What is neuroblastoma?
Neuroblastoma is a cancerous disease that affects the nerve cells. It usually begins from the sympathetic nervous system and attacks an immature or a developing cell. Neuroblastoma mostly affects young children age 5 and below while it is less common amongst children who are over 10 years and above.
The sympathetic nervous system
This is a part of the autonomic nervous system which includes nerve fibers that run along either side of the spinal cord and aggregates of nerve cells at a particular place along the nerve fibers route. The brain, spinal cord, and the nerves all make the human nervous system. We all need the nervous system to enable us to move, think and also have immense sensation towards things. Also, the autonomic nervous system is a part of the nervous system that controls your blood pressure, heart rate, digestion, breathing, and all other functions.
The sympathetic nervous system forms part of the autonomic nervous system which includes:
- Aggregates of nerve cells known as ganglia at particular points along the path of the nerve fibers.
- Nerve fibers that run on either side of the spinal cord.
- Nerve-like cells present in the medulla (center) of the adrenal glands.
The adrenals are basically small glands that sit on top of each kidney. These glands produce hormones like the adrenaline (epinephrine) that help regulate blood sugar, heart rate, blood pressure, and how the body responds to stress.
The main cells that constitute the nervous system are known as neurons or nerve cells. These cells interact with several other cells in the body by releasing minute amounts of chemicals called hormones. This is important because neuroblastoma cells often bring about certain chemicals that can cause symptoms.
Consequently, some neuroblastomas may grow and spread rapidly, while others tend to grow slowly. The cancer cells may die freely and the tumor isn’t found especially amongst very young children. Sometimes, the cells mature on their own into normal ganglion cells and stop replicating, therefore, making the tumor a benign ganglioneuroma.
Several other autonomic nervous system tumors in children
Never take it that all childhood autonomic nervous system tumors are cancerous as some may be non-cancerous.
Ganglioneuroma: This is a non-cancerous tumor that comprises of mature ganglion and nerve sheath cells.
Ganglioneuroblastoma: This particular tumor has both cancerous and non-cancerous parts. It comprises of immature nerve cells that grow and spread abnormally which are similar to that of neuroblastoma and having areas of more mature tissue that looks like ganglioneuroma.
Surgery is usually performed to help diagnose ganglioneuroma and is then viewed diligently with a microscope to be certain that they’re no more cancerous areas which might make the tumor develop into a ganglioneuroblastoma. A situation where the final diagnosis is ganglioneuroma, it won’t require any more treatment but if ganglioneuroblastoma was detected, then it can be treated the same way as neuroblastoma.
What are the causes of neuroblastoma?
Neuroblastoma occurs when neuroblasts grow and replicate without control instead of developing into nerve cells. Researchers are working tirelessly to determine the precise causes of this abnormal growth, but other scientists believe a deformity in the genes of a neuroblast paves way for it to divide without control.
Read Also: Neuroblastoma- Genetics Home Reference
What are the signs and symptoms of neuroblastoma?
Its signs and symptoms depend on the part of the body affected.
Neuroblastoma within the chest
The following signs and symptoms could be found when it attacks your chest:
- The feeling of chest pain
- Feeling of some changes around the eyes like the pupil size not of the same size and eyelids drooping
Neuroblastoma within the abdomen
The following are its commonest signs and symptoms in the abdomen:
- A mass under the skin that is not painful when touched
- Feelings of pain in the abdomen
- Alteration in bowel habits like constipation or diarrhea
Other signs and symptoms associated with this medical condition are:
- Proptosis which is eyeballs that seems to bulge from the sockets
- Unusual loss in weight
- Decreased appetite
- Swellings of tissue under the skin
- Some dark circles around the eyes that look like bruises
- Feelings of fever
- Bone pains
When you can see a doctor
Immediately consult a pediatrician if your child experiences any of the above signs or symptoms and tell the doctor any changes in your child’s attitude or habits.
What are the risk factors of this cancer?
Children whose family does experience neuroblastoma are more likely to develop the disease easily. A cause is never identified in most cases of neuroblastoma.
What are the complications of neuroblastoma?
Complications of this disease include the following:
Metastasis (spread of cancer)
Neuroblastoma may extend to other parts of the body like the bone marrow, lymph nodes, skin, liver, and bones.
