Neuroblastomas

Neuroblastoma is one of the most frequently encountered solid tumours in early childhood and almost always occurs in the first 5-6 years of life.

It originates in the autonomic nervous system which means tumours can arise in the abdomen, pelvis, chest or the neck. The abdomen is the most common area affected, with the adrenal glands, which are located in the abdomen, being the site of origin in more than 50% of cases.

Regardless of its origin, Neuroblastoma can be widespread throughout the body by the time diagnosis is confirmed.

Signs and symptoms

Symptoms can vary depending on where the Neuroblastoma is growing. For example: abdominal tumours may cause a swollen tummy, constipation or difficulty passing urine but a tumour in the chest cavity may cause difficulty breathing.

Prognosis

The prognosis of Neuroblastoma  is influenced by several factors such as:

  • The age of the child at diagnosis, if the patient is less than 18 months they have a better prognosis.
  • The original site of the tumour and how far it has spread.
  • Specific changes of genes inside the cancer cells.

Staging

Staging of the disease is based on the tests done at diagnosis such as the CT scan or MRI, urine tests, MIBG scan, bone marrow biopsy and blood tests.

  • Stage I – Tumour completely removed by surgery.
  • Stage II – Tiny amount of tumour left behind after surgery or lymph nodes are involved.
  • Stage III – Extensive area of tumour crossing the midline.
  • Stage IV – Tumour spread to other parts of body.
  • Stage IVS – Tumour spread to bone marrow, skin or liver in very young patients.

Treatment

The treatment of Neuroblastoma may involve a combination of surgery, chemotherapy, radiotherapy and in some cases, bone marrow transplantation to achieve optimal results.

Some children with the most benign form of the disease may not require any treatment at all, as the tumour is known to resolve spontaneously in specific cases.  Other children with Stage I disease may only require surgery whereas children more than 18 months of age with Stage IV disease usually need intensive chemotherapy and radiation therapy along with a bone marrow transplant.

The total treatment program is designed to ensure remission occurs and may take up to a year or more to complete. Regular check-ups for recurrence and/or long term side effects of treatment will then be necessary.