Neuroblastoma
What is it?
Neuroblastoma is a childhood cancer that grows in parts of the nervous
system. The cancer usually begin in the adrenal glands, which are located
above each kidney. Tumors are most common in the nerve tissue in the neck,
chest, abdomen, or pelvis. A blastoma is a tumor made up of abnormal and
immature cells, and "neuro" refers to the nerves.
Who gets it?
Neuroblastoma is the fourth most common childhood cancer. Around 75% of
all cases of neuroblastoma occur in children under the age of five, while
approximately 60% of all cases occur in children younger than two.
What causes it?
The cause of neuroblastoma is not known. However, because it sometimes
runs in families, it would appear to be an inherited disease.
What are the symptoms?
The symptoms of neuroblastoma depend upon where the cancer began and
whether it has progressed. The first symptoms are usually abdominal pain,
swelling, and feelings of fullness caused by the pressure of the tumor. If
the cancer has spread to the bone, the child may also feel bone pain. If
the cancer has spread to the bone marrow, the child can become anemic, due
to low red blood cells; may get sick easily because of a low red blood
cell count; or may bruise easily because of reduced platelets.
Neuroblastoma that has spread to the eye area causes protruding eyes and
darkened skin around the eyes. Neuroblastoma can also spread to the skin,
producing small bumps, or nodules, and to the spinal cord, which can cause
weakness in the arms or legs and even paralysis. In rare cases, symptoms
can include sudden, uncontrollable eye movements; poor coordination;
sudden muscle spasms and contractions that result in jerky movements; and
watery diarrhea.
How is it diagnosed?
Although neuroblastoma may be present at birth, a diagnosis usually is
not made until the cancer has grown enough to produce symptoms. At this
point, however, the disease may have also spread to other parts of the
body. Your child's doctor will perform a complete physical examination. If
the tumor is large enough, he or she may be able to feel it in the
abdominal area. If your doctor suspects a neuroblastoma, he or she will
order tests that scan the chest and abdomen, such as computed tomography
(CT) and magnetic resonance imaging (MRI). If these tests reveal any
tumors, your doctor will want to take a small tissue sample, called a
biopsy, from the tumor to examine under a microscope. Determining whether
and how far the cancer has spread from its original location is called
"staging," and helps determine treatment. The stages of
neuroblastomas are classified as localized resectable, localized
unresectable, regional, disseminated, or stage IV. A localized resectable
neuroblastoma has not spread to other tissues and can be surgically
removed in its entirety. A localized unresectable neuroblastoma has not
spread to other tissues, but can't be completely removed surgically. A
regional neuroblastoma has spread to the lymph nodes, as well as other
organs and/or tissues in the area immediately around the original tumor,
but hasn't spread to more distant areas of the body. Disseminated
neuroblastoma has spread to more distant areas of the body, including the
lymph nodes and the bone, liver, skin, bone marrow, and/or other organs.
Type IV neuroblastoma, also called ÒspecialÓ neuroblastoma, has spread
only to the liver, skin, and/or to a limited portion of the bone marrow.
Neuroblastoma that is diagnosed as recurrent continues to spread after
treatment, or comes back at a later time.
What is the treatment?
The prognosis for all children with neuroblastoma improves with early
treatment. Localized tumors, which are those that have not spread, can be
surgically removed, either completely or incompletely. Nonsurgical
treatments include radiation and chemotherapy. Radiation therapy uses very
strong x-rays to kill the cancer cells. Radiation can make your child feel
extremely tired and may cause nausea and vomiting. Chemotherapy involves
doses of very strong medicines to kill the cancer cells. Chemotherapy also
has side effects, including hair loss, nausea, vomiting, and extreme
tiredness. These side effects are temporary and will go away once the
radiation and chemotherapy treatments are finished. Your doctor can
prescribe medicine to counteract these side effects if your child cannot
tolerate them. Chemotherapy may also be used before surgery to shrink the
tumor so it is easier to remove. In addition to destroying the cancer
cells, radiation and chemotherapy can kill bone marrow cells. For this
reason, the child's healthy bone marrow can be removed before treatment,
and then replaced later. Diseased or destroyed bone marrow can also be
replaced with healthy bone marrow from a donor, usually a family member.
Children under the age of one and those with small tumors have the best
survival rate.
Self-care tips
There is currently no known way to prevent neuroblastoma.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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