Compression of the spinal cord
The lump may grow and press on the spinal cord, making the spinal cord compressed. Compression of the spinal cord may bring about paralysis and pains in your body.
Most neuroblastoma cells may give off certain chemicals that provoke other normal tissues, giving rise to paraneoplastic syndromes. A rapid eye movement and difficulty with coordination are common in children with paraneoplastic syndrome. Diarrhea and abdominal swellings are other rare signs and symptoms common amongst children with paraneoplastic syndrome.
How to diagnose neuroblastoma
The following are the tests and procedures you must follow for optimal diagnosis of this medical condition:
Undergoing physical examination: Here, your pediatrician conducts a physical exam on your child to look out for any signs and symptoms. You will also be asked if your child experiences some unusual behaviors and habits for optimal diagnosis.
Imaging tests: It involves the use of X-ray, CT (computerized tomography) scan, ultrasound to help discover a mass that can depict a tumor. Others include MRI (magnetic resonance imaging) and MIBG (metaiodobenzylguanidine).
Blood and urine tests: This help determine the cause of any signs and symptoms experienced by your child. Looking out for high levels of some chemicals that arise from the neuroblastoma cells producing too many catecholamines are carried out using the urine tests.
Removal of a sample of bone marrow for testing: The use of bone marrow aspiration and bone marrow biopsy are carried out on your child’s body to know if neuroblastoma has spread to the bone marrow. Bone marrow is a spongy material found inside the largest bones where blood cells are produced. A needle is usually inserted into the hipbone or lower back of your child in order to remove the marrow and finally used for testing.
Removal of a sample of tissue for testing: Your child’s doctor may want to remove any sample of the tissue lumps present for biopsy. Some specialized tests may be performed on the tissue sample to know the types of cells that cause the tumor and precise genetic characteristics of the cancer cells in the body. This information will help the pediatrician prepare an optimal treatment plan for your child.
After an effective diagnosis of neuroblastoma, your child’s doctor may request for further testing to ascertain the extent of cancer if it has spread to other organs of the body usually through a process known as staging. Knowing precise cancer’s stage enables your child’s doctor to devise the best treatment for your child.
X-rays, CT scan, MIBG scan, bone scans, and MRI scans are other imaging tests used to stage cancer.
Roman numerals usually from 0 to IV are mostly used to indicate the stages of neuroblastoma, with the lowest stages showing cancer that is limited to an area. When it reaches stage IV, then the cancer is regarded to be in an advanced stage which has definitely spread to other parts of the body.
Read Also: Best Hospitals For Pediatric Cancer In U.S.
What are the treatments of this cancer?
Most treatments rely on several factors that affect your child’s prognosis like the cancer stage, age of your child, the type of cells involved in cancer, and if they are any abnormalities in the genes and chromosomes. This information helps your child’s doctor know how to categorize cancer into low risk, intermediate or high risk. Optimal treatment of this cancer depends on the risk category associated with your child.
Your child’s doctor uses scalpels and other surgical tools for effective removal of cancerous cells. Surgery may be recommended amongst children with low-risk neuroblastoma to help remove the lump. Complete removal of the lump depends on its size and location in the body. If the tumor is found in delicate organs like the spinal cord or the lungs, care should be taken as they are extremely risky to remove.
In a case of intermediate-risk or high-risk neuroblastoma, doctors may try to remove as much of the lump as possible. Chemotherapy and radiation may be needed to help kill the remaining cancerous cells in the body.
This involves the use of chemicals to kill cancerous cells and they target rapidly growing cells/cancer cells in your child’s body. Chemotherapy is usually employed before undergoing surgery and bone marrow transplant. It has adverse effects on your child as it destroys healthy cells that grow rapidly like cells in the gastrointestinal system and in the hair follicles.
A combination of chemotherapy drugs before surgery is employed in children with intermediate-risk neuroblastoma to help improve the chances for the entire removal of the tumor from the body.
High doses of chemotherapy drugs are usually given to children with high-risk neuroblastoma to make the tumor smaller in size/amount and eventually destroy any cancer cells that must have spread to any part of the body.
It involves the usage of drugs which helps signal your child’s immune system to fight the cancerous cells. Immunotherapy drugs may be given to children with high-risk neuroblastoma to help trigger the immune system into destroying the neuroblastoma cells. Tumor vaccines are also employed in this aspect.
