had neuroblastoma to determine if genetic testing is needed.
Genetic testing helps tell if the child has gene markers for inherited neuroblastoma. Inherited neuroblastoma is very rare. Some gene mutations that are passed down through families are likely to increase the risk of neuroblastoma.
For instance, Li Fraumeni syndrome increases the risk for neuroblastoma and other conditions.
The outlook for children with neuroblastoma is different. Cancer outlook is measured by the 5-year survival rate. Children who are younger and with a low to intermediate-risk neuroblastoma have a good prognosis with a 90-95% rate of survival.
The survival rate and prognosis for older children with high-risk neuroblastoma is around 60%. Researchers and healthcare providers are researching to come up with better treatments for this category of patients and the studies look promising.
The prognosis for neuroblastoma depends on the following factors:
Living with neuroblastoma
Parents whose children show any signs and symptoms of neuroblastoma should take their children to the doctor immediately. The prognosis of the child depends on how early the diagnosis is made and how early the treatment begins.
A cancer diagnosis can change the life of the entire family. However, it is not the end. There is hope. Today, researchers and healthcare providers are working to come up with treatments that are likely to greatly improve the prognosis for kids with neuroblastoma.
Researchers have performed several clinical trials with very promising outcomes. More research is still going on. Parents whose children are diagnosed with neuroblastoma should consider joining a cancer support group for emotional support. Sharing experiences and stories of hope can help them feel supported and encouraged.
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