About Neuroblastoma

Neuroblastoma is a rare form of childhood cancer. In the UK around a hundred children are diagnosed each year with Neuroblastoma.

The condition arises when a tumour develops from particular nerve cells which run in two chains from the skull down the back of a child's chest and abdomen on each side of the spine. The solid tumours will take the form of a lump or mass most commonly above the kidney in the adrenal gland or elsewhere in the abdomen, less frequently elsewhere such as th neck, chest or pelvis. Often by the time of diagnosis the cancer has spread to other areas of the body such as the lymph nodes, bone or bone marrow.

Symptoms

Sometimes no symtoms are present at the time of diagnosis, and neuroblastoma is the chance finding in a medical examination of a well baby. The first symptoms of neuroblastoma may be related to the presence of a primary tumour, which depends upon its location:

• tumours situated in the abdomen may cause a swollen belly, stomach pain, constipation, or diarrhoea.


• A tumour in the chest may cause breathing problems, often similar to a chest infection.


• A tumour resting on the spinal cord may cause weakness or difficulty walking.

Not uncommonly the cancer presents as a result of spread to other parts of the body, called metastatic disease. These symptoms are often vague and can include fatigue and loss of appetite. Some children experience bone pain, some may have unexplained "black eyes" or bulging eyes.

Many of these symptoms are similar to those of other more common illnesses and unless a parent or doctor discovers a lump, a diagnosis of neuroblastoma may not be initially considered.

Neuroblastoma may occur at any age. It may be present at birth, or even be diagnosed on a scan during pregnancy. Most patients are of pre-school age, the average age for diagnosis of children affected by neuroblastoma is two years old. However it can also occur in older children and teenagers or very rarely in adults.

Outlook

The prognosis for babies and children affected by neuroblastoma varies greatly. Newly diagnosed patients are assigned to a 'risk group' depending on a number of factors such as:

• how old they are


• the extent of the disease within the body (stage)


• the cellular and molecular characteristics of the cancer (pathology).

Low-risk

The majority of 'low-risk' patients are babies who are cured with very limited treatment.

Intermediate-risk

A small group have 'intermediate-risk' disease which requires more treatment and not such a good outcome.

High-risk

Unfortunately the largest group of patients fall into the 'high-risk' category where despite intensive treatment, the majority are not cured.