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Description
Neuroblastoma is a children’s cancer diagnosed in approximately 500 to 1,000 children per year in the USA. Neuroblastoma is a complex tumor of the sympathetic nervous system, a condition that has been known for 35 years. Its frequency is second only to brain tumors and it is seldom seen in children over 14 years old.
The median age for tumor discovery is two years, and it occurs somewhat more in boys than girls. Like most cancers, its cause is unknown. It is extremely difficult to diagnose in small children, and once diagnosed, its progression is often rapid, and very painful. Although neuroblastoma accounts for only 8% of all cancers, it is responsible for over 15% of the deaths.
Stages of Neuroblastoma:
Stage 1
- In stage 1, the tumor is in only one area and all of the tumor that can be seen is completely removed during surgery.
Stage 2
- Stage 2 is divided into stage 2A and 2B.
- Stage 2A: The tumor is in only one area and all of the tumor that can be seen cannot be completely removed during surgery.
- Stage 2B: The tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery. Cancer cells are found in the lymph nodes near the tumor.
Stage 3
- In stage 3, one of the following is true:
- the tumor cannot be completely removed during surgery and has spread from one side of the body to the other side and may also have spread to nearby lymph nodes; or
- the tumor is in only one area, on one side of the body, but has spread to lymph nodes on the other side of the body; or
- the tumor is in the middle of the body and has spread to tissues or lymph nodes on both sides of the body, and the tumor cannot be removed by surgery.
Stage 4
- Stage 4 is divided into stage 4 and stage 4S.
- In stage 4, the tumor has spread to distant lymph nodes, the skin, or other parts of the body.
- In stage 4S, the following are true:
- the child is younger than 1 year; and
- the cancer has spread to the skin, liver, and/or bone marrow; and
- the tumor is in only one area and all of the tumor that can be seen may be completely removed during surgery; and/or
- cancer cells may be found in the lymph nodes near the tumor.
Depending on the stage of the disease, treatment may be limited to tumor removal surgery, or may be as extensive as tumor removal surgery combined with chemotherapy, radiation, and bone marrow transplants.
In most cases, children with neuroblastoma are not diagnosed until Stage IV, when, until recently, long-term survival rates stood at a dismal 20% or less. However, encouraging developments in treatment and research are helping children to be diagnosed earlier, and to have increased chances of survival.
Diagnosis of Neuroblastoma
The two most important factors in the prognosis for a child with neuroblastoma are the stage of the disease and the age of the child at the time of diagnosis. For all stages, infants less than one year old have a much better chance for remission and survival than older children. Early diagnosis is one of our best weapons in the war against neuroblastoma.
Often, neuroblastoma is first discovered when parents or a physician feel a mass or tumor somewhere in the child's body. Sometimes the child shows no outward symptoms, and sometimes symptoms resemble those of many more common childhood illnesses, such as bruising, mild flu symptoms, diarrhea, and loss of appetite.
More acute symptoms can include bone pain, hypertension, anemia, skin nodules, a pronounced limp, or a refusal to walk.
Pediatricans can order a simple, non-invasive 24-hour urine test, which is nearly 100% accurate in detecting neuroblastoma cancer. Also, ultrasound, CT scans, and MRI scans can effectively detect neuroblastoma-related tumors.
References
- National Cancer Institute; The Neuroblastoma Children's Cancer Society.
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