Neuroblastoma in children
Neuroblastoma is a rare
childhood cancer of the so-called “sympathetic nervous system,” the network of
nerves that relay messages from your brain to the rest of your body.
Cancer most often starts
around the adrenal glands, the hormone-producing organs that sit above the
kidneys and have nerve-like cells. But neuroblastoma can also occur in other
areas of the body where groups of nerve cells stick together.
Doctors most often diagnose it
in children under 5 years of age. Rarely seen in children over 10 years of age.
There are several treatments
that help many children with neuroblastoma survive and lead healthy lives.
Parents also have resources they can turn to after receiving a diagnosis.
What are the reasons?
As a rule, cancer begins with
changes in certain cells of the human body. The changes allow these cells to
grow uncontrollably. They can form tumors and often prevent cells from doing
what they normally should.
In neuroblastoma, mutations
affect the immature nerve cells of a child still in the womb. The cells are
called neuroblasts. As the baby continues to grow until birth, neuroblasts
develop into functional nerve cells.
In a healthy child,
neuroblasts completely disappear as the nervous system matures. But in infants
with the disease, the mutated neuroblasts remain and form a tumor.
Symptoms
They vary greatly depending on
the location of the tumor, its size and stage of growth. Many of the symptoms
may indicate conditions other than neuroblastoma.
In the baby's abdomen, it can
cause:
- Lumps or swelling in the belly
- Stomach pain or a constant feeling of being full, which can lead to weight loss
- Swelling in the child’s legs or in the scrotum caused by tumors pressing against blood and lymph vessels
- Problems peeing or having bowel movements
In the cheek or neck, it might
cause:
- Swelling in the face, neck, arms, and chest
- Headaches and dizziness
- Coughing or trouble breathing or swallowing
- Changes to the eyes, including drooping eyelids and unequal pupil sizes
Disseminated neuroblastoma can
cause symptoms such as:
- Enlarged lymph nodes. They feel like hard bumps in the armpits, neck, or groin. Although they are most often a sign of an infection, they can be the result of cancer that has spread to the lymphatic system.
- Bone pain, weakness in the legs or arms, and bruising around the eyes can be caused by cancer that has spread to the bones.
- If neuroblastoma affects the bone marrow that produces blood cells, the child may be tired, irritable, weak, and have many bruises and infections.
Two more signs to look out
for:
- A special and common type of neuroblastoma that only occurs during the first few months often causes blue or purple bumps that look like small blueberries. This is a sign that the cancer may have spread to the skin. It responds well to treatment and often decreases or disappears on its own.
- Hormone-secreting neuroblastomas can cause other symptoms such as persistent diarrhea, fever, high blood pressure, sweating, and flushing of the skin.
Diagnosis
Because many of the symptoms
can be caused by more common conditions, your doctor will need to do lab tests,
scans, and a biopsy to make sure your child has this rare cancer. This
includes:
- Blood and urine tests.
They measure the levels of hormones in the blood that can be produced by
neuroblastomas.
- Image tests.
This can help doctors determine how far the cancer has spread.
- Ultrasound. It
may look for tumors in the abdomen.
- X-rays.
They can detect cancer in the chest and bones.
- Other types of analysis.
You may have a CT scan, positron emission tomography (PET), or magnetic
resonance imaging (MRI) so your doctor can determine where the neuroblastoma is
and whether treatments are working.
- Biopsy. The doctor may take a sample of the tumor or bone marrow. The lab will test the sample for cancer.
You can also have lab tests
that measure your blood cell count, liver and kidney function, and salt balance
in your body.
Neuroblastoma is a cancer that
can be treated. The extent to which the cancer has spread is the most important
factor in determining whether a child can be cured. The younger the age at
diagnosis, the better the survival rate.
Treatment
The type of treatment your
child will receive will depend on several factors. They include:
- The “stage” of the cancer.
- The age of your child
- Where the tumor started
- How the tumor is expected to respond to treatment
The types of treatment your
child may receive include:
- Surgery. Takes out the tumor.
- Chemotherapy. Your child is given chemicals to kill cancer cells.
- Radiation therapy.
This uses high-energy beams, such as X-rays, to kill cancer cells.
- Transplantation of stem cells. Your doctor takes your child's own blood stem cells, uses
chemotherapy to kill cancer cells, and then injects healthy cells back into his
body.
- New methods of treatment. These include immunotherapy, which works by signaling
your child's immune system to help fight cancer cells.
Can I reduce my child's chances of getting it?
In a small percentage of
neuroblastoma cases, children inherited the genetic problem from their parents,
making them more likely to get it.
However, there are no other
causes that cause neuroblastoma.
Unlike many adult cancers, problems such as body weight, diet, exercise, and exposure to toxins and chemicals are not thought to be related to the disease.