Childhood cancers

Neuroblastoma

Each year about 700 children are diagnosed with neuroblastoma. This type of cancer is sometimes referred to as a tumor of the sympathetic nervous system (which controls heart rate, sweating, etc.) These cancers begin in immature sympathetic nerve cells and are most common in infants and young children (before age five). In fact, neuroblastoma is the most common cause of cancer in infants, accounting for 41 percent of cancers diagnosed during the first three months of life. Overall, two-thirds of all cases of neuroblastoma occur before the age of five.

Risk factors
Exactly what causes neuroblastoma is not clear. Because the cancer develops so early in life, researchers are looking at conception and gestation for clues.

Symptoms
Symptoms include pale skin, chronic fatigue, diarrhea, enlarged abdomen, flushed red skin and rapid pulse. Neuroblastomas can occur in many areas, but most commonly begin in the abdomen in the adrenal gland, the gland near the kidneys that secretes steroid hormones and adrenaline. This type of cancer can spread rapidly to the lymph nodes, bones, bone marrow and liver.

Questions to ask your child's doctor

Diagnosis
Before treatment decisions are made, a patient may have to undergo one or more diagnostic tests. These include tissue sampling or biopsy, blood work, X-rays, ultrasound, magnetic resonance imaging (MRI) scans and computed tomography (CT) scans. Surgical biopsy may be performed to determine if cancer is present. Diagnosing cancer

The goal is to determine if cancer is present, what type of cancer it is, and, in some cases, if it has spread. The diagnosis of neuroblastoma requires the involvement of pathologists who are familiar with childhood tumors.

Treatment
Before cancer is treated, it has to be staged. Staging involves finding out where the cancer is located, the extent of the cancer and whether it has spread. Early stage cancers (Stage 1 and 2 that have not spread) are the easiest to treat.

When neuroblastoma is detected early, surgery alone to remove the cancer can be the cure. If the cancer has spread, radiation therapy or chemotherapy may be used alone or after surgery. It is important for the child to be evaluated by several specialists as early as possible so that treatment may be coordinated effectively from the beginning. Depending on the disease, these specialists may include a radiation oncologist, radiologist, pediatric oncologist, pediatric surgeon and a pathologist.

Survival for children affected by this cancer depends greatly on the stage at which it is diagnosed. About 83 percent of infants with the disease survive. Survival has improved significantly in the past decade for children age one to four.

Clinical trials, protocols and research

Learn more
• YNHH Health Library: Neuroblastoma

Last revised: May 9, 2007 (dh)

Home page URL: http://www.ynhh.org

All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.