Neuroblastoma Facts

Neuroblastoma is a type of cancer that affects children and infants. It forms in the developing nerve cells of an embryo or fetus, and is sometimes detected before birth during a routine ultrasound. According to the Mayo Clinic, there are no known risk factors for developing neuroblastoma, but children born into families with a history of this type of cancer are at a slightly increased risk of developing it themselves. Treatment depends on many factors, but generally includes a combination of surgery, radiation and chemotherapy.

Significance

• According to the American Cancer Society, neuroblastoma typically occurs in young children and infants. The cancer is rarely seen in children over the age of ten years. This type of cancer is the most common cancer to affect infants, and accounts for nearly 7% of all childhood cancers. While some neuroblastomas are detected via ultrasound before birth, most cases are diagnosed between one and two years of age. Unfortunately, two-thirds of neuroblastoma cancers are not diagnosed until after the cancer has spread to other parts of the body.

Cancer Location

• Neuroblastomas are tumors of the sympathetic nervous system, which includes the nerve fibers on both sides of the spinal cord, clusters of nerve cells, or ganglia, that exist at certain points along the path of these nerve fibers, and cells located in the adrenal glands. Approximately one-third of all neuroblastomas begin in the adrenal glands, with another one-third starting in the abdominal sympathetic nerve ganglia. The remaining cases begin in the sympathetic ganglia of the neck, chest, or pelvis. The specific location of the neuroblastoma determines what, if any, symptoms are experienced, according to the American Cancer Society.

Primary Symptoms

• Recognizing the signs and symptoms of neuroblastoma is very difficult, as the symptoms vary widely and depend on the location of the tumor and other factors. The most common symptom in young children is a lump or mass in the abdomen. Children with an abdominal tumor may be reluctant to eat or complain of discomfort or pain in the region. Masses may also occur in the neck, groin, or other areas of the body. Sometimes, symptoms such as pain, loss of bladder control, or swelling may result from a growing tumor pressing on nearby organs or tissues. According to the Neuroblastoma Children's Cancer Society, early symptoms of neuroblastoma are extremely difficult to detect, but a noninvasive urine test can be ordered in suspected cases that is nearly 100% diagnostically accurate.

Symptoms of Metastases

• Once the primary tumor spreads, or metastasizes, to other areas of the body, new signs and symptoms may develop. If the cancer spreads to the bones, the affected child may experience severe pain, weakness, numbness, or even paralysis if nerves become compressed. If the skin becomes affected, purple patches may develop, and symptoms such as tiredness, weakness, irritability, excessive bleeding, and frequent infections may occur if the cancer spreads to the bone marrow. In cases where the neuroblastoma releases hormones, a set of symptoms called paraneoplastic syndrome may develop. Symptoms of paraneoplastic syndrome include fever, rapid heartbeat, constant diarrhea, skin flushing, sweating and high blood pressure.

Prevention/Treatment

• There is no known means of preventing neuroblastoma. Treatment depends on the stage of neuroblastoma upon diagnosis, prognosis markers, and the overall health of the patient. Treatment options include surgery to remove localized tumors, chemotherapy to destroy cancer cells, and radiation therapy. Some children with high-risk neuroblastoma are treated with retinoid therapy. According to the National Cancer Institute, retinoid therapy is thought to slow cancer cell multiplication and help the undeveloped nerve cells involved in neuroblastoma mature into normal, healthy cells. Stem cell transplants may be performed to replace bone marrow damaged by other treatment options.