What is neuroblastoma?
Neuroblastoma is a solid tumour that begins in the neural crest cells. These versatile cells help form the nervous system amongst other things. Neuroblastoma means “Neuro” = nerve and “blastoma” = cancer in immature cells. Neuroblasoma most commonly starts in the tummy, with around 50% starting in the adrenal glands. The adrenal glands produce adrenaline and also regulate our blood pressure and salt levels. There are two glands, one above each kidney. 

Who does it affect?
Neuroblastoma affects mainly children under five and is most common in infants and babies. There are around 90 children diagnosed a year  in the UK.

What are the symptoms?
The symptoms of neuroblastoma will vary depending upon where the tumour is located. If it is in the abdomen then the tummy may be swollen. The child may have a cough if the tumour is in the chest or difficulty swallowing if the tumour is in the neck. The child may also have high blood pressure if the tumour is in the adrenal glands.

How is it diagnosed?
A child will be diagnosed with a variety of tests including an MRI scan, bone marrow examination and blood tests. The child will be given a urine test because most children with this condition will have increased levels of vanyllylmandelic acid (VMA) and Homovanillic acid (HVA) in their urine. This is a good indicator of the disease and success of the treatment, as levels will fall when the treatment starts to work. The child will usually be given a biopsy to determine the stage of the disease.

How is it treated?
Neuroblastoma is treated using surgery, chemotherapy and radiotherapy. The combination of therapies will be determined by the location, the size and spread of the tumour, (its stage) as well as how fast growing it is (its grade). The age of the child is also taken into consideration as neuroblastoma behaves differently in infants under one year so requires different treatment. The most common forms of treatment will be surgery alone or surgery and chemotherapy if the tumour has spread or is classified as aggressive. If the tumour has spread to many other parts of the body, high-dose chemotherapy with stem cell rescue can be used.  Parents can contact their child’s Consultant about this treatment or visit our high-dose treatment section – which is a general guide to the procedure. Radiotherapy is also used if the tumour has spread. It is worth noting that in many cases, the disease has spread before diagnosis.

Infants under one year
In these children, neuroblastoma can get better without treatment. The child will be monitored closely but often the tumour will shrink by itself or remain harmless and the infant will be cured.

Side-effects
The side-effects associated with chemotherapy are tiredness, sickness and diarrhoea, temporary hair loss and infection, all of which can be managed with help from the child’s consultant or nursing team.

Long term side-effects
Some children may go on to develop longer term side effects. Please remember that all children are different and only a small number develop long-term problems as a result of their treatment. Parents can talk to their child’s Consultant if they are concerned about them.

Follow-up care
All children will need to be monitored regularly at an outpatient's clinic. The Consultant will be looking for any signs that the cancer has returned (recurrent cancer) and checking the functions of major organs to make sure that they have not been affected by the cancer treatment.

Source: www.clicsargent.org.uk