A complete guide to neuroblastoma, its causes, symptoms and treatment

Neuroblastoma is a rare cancer that mainly affects children. It starts in the early form of the cells that make up the nerves. Sometimes neuroblastoma tends to grow slowly. In many cases, it spreads quickly. In other cases, it gradually disappears without treatment.

What is Neuroblastoma?

In case of Neuroblastoma in babies, the immature nerve cells, known as neuroblasts, become cancerous. It means that they begin to grow and multiply uncontrollably.

It can affect any part of their sympathetic nervous system. This sympathetic nervous system happens to be a part of the autonomic nervous system that the body uses to regulate most of its crucial functions.

In most cases, Neuroblastoma in babies starts in the abdomen. In some babies, the condition starts in the adrenal gland. In the rest of the cases, it starts near the spine in the neck or chest, or in the pelvis.

Now that you know What is Neuroblastoma?Let’s move on to the other details related to it.

symptoms of neuroblastoma

The symptoms of neuroblastoma and signs vary based on which part of the body is affected.

The occurrence of neuroblastoma in children, the most common type, can lead to symptoms and signs such as:

  • Stomach ache
  • Changes in bowel habits, such as constipation or diarrhea
  • A mass under the skin that is not soft to the touch

Neuroblastoma cancer in the chest can lead to symptoms and signs such as:

  • chestpain
  • Wheezing
  • Changes in both eyes, such as unequal pupil size and droopy eyelids

Some of the other symptoms and signs of Neuroblastoma in children include the following:

  • A fever
  • backache
  • Nodules of tissue present under the skin
  • Dark circles, almost like bruises, around the eyes
  • Proptosis (eyeballs protrude from sockets)
  • bone pain
  • Unexplained weight loss
Neuroblastoma causes

Generally, Neuroblastoma cancer begins with a kind of genetic mutation that allows healthy, normal cells to multiply without any reaction to the signals that stop multiplication, as in normal cells. The buildup of abnormal cells leads to a mass called a tumor.

Neuroblastoma in children begins in neuroblasts, which are immature nerve cells that make fetuses during the developmental process.

When the fetus begins to mature, these neuroblasts mature into nerve fibers and cells that form the adrenal glands and other sympathetic nerves. As such, most neuroblasts begin to mature at birth, although a smaller number of immature neuroblasts are seen in neonates. independently of Neuroblastoma Causes, it tends to disappear or mature in most cases. Others, however, form the kind of tumor called neuroblastoma.

The kind of initial genetic mutation that can lead to neuroblastoma is still not clear.

Risk factors

Children with a family history of Neuroblastoma are more likely to get the disease. And yet, familial neuroblastoma only affects a small fraction of neuroblastoma cases. In most cases of Neuroblastomathe cause has not been identified.

Diagnostics

The child with symptoms and signs will undergo imaging with ultrasound, CT scan, or PET-CT. A biopsy of the tumor is then done to confirm the diagnosis. Based on the biopsy report and the findings in the image, the diagnosis is made and the staging of the neuroblastoma is confirmed. Bone marrow aspiration and biopsy may also be necessary to stage the disease. Other basic blood tests and ECHO will be done before starting treatment.

A special intravenous access called a central line may be placed for children with intermediate-risk and high-risk neuroblastoma to avoid poking the child for every blood test and injections.

neuroblastoma treatment

Your child’s doctor chooses a neuroblastoma treatment plan depends on a number of influencing factors Neuroblastoma prognosisThe factors include:

  • the stage of the cancer
  • your child’s age
  • the type of cells involved in the cancer
  • abnormalities in the genes and chromosomes

surgery

Surgeons use their scalpels and similar surgical instruments to remove cancer cells. In children with a lower risk Neuroblastoma prognosissurgery to remove the tumor may be the only treatment needed.

Whether this tumor can be completely removed depends on its location and size. Also, tumors are attached to nearby vital organs and can be difficult to remove, in which case the child may require chemotherapy and/or radiotherapy.

In high- and intermediate-risk neuroblastoma, surgeons may attempt to remove most of the tumor. Other types of treatments involving Neuroblastoma may be helpful in killing the rest of the cancer cells.

chemotherapy

Chemotherapy uses chemicals to destroy cancer cells. It targets the rapidly growing cancer cells in the body. However, it also affects healthy cells that grow rapidly, such as cells in the gastrointestinal tract and hair follicles.

Children with intermediate- and high-risk neuroblastoma are usually given a combination of several chemotherapy drugs before their surgery to increase the chances of shrinking the tumor and killing the cancer cells that have spread to other parts of the body.

Depending on the response to initial chemotherapy, children with high-risk neuroblastoma receive higher doses of chemotherapy, followed by stem cell transplantation of their own healthy cells to prevent future recurrence of the tumor.

radiation therapy

Radiation therapy uses high-energy rays such as X-rays to destroy cancer cells. Children with intermediate- or low-risk neuroblastoma tend to receive radiation therapy in case chemotherapy and surgery have not been entirely helpful. Children with high-risk neuroblastoma undergo radiation therapy after completion of high-dose chemotherapy followed by stem cell transplantation to prevent complications during treatment.

This type of therapy mainly affects the part it targets, although some healthy cells may be damaged by the radiation. The side effects that your child will experience depend on the part that this radiation is aimed at and the amount of radiation that is administered.

Bone marrow transplant

Children with high-risk neuroblastoma can receive transplants using stem cells collected from their own blood, ie autologous stem cell transplantation.

Before a bone marrow transplant, also called a stem cell transplant, the children go through a process where stem cells are collected from their blood and filtered. These stem cells are safely stored for later use. After this, they receive chemotherapy, undergo surgery, and receive higher doses of chemotherapy to eliminate the rest of the cancer cells. At a scheduled date after high-dose chemotherapy, the stored stem cells are thawed and injected back into the body as a blood transfusion to form healthy, new blood cells.

maintenance therapy

All children with high-risk neuroblastoma are given a drug called 13 cis-retinoic acid after radiotherapy to prevent recurrence and to help with the maturation of the remaining neuroblasts. At least 6 courses of this drug are given.

Immunotherapy

Immunotherapy uses drugs that do their job by signaling the body’s immune system to help fight cancer cells. Children with high-risk neuroblastoma may receive immunotherapy to boost the immune system and kill the neuroblastoma cells.

See a doctor and seek the right treatment to relieve the symptoms and find a cure for neuroblastoma.

Neuroblastoma, when diagnosed at an early stage, is completely curable. In later stages, cure rates decrease and require multimodal treatment as mentioned above.

Dr. Shobha Badiger | Consultant bone marrow transplant, hemato-oncology, oncology, oncology – pediatrics | Mazumdar Shaw Medical Center, Bommasandra, Bangalore

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