What Is Neuroblastoma?
Neuroblastoma is one of the most frequently occurring childhood cancers. It develops outside the brain. It represents nearly 8 per cent childhood cancers. The patients are diagnosed approximately at the age of two.
Neuroblastomas are formed in the nerve cells that are in charge of the body’s "fight-or-flight" reaction, which is the ability to response to a life-threatening emergency. These nerve cells structure the sympathetic nervous system.
Neuroblastomas are normally molded in one of two parts of the sympathetic nervous system:
* The adrenal glands - These glands are situated in the abdominal area. They produce the adrenaline, a hormone that is released in an emergency to help the body response. When a neuroblastoma develops in the adrenal gland, it usually grows into a large, firm abdominal mass that is able to compress nearby organs.
* The chain of sympathetic ganglia - These consist of collections of nerves near the backbone (spine). When a neuroblastoma occurs along the sympathetic chain, it may attack nearby areas of the spine and lead to injury to spinal nerves.
Neuroblastomas may also occur in other areas of the body, such as the chest, neck and pelvis, however this is not so widespread.
While a neuroblastoma is growing, it is very likely to spread (metastasize) to other areas, most frequently to the bone marrow, bones, liver and skin.
Scientists have not discovered any convincing evidence that neuroblastoma is associated with any toxic chemical substance or environmental risk factor. Genetic (inherited) factors appear to affect the development of some neuroblastomas.
Symptoms
The most common symptoms of a neuroblastoma are:
* A firm mass in the abdomen, with or without abdominal pain or discomfort
* Problems with breathing (caused by the abdominal mass pressing on the infant’s chest and lungs)
* Weight loss or lack of gain weight (called failure to thrive)
* Anemia (a low number of red blood cells)
* Fever and irritability
* Bone pain
* Neurological symptoms if the tumor destroys nearby nerves, such as paralysis, difficulty swallowing, problems with walking, uncontrolled eye movements, a drooping eyelid, or jerky or uncontrolled limb movements
* Protruding eyes or dark circles around the eyes ("panda eyes")
* Symptoms caused by chemical substances produced by the tumor, such as high blood pressure, rapid pulse, flushing, sweating or diarrhea
Sometimes, a child’s neuroblastoma is diagnosed accidentally before it expresses any symptoms. The tumor is found in the chest or abdominal area when the child has an X-ray to be tested for some not linked disease.
Diagnosis
Your healthcare provider will review your child’s symptoms and observe the child. The physician will order blood and urine tests and X-rays. A computed tomography (CT) scan or magnetic resonance imaging (MRI) is frequently necessary to provide further detail.
If any of these examinations reveal symptoms of a cancerous (malignant) tumor, your physician will refer you to a medical center that is in the possession of the appropriate facilities, staff and experience to treat childhood cancer. There, your child will undergo additional examinations in order to acknowledge the diagnosis of neuroblastoma. These can include a biopsy, in which a small piece of the tumor is removed and scrutinized in a laboratory. A sample of bone marrow also may be removed.
Expected Duration
In the majority of cases, neuroblastoma will keep on growing until it is fully treated. Without appropriate treatment, the cancer is likely to spread to the bone marrow, bones, liver, skin and other parts of human body. Very seldom, normally in children below one year old, neuroblastomas decline in size sooner or later and do not require aggressive treatment.
Prevention
Neuroblastoma is impossible to prevent. Nevertheless, due to the fact that genetic factors appear to play crucial role in the development of this cancer, people with a strong family history of cancer, particularly childhood cancer, might be willing to ask their healthcare providers about the necessity for genetic examination before setting up a family.
Treatment
The treatment of neuroblastoma is dependent on how much it has already spread. This is known as the tumor stage. Tumor stage is determined by how many of the cancerous cells are possible to be removed surgically and whether the illness has spread to nearby lymph nodes or to distant organs.
Here are all the stages of neuroblastoma:
* Localized neuroblastoma – In this case the tumor has not spread. If it is localized and is possible to be removed entirely during surgery, additional treatment may be not necessary. If it happens that the tumor is localized but it can’t be removed entirely, the child will require chemotherapy. After chemotherapy, the child may have to undergo another surgery in order to remove any remaining tumor. This may be followed by radiation therapy.
* Regional neuroblastoma – This type of neuroblastoma has spread to local lymph nodes or to nearby tissues or organs, however it has not spread to areas further away. A regional neuroblastoma is cured with a mixture of surgery and chemotherapy. Older children can undergo radiation therapy as well.
* Disseminated neuroblastoma - A disseminated neuroblastoma has already spread to various distant organs or tissues. This is the most widespread stage of the disease, at which children can be diagnosed. This advanced stage is usually treated with aggressive chemotherapy, with or without surgery or radiation.
* Special neuroblastoma, also known as stage IVS neuroblastoma - In special neuroblastoma, the tumor is fairly localized, however the cancer has partly spread to the liver, skin or bone marrow. Normally, this stage occurs in infants younger than twelve months. In the majority of cases, children with tumors of this stage do very well. This treatment appears to be controversial, due to the fact that some physicians apply only moderate chemotherapy and other physicians choose a watch-and-wait approach.
When To Contact A Specialist
Contact your healthcare provider immediately if your child demonstrates symptoms of neuroblastoma, particularly if your child has an unusual fullness or swelling in the abdominal area.
Prognosis
If treated, nearly 90 per cent of children with localized neuroblastoma or special neuroblastoma can be cured. You can take a genetic test in order to better estimate a child’s prognosis. Neuroblastoma that has spread to the surrounding area or to other areas has a worse outlook. Nevertheless, the vast majority of children react to treatment of this cancer even in advanced stages. Children suffering from special neuroblastoma may do perfectly well without any treatment, however they still require close observation by a professional.