In this therapy, high energy lights are used to kill cancer cells like X-rays. Radiation therapy is given to children with low-risk or intermediate-risk neuroblastoma where surgery and chemotherapy are not helpful. Children with high-risk neuroblastoma are given radiation therapy after undergoing surgery and chemotherapy, to help avert cancer from appearing again.
Although radiation therapy affects the targeted, but might also destroy some healthy cells in the child’s body. It has some side effects on the child that is only experienced depending on where the radiation is administered and how much radiation was given.
Retinoid therapy can help cure neuroblastoma by enabling cancer cells to turn into mature nerve cells according to scientists. These retinoids are substances that work effectively in the child’s body similar to vitamin A. this therapy is mostly used after other treatments to help avert cancer from growing again.
Transplanting involving a bone marrow
Stem cells received from bone marrow are usually given to children with high-risk neuroblastoma. Your child will have to undergo a procedure where collected stem cells from his or her blood are filtered before bone marrow transplant can be carried out. The stem cells will be stored later for use. The cancerous cells in your child’s body are killed because of the high doses of chemotherapy given to him or her. The stem cells of your child will then be injected into his or her body, where it can result in the production of new and healthy blood cells.
Most recent treatments
A newer aspect of radiation therapy is being studied by medical doctors that will be suitable for controlling high-risk neuroblastoma. This recent treatment involves the usage of a radioactive form of the chemical called MIBG (metaiodobenzylguanidine) and when injected into the bloodstream of the child, the MIBG swims to the neuroblastoma cells and the radiation is being released.
Also, metaiodobenzylguanidine therapy may be used alongside bone marrow transplant or chemotherapy. Treatment involving MIBG therapy takes a few days to complete. Your child will have to remain in a special room in the hospital after undergoing MIBG so that the radiation leaves his or body in the urine.
What is the outlook for children with this cancer?
Most children have a good chance of surviving while undergoing effective treatment. Your child may stand a better chance if cancer has not been spread to other parts of the body or if he or she is a year old when diagnosed with cancer.
Children having high-risk neuroblastoma find it difficult to enjoy optimal cure and are more likely to become resistant to standard therapies or cancer resurfaces after initially successful treatment.
Late effects of this cancer
Most children treated for neuroblastoma may be at risk of contracting other cancers. These late effects can surface in children after completing successful cancer treatment. Its late effects include loss of function in any organs involved and growth/developmental delays. Your chance of experiencing late effects depends on either the age of the child during treatment or the particular treatments employed
Some children may develop the opsoclonus-myoclonus syndrome, which is a condition where the immune system attacks normal nerve tissue in the child’s body. Language problems, learning disabilities, behavioral issues, and delays in muscle and movement development may also be found amongst some children.
Recent clinical trials
Mayo clinic studies are exploring new treatments and interventions as a means to detect, prevent, treat, and manage this medical condition.
How to care for your child
It is advisable for parents to play a vital role in making their kids recover from this cancer by learning more about this cancer and its treatment. I know you might feel all hope is lost being told your child has neuroblastoma but being diligent will aid you in making decisions and help your child cope very well while undergoing the tests or treatments.
Always ask your child’s doctor questions, if you don’t understand anything.
Why not look out for support groups of parents with neuroblastoma as you may gain useful information on how to manage cancer?
Try maintaining normalcy as much as possible like allowing him to play when he or she feels like playing.
Always try explaining to your child’s doctor the signs and symptoms experienced in details to help the doctor know the best treatment to offer your child.
Try encouraging your child while he or she is undergoing tests and treatment that he or she will soon be whole again. Explain to your child why he or she needs the treatment by so doing your child won’t be afraid to undergo necessary treatments and tests.
What you can do for your child
- Never neglect any pre-appointment restrictions.
- Always make sure you put into writing any symptoms experienced by your child.
- Have a list of all medications taken by your child.
- You can write down questions you want to ask your child’s doctor.
- Write down any key personal information like recent life changes can help your child greatly.
You can confide in any of your family member or friend you trust on your child’s illness.
Why not share this great article to help any of your loved ones or family friends with neuroblastoma to enjoy a healthy life?