Neuroblastoma is a cancer that most often affects children. It’s very uncommon. Neuroblastoma begins in the early forms of the cells that make up the nerves. Neuroblastoma can develop slowly at times. In certain instances, it can easily spread. It sometimes vanishes on its own.
By the time doctors detect it, the cancer has normally spread. Cancer cells in younger children, on the other hand, will also die on their own. The cells may also become benign, which means they are no longer harmful.
This article will outline the signs, stages, causes, diagnosis, and treatment of neuroblastoma.
What is it?
Neuroblasts, or immature nerve cells, become cancerous in children with neuroblastoma. This means they multiply and grow out of control.
Any portion of the sympathetic nervous system may be affected by neuroblastoma. The sympathetic nervous system is a component of the autonomic nervous system, which regulates many of the body’s most important functions.
The majority of neuroblastomas begin in the abdomen. The adrenal gland is where half of the process starts. The majority of the rest begin in the pelvis or near the spine in the chest or neck.
Per year, approximately 800 new cases of neuroblastoma are diagnosed in the United States, according to the American Cancer Society.
Neuroblastoma symptoms differ depending on where the cancer is located in the body.
The following are some of the more common symptoms:
- a painless lump in the abdomen, chest, pelvis, or neck
- swelling of the upper chest, neck, and face
- swollen legs
- chest pain
- weight loss
- persistent cough
- back pain
- leg weakness, numbness, or paralysis
- skin lesions or nodules, which may be blue or purple in color
If neuroblastoma has spread to the bones, it can cause pain. As a result, a child might:
- not want to walk
- not be able to walk
In the eyes
Caregivers can also notice that a child is having problems with his or her eyes, such as:
- bulging out
- dark circles under the eyes
- problems with vision
- black eyes or bruising around the eyes
- a droopy eyelid
- a constricted, smaller pupil
- change in color of the iris
- rotating movements of the eyes
Neuroblastoma’s exact cause is unclear.
Neuroblastoma occurs when developing nerve cells become cancerous, according to St. Jude Children’s Research Hospital. It may happen during pregnancy or after birth.
Neuroblastoma is a cancer that can be passed on over the generations. This suggests that biological parents who have a personal or family history of the disease will be able to pass it on to their offspring.
A healthcare practitioner should use one of two staging schemes, according to the American Society of Clinical Oncology:
The International Neuroblastoma Staging System Committee (INSS) is a system for determining the stage of neuroblastoma.
- Stage 1: Surgery can successfully remove the entire tumor. Local lymph nodes do not contain cancer, although ones attached to the tumor may.
- Stage 2A: Surgery is unable to remove the entire tumor, but the tumor has not spread. Nearby lymph nodes do not contain cancer.
- Stage 2B: Surgery may or may not be able to remove the entire tumor. The tumor has not spread, but nearby lymph nodes do contain cancer.
- Stage 3: Surgery cannot remove the tumor, and cancer has spread to nearby lymph nodes or other areas near the tumor. Cancer has not spread to other parts of the body.
- Stage 4: The tumor has spread to lymph nodes in parts of the body away from its original site, or to the bones, bone marrow, liver, skin, and other organs.
- Stage 4S: The physical tumor is only where it originally began, however, it has spread to the liver, skin, and/or bone marrow in children under 1. Usually, less than 10% of bone marrow cells show cancer.
The International Neuroblastoma Risk Group Staging System (INRGSS) system
Since various countries use different staging methods, comparing the findings of international studies can be difficult. This framework was created by researchers to help with this issue.
The INRGSS makes use of image-defined risk factors (IDRFs), which are factors that could make removing the tumour more difficult. There are four steps to it:
- L1: The tumor has not spread into vital structures of the body, and is confined to one area, like the neck, chest, or stomach. There are no IDRFs.
- L2: The tumor has not spread far from where it originated but does have at least one IDRF.
- M: The tumor has spread to other parts of the body.
- MS: The tumor has spread to only the skin, liver, and/or bone marrow in children younger than 18 months. Upon examination, less than 10% of marrow cells are cancerous.
The prognosis for a child is determined by the risk category in which they are placed. In the United States, doctors also use risk classes to categorise and estimate how likely a child’s therapy would be to heal him or her.
Doctors divide patients into risk categories based on a variety of factors, including the stage of the neuroblastoma and the child’s age at the time of diagnosis. A person should speak with a doctor about their specific risk groups.
- Low-risk group: In the low-risk group, children have a 5-year survival rate that is higher than 95%.
- Intermediate-risk group: For children in the intermediate-risk group the 5-year survival rate is between 90% to 95%.
- High-risk group: Children in the high-risk group have a 5-year survival rate of approximately 40% to 50%.
It’s worth noting that researchers looked at data from 5 years ago to come up with these 5-year survival rates. Given the advancements in medicine during that time period, these rates may have increased.
Children vs. adults
Adult neuroblastoma is highly rare. Every year, it affects one out of every ten million adults.
Adults with neuroblastoma have a much worse prognosis than infants, with a 5-year survival rate of 36.3 percent on average.
Early detection, on the other hand, will help care be more successful.
Vs. Wilm’s tumor
Nephroblastoma, also known as Wilm’s tumour, is a disease that has signs and symptoms that are similar to neuroblastoma.
Wilm’s tumour is the most common type of kidney cancer in children, as well as the most common type of abdominal cancer. It normally affects children between the ages of three and five.
Every year, approximately 650 new cases of Wilm’s tumour are diagnosed in the United States.
Depending on the stage of the disease, there are a few different treatment options for neuroblastoma.
Neuroblastoma treatment options include:
- Surgery: This involves an operation to remove as much of the tumour as possible. Surgery may be the only option for a child whose tumour has not spread across the body.
- Chemotherapy: This is normally reserved for children who are at intermediate or high risk.
- Radiation: This entails killing cancer cells with high-energy rays such as X-rays.
Children with neuroblastoma require imaging scans for diagnosis, staging, treatment planning, and follow-up. Imaging tests include the following:
- magnetic resonance imaging (MRI) scan
- computed tomography (CT or CAT) scan
- positron emission tomography (PET) scan
These scans will assist doctors in developing a care plan that is tailored to the specific needs of each child.
Following the completion of neuroblastoma therapy, children may develop other health problems.
They can include:
- growth and development issues
- hearing loss
- bone or muscle issues, such as scoliosis, a curving of the spine
- thyroid problems
- neurological problems
- second cancers, including leukemia
- emotional or psychological difficulties
- problems with fertility
The likelihood of having these late effects varies based on a number of factors, including the medications used during treatment, their dosage, and the child’s age at the time of treatment.
A neuroblastoma diagnosis can be very upsetting for both the child and the caregiver. It is important to seek treatment, and there are many mental health services available.
The most common cancer in children is neuroblastoma. While it shares many symptoms with other illnesses, parents can take their children to the doctor if they experience any signs or symptoms, such as bone pain or inability to walk.
The prognosis for a child with neuroblastoma is dependent on a variety of factors, but it may be as high as 95 percent in some cases.
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- Dumba, M., et al. (2014). Neuroblastoma and nephroblastoma: An overview and comparison.
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- Zhang, H., et al. (2019). Adrenal neuroblastoma in an elderly adult: A case report and review of the literature.