What is Neuroblastoma?



As a nurse practitioner in the Children’s Center for Cancer and Blood Diseases at Children’s Hospital Los Angeles, I see many children diagnosed with neuroblastoma. Unless you know a child with this condition or follow one of our inspiring patients like Hazel Hammersly, it’s likely that neuroblastoma is unfamiliar to you. This is the inspiration for this RN Remedies® blog post.

Neuroblastoma: third most common type of childhood cancer

Neuroblastoma is a type of solid tumor that is cancerous; it starts in immature nerve cells of the sympathetic nervous system. The sympathetic nervous system is part of the general nervous system, which is the network of cells and fibers that transmits nerve impulses between parts of the body. The sympathetic nervous system is responsible for releasing chemicals in the body that help in a “fight or flight” response. These nerve cells are found all over the body but are concentrated near the adrenal glands (small glands found on top of the kidneys), neck, chest and spinal cord. Scientists and doctors do not know what causes neuroblastoma. What is Neuroblastoma? Information from Children's Hospital Los Angeles

While neuroblastoma is the third most common type of pediatric cancer, it is still very rare. Out of the 13,000 children who are diagnosed with cancer each year, only about 650-700 are diagnosed with neuroblastoma. The disease primarily occurs in children younger than age 10 and is most common in infants and very young children. Very rarely, it can occur in children older than 10 and adults.

Signs and symptoms of neuroblastoma

Symptoms of neuroblastoma can include:

  • A lump in the stomach area, neck, chest or on the back near the spine
  • Bulging or bruise coloring around the eyes
  • Comments from your child of pain in their bones
  • Weakness or paralysis of body parts
  • Swollen stomach or bluish lumps under the skin (This is common in infants)

In order to diagnose neuroblastoma, your physician will need to do a good physical exam and blood and urine tests. Further imaging is most likely necessary and can include:

  • Bone marrow biopsy
  • CT scans
  • MRI scans
  • Radionuclide scans
  • Ultrasounds
  • X-rays

Thorough testing helps identify the stage of the tumor. There are four stages of neuroblastoma, depending on how widespread the tumor is in the body and how much can be removed by surgery. Once the risk group, categorized as low, intermediate or high, is ascertained, then treatment can be decided. Risk group is determined by:

  • The child’s age
  • Tumor staging
  • The tumor’s characteristics seen under the microscope
  • Other scientific characteristics of the tumor

Treating neuroblastoma

Treatment for neuroblastoma can be as simple surgery or as complex as a rigorous course of chemotherapy including a bone marrow transplant and radiation, based on risk group. Newer therapies, such as monoclonal antibodies (immunotherapy) and retinoid therapy, may be used in the child’s treatment. In very rare instances, the neuroblastoma can be monitored or “watched” and will disappear without treatment. Because neuroblastoma is rare and its treatment is complex, it requires a team of doctors and nurses that have experience in treating childhood cancer. Here are helpful tips on preparing for a child’s chemotherapy treatment. Prognosis, also known as “cure rate” for neuroblastoma, depends upon diagnostic risk group.

  • The low-risk group has a 5-year survival rate of higher than 95 percent.
  • The intermediate-risk group has a 5-year survival rate of around 90 to 95 percent.
  • The high-risk group has a 5-year survival rate of around 40 to 50 percent.

Sometimes children will complete treatment and be considered in remission, but the cancer will return. There are treatment options for those children, but the chance of overall survival is lower.

Many children treated for neuroblastoma have a very good chance of being cured. But often, these treatments can have lifelong side effects. These side effects depend upon the type of treatment given, as well as the age of the child when the treatment was received. Once a child is considered cured, they will need to be monitored to ensure they:

  • Have normal growth,and development
  • Have normal earing
  • Are learning well in school
  • Have healthy internal organs

I hope you found this blog post helpful! Do not use it to diagnose your child, but if you are concerned about your child’s health, contact your pediatrician.