Cancer, Neuroblastoma

Neuroblastoma is a type of cancer that starts in immature nerve cells. These cells are found in different parts of the body.

Often, neuroblastoma begins near the adrenal glands. These glands are located above the kidneys and are related to nerve cells. But it can also start in other places, like the belly, chest, neck, or near the spine, where nerve cells are present.

Neuroblastoma mostly affects young children, typically those five years old or younger, although it can sometimes happen in older kids.

Some cases of neuroblastoma may disappear on their own. Other times, treatment is needed. The best treatment for your child will depend on several things, such as how advanced the cancer is, where it started, and the specific type of neuroblastoma.

Neuroblastoma is a type of cancer that can develop in different parts of the body. The signs and symptoms can change depending on where the cancer starts.

Neuroblastoma in the tummy (abdomen): This is the most common type. If the cancer is in the tummy, you might notice:

• Stomach pain: This pain could be mild or severe.
• A lump: There might be a growth under the skin that doesn't hurt when you touch it. It can be a noticeable swelling.
• Changes in bathroom habits: This could mean having more frequent diarrhea or constipation than usual.

Neuroblastoma in the chest: If the cancer starts in the chest, you could experience:

• Breathing problems: Wheezing, or difficulty breathing, might occur.
• Chest pain: A feeling of discomfort or pain in the chest area.
• Eye problems: Changes to the eyes can include one eyelid drooping lower than the other, or one pupil being a different size from the other.

There are other possible signs that might suggest neuroblastoma, too:

• Skin lumps: Growths or bumps under the skin in various parts of the body.
• Bulging eyes: The eyes might appear to stick out from their sockets (called proptosis).
• Dark circles around the eyes: These could look like bruises.
• Back pain: Pain in the back.
• Fever: A high body temperature.
• Weight loss: Losing weight without trying to.
• Bone pain: Pain in the bones.

If you or someone you know is experiencing any of these symptoms, it's important to see a doctor right away. Early diagnosis is crucial for effective treatment. These symptoms can be caused by other conditions, so a doctor can properly diagnose the cause.

If you're concerned about your child's health, talk to their doctor. Let the doctor know about any changes you've noticed in your child's behavior or usual routines. This could be anything from a new habit to a change in their mood or energy levels.

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Cancer happens when normal body cells get damaged. This damage, a change in the cell's instructions (called a mutation), allows the cells to grow and divide without stopping, unlike healthy cells. These uncontrolled cells accumulate, forming a lump called a tumor.

Neuroblastoma is a type of cancer that starts in immature nerve cells called neuroblasts. These neuroblasts are part of the developing nervous system in a fetus (an unborn baby).

As a baby grows, most neuroblasts develop into mature nerve cells and fibers. They also help form the adrenal glands, which are important for producing hormones. Usually, almost all neuroblasts mature before birth, but a small number might still be present at birth. In the majority of cases, these remaining immature neuroblasts either mature or disappear. However, sometimes, a few don't, and they start to grow uncontrollably into a tumor called a neuroblastoma.

The exact reason why these genetic changes happen, leading to neuroblastoma, isn't fully understood. Scientists are still researching the causes.

Some children are at a higher risk of developing neuroblastoma if a family member has had the disease. However, this is believed to be a rare reason for neuroblastoma. In the majority of cases, doctors can't pinpoint a specific cause for the cancer.

Neuroblastoma, a type of cancer that starts in nerve tissue, can have several problems. One significant issue is the cancer potentially spreading to other parts of the body. This spread, called metastasis, can affect different areas, including the lymph nodes, bone marrow, liver, skin, and bones.

Another way neuroblastoma can cause problems is through the release of chemicals by the cancer cells. These chemicals can irritate healthy tissues in the body, leading to a range of symptoms. These are known as paraneoplastic syndromes. In rare cases, neuroblastoma can cause unusual eye movements and trouble with balance and coordination. Another less common, but still rare, symptom is swelling in the belly and frequent diarrhea. These symptoms are a result of the cancer's byproducts affecting normal bodily functions.

Diagnosing Neuroblastoma: Tests and Procedures

Doctors use several tests to find out if a child has neuroblastoma, a type of cancer. These tests help determine the type and extent of the cancer, which is key to creating a treatment plan.

Initial Checks:

• Physical Exam: The doctor examines the child for any signs of the disease, like unusual lumps or changes in behavior. They'll also ask questions about the child's health history.
• Urine and Blood Tests: These tests can help identify possible causes of the child's symptoms. For instance, urine tests might show high levels of certain chemicals, which can be a sign that neuroblastoma cells are producing too much of these substances.

