Neuroblastoma most commonly occurs in one of the adrenal glands situated above the kidneys, or in the nerve tissue that runs alongside the spinal cord in the neck, chest, tummy or pelvis.It can spread to other organs such as the bone marrow, bone, lymph nodes, liver and skin.It develops from specialised nerve cells (neuroblasts) left behind from a baby’s development in the womb.
The early symptoms can be vague and hard to spot, and can easily be mistaken for those of more common childhood conditions.Symptoms can include:a swollen painful tummy, sometimes in association with constipationand difficulty passing urine, breathlessness and difficulty swallowing, a lump in the neck, blueish lumps in the skin and bruising, particularly around the eyes, weakness in the legs and an unsteady walk, with numbness in the lower body, constipation and difficulty passing urine.
A number of tests may be carried out if it’s thought your child could have neuroblastoma which may include:
- • a urine test – to check for certain chemicals produced by neuroblastoma cells that are found in urine
- • scans – such as ultrasound scans, CT scans and MRI scans of various parts of the body to look at these areas in detail
- • an mIBG scan – this involves the injection of a substance taken up by neuroblastoma cells
- • a biopsy – the removal of a sample of cells from the tumour tissue for examination under a microscope so the type of cancer can be identified; the sample is usually removed under general anaestheticusing a special needle
- • bone marrow biopsies – to see if there are cancer cells in the bone marrow
The staging system used for neuroblastoma is:
- • stage L1 – the cancer is just in one place and hasn’t spread, and can be removed by surgery
- • stage L2 – the cancer is in one place and hasn’t spread, but can’t be removed safely by surgery
- • stage M – the cancer has spread to other parts of the body
- • stage Ms – the cancer has spread to the skin, liver or bone marrow in children aged less than 18 months
The main treatments for neuroblastoma are:
- • surgery to remove the cancer – sometimes this may be all that’s needed
- • chemotherapy (where medication is used to kill cancer cells) – this may be the only treatment needed or it may be given to shrink the cancer before surgery
- • radiotherapy (where radiation is used to kill cancer cells) – this may sometimes be used after surgery to destroy any remaining cancer cells in the affected area
- • high-dose chemotherapy followed by a stem cell transplant – where stem cells from your child are collected, frozen and stored prior to intensive chemotherapy, and are given back to them afterwards
- • immunotherapy – where a medication that directly targets the neuroblastoma cells is given, although this isn’t used routinely yet.
By – Tutor – Ms.Aradhana George
Department of Nursing
Uttaranchal (P.G.) College Of Bio-Medical Sciences & Hospital