A type of cancer known as neuroblastoma arises from immature nerve cells, which can be found throughout the body.
The adrenal glands, which are located atop the kidneys and have origins akin to nerve cells, are where neuroblastoma most frequently occurs. Nevertheless, neuroblastoma can also arise in other abdominal regions, as well as in the neck, chest, and vicinity of the spine, where nerve cell clusters are present.
Though it can sporadically affect older children, neuroblastoma primarily affects those who are 5 years of age or younger.
While some types of neuroblastoma resolve on their own, others might need several treatments. The neuroblastoma treatment options for your child will vary depending on a number of factors.
Symptoms
The body part affected by neuroblastoma affects the signs and symptoms that appear.
The most common type of neuroblastoma in the abdomen can present with symptoms and signs like:
- stomach ache
- a lump beneath the skin that is not sensitive to touch
- alterations in digestive patterns, such as constipation or diarrhoea
Chest neuroblastoma symptoms and indicators could include:
- Sighing
- chest ache
- alterations to the eyes, such as uneven pupil size and drooping eyelids
Additional indications of neuroblastoma symptoms and indicators include:
- tissue lumps beneath the skin
- eyes that appear to be sticking out of their sockets
- like bruises, dark circles form around the eyes.
- back discomfort
- high temperature
- unexpected weight reduction
- bone ache
Causes
Cancer usually starts from a genetic mutation that keeps healthy, normal cells from stopping their growth in spite of signals telling them to, which healthy cells do. Cancer cells proliferate and grow uncontrollably. The aberrant cells build up to form a mass known as a tumour.
A foetus produces neuroblasts, which are immature nerve cells, as part of its development process. This is where neuroblastoma starts.
Neuroblasts eventually develop into nerve cells, fibres, and the cells that comprise the adrenal glands as the foetus grows. Though a tiny percentage of immature neuroblasts can be detected in newborns, the majority of neuroblasts mature by birth. These neuroblasts usually mature or vanish. On the other hand, some develop a neuroblastoma tumour.
Complications
Neuroblastoma complications can include:
The cancer’s metastasis, or spread. It is possible for neuroblastoma to metastasize, or spread, to other body parts like the liver, lymph nodes, bone marrow, skin, and bones.
Tompression of the spinal cord. Spinal cord compression can result from tumours that enlarge and press against the spinal cord. Pain and paralysis may result from compression of the spinal cord.
Symptoms and indicators brought on by tumour secretions. Neuroblastoma cells have the potential to release specific chemicals that can cause irritation to normal tissues, leading to symptoms known as paraneoplastic syndromes. There is a rare paraneoplastic syndrome that causes rapid eye movements and coordination problems in individuals with neuroblastoma. Diarrhoea and swollen abdomens are symptoms of another uncommon syndrome.
Treatment
The doctor for your child chooses a course of treatment based on a number of variables that impact your child’s prognosis. The age of your child, the cancer’s stage, the kind of cells causing it, and any chromosomal or genetic abnormalities are among the variables.
Based on these details, the physician treating your child will determine whether the cancer is low, intermediate, or high risk. Depending on their risk category, your child’s neuroblastoma treatment or course of treatment may vary.
Operation
To remove cancer cells, surgeons employ scalpels and other surgical instruments. The only treatment required for children with low-risk neuroblastoma may be surgery to remove the tumour.
The tumor’s size and location determine whether it can be entirely removed. It might be too dangerous to remove a tumour that is connected to one or more nearby critical organs, like the spinal cord or lungs.
When treating neuroblastomas that are high-risk or intermediate-risk, surgeons may attempt to remove the tumour as much as possible. The remaining cancer cells may then be killed with additional treatments like radiation and chemotherapy.
Chemotherapy
Chemicals are used in chemotherapy to kill cancer cells. Chemotherapy goes after the body’s fast proliferating cells, including cancerous ones. Regrettably, side effects may result from chemotherapy’s damage to rapidly growing healthy cells, including those in the gastrointestinal tract and hair follicles.
To increase the likelihood that the entire tumour can be removed during surgery, children with intermediate-risk neuroblastoma frequently receive a combination of chemotherapy medications prior to the procedure.
High dosages of chemotherapy are often given to children with neuroblastomas that are at high risk in order to reduce the tumor’s size and eradicate any cancer cells that may have spread to other parts of the body. Chemotherapy is typically administered prior to bone marrow transplantation and surgery.
Radiation treatment
High-energy beams, like X-rays, are used in radiation therapy to kill cancer cells.
If chemotherapy and surgery aren’t working for children with low-risk or intermediate-risk neuroblastoma, radiation therapy may be used. After chemotherapy and surgery, children with high-risk neuroblastoma may receive radiation therapy to stop the cancer from coming back.
Although the primary effect of radiation therapy is localised, certain healthy cells may be harmed by the radiation. How much radiation is given and where it is directed will determine what side effects your child has.
Transplantation of bone marrow
Children diagnosed with neuroblastoma at high risk may be eligible for an autologous stem cell transplant, which involves the use of bone marrow-derived stem cells.
Your child will go through a process that separates and gathers stem cells from his or her bloodstream prior to the bone marrow transplant, also referred to as a stem cell transplant. The stem cells are kept for potential future use. Subsequently, your child’s body is treated with high dosages of chemotherapy to eradicate any leftover cancer cells. After that, your child’s stem cells are injected into their body so they can develop into new, healthy blood cells.
Immunotherapy
Drugs used in immunotherapy stimulate your body’s immune system to fight cancer cells. Drugs known as immunotherapy, which stimulate the immune system to kill neuroblastoma cells, may be given to children with high-risk neuroblastoma.
Newer treatments
Researchers are looking at a more recent type of radiation treatment that might be able to manage neuroblastomas at high risk. A radioactive version of the drug metaiodobenzylguanidine (MIBG) is used in the procedure. The MIBG reaches the neuroblastoma cells after being injected into the bloodstream, where it releases radiation.
MIBG treatment is occasionally coupled with bone marrow transplantation or chemotherapy. Your child will need to stay in a special hospital room after receiving an injection of the radioactive MIBG until the radiation leaves their body through their urine. MIBG treatment typically requires a few days.