Finding the Tumor:

• Imaging Tests: Different imaging tests can help doctors see inside the body. These tests might include X-rays, ultrasounds, CT scans, MRI scans, and special scans like MIBG scans. These scans can reveal if there's a tumor and its location.
• Biopsy: If a tumor is found, the doctor may take a small tissue sample (biopsy). A lab examines the cells to determine the type of cancer and its genetic features. This information is crucial for tailoring the best treatment.
• Bone Marrow Tests: Doctors may also take a sample of bone marrow – the soft tissue inside bones where blood cells are made. This is done with a needle to check if the cancer has spread to the bone marrow. This helps see if the cancer has spread.

Staging the Cancer:

Once neuroblastoma is diagnosed, doctors want to know how far it has spread. This process is called staging. Staging helps determine the best treatment.

• More Imaging: Further imaging tests, such as X-rays, bone scans, CT scans, MRI scans, and MIBG scans, are used to determine the stage.
• Staging System: Neuroblastoma stages are labeled with Roman numerals (I through IV). Lower stages (I and II) mean the cancer is mostly contained in one area, while stage IV means the cancer has spread to other parts of the body. The stage helps doctors choose the right treatment approach.

Understanding the stage of the cancer is important because it helps doctors decide on the best treatment plan. Different stages of cancer require different approaches.

Understanding Neuroblastoma Treatment for Children

When a child is diagnosed with neuroblastoma, a type of cancer, doctors create a treatment plan based on several factors. These factors include the child's age, how advanced the cancer is (the stage), the type of cancer cells, and if there are any unusual changes in the child's chromosomes or genes. This information helps categorize the cancer as low-risk, intermediate-risk, or high-risk. The treatment plan, including what combination of treatments a child receives, depends on this risk category.

Surgery:

Surgeons use tools to remove as much of the tumor as possible. In low-risk cases, surgery might be the only treatment needed. However, complete removal isn't always possible. The location and size of the tumor are important. If the tumor is close to vital organs like the lungs or spinal cord, removing it may be too risky. In intermediate and high-risk cases, surgeons try to remove as much of the tumor as they can, and then other treatments are used to destroy any remaining cancer cells.

Chemotherapy:

Chemotherapy uses special drugs to kill cancer cells. These drugs target rapidly growing cells, including cancer cells. Unfortunately, chemotherapy can also harm healthy cells that grow quickly, like those in the hair and digestive system, which can lead to side effects. For intermediate-risk neuroblastoma, chemotherapy is often given before surgery to improve the chances of removing the entire tumor. High-risk cases usually receive higher doses of chemotherapy to shrink the tumor and kill any cancer cells that may have spread. Chemotherapy is often given before surgery and before a bone marrow transplant.

Radiation Therapy:

Radiation therapy uses high-energy beams (like X-rays) to destroy cancer cells. Children with low- or intermediate-risk neuroblastoma might get radiation if surgery and chemotherapy aren't enough. In high-risk cases, radiation may be given after chemotherapy and surgery to help prevent the cancer from coming back. Radiation primarily affects the targeted area, but it can sometimes harm healthy cells too. The side effects depend on the area treated and the amount of radiation used.

Other Treatments:

• Bone Marrow Transplant: Children with high-risk neuroblastoma might receive a bone marrow transplant using their own stem cells (autologous transplant).
• Immunotherapy: This treatment uses drugs that help the body's immune system fight the cancer cells. Some immunotherapy drugs are used for high-risk neuroblastoma.
• MIBG Therapy: This newer radiation therapy uses a special radioactive chemical (MIBG) that travels to neuroblastoma cells and releases radiation there. It's sometimes combined with chemotherapy or a bone marrow transplant. After the injection, the child needs to stay in a special room until the radiation leaves their body through their urine.

Coping with the Diagnosis:

A cancer diagnosis can bring up many strong emotions, like shock, disbelief, guilt, and anger. Making decisions about treatment during this time can be very difficult. Here are some ways to cope:

• Get Informed: Learn as much as you can about neuroblastoma. Talk to the medical team and keep a list of questions for appointments. Use reliable resources like the National Cancer Institute and the American Cancer Society websites, and your local library.
• Use Available Resources: Find support groups for families of children with cancer. Ask your clinic's social workers about any support programs available. These can include things like summer camps, temporary housing, and other assistance.
• Maintain a Routine: Try to keep your child's daily life as normal as possible. This includes regular meal times, nap times, and playtime. If your child is in the hospital, bring familiar items from home. Talk to the medical team about ways to comfort your child during treatment. Some hospitals have recreation therapists or child life specialists who can provide specific support.

Remember, you're not alone. There are resources available to help you and your child during this challenging time.