Danger level: High

What is it?

Neuroblastoma is the most common cancer in infants. Cancer forms here in the adrenal gland, neck, chest or spinal cord.

Who gets it?

1 in 100,000 children will get neuroblastoma. Two thirds of cases of neuroblastoma occur in children younger than 5 years. After age 10 the disease is rare.

This cancer is a little more common in boys than girls, and more common in white people.

What causes it?

There is a part of our nervous system which is called the autonomic nervous system. This part controls functions of our bodies, such as the heart rate, breathing, blood pressure, digestion and other things.

The autonomic nervous system is divided in to the sympathetic system and parasympathetic system. Neuroblastoma arises from the sympathetic system. The sympathetic system includes -

1. Nerves that run alongside our spinal cord
2. Clusters of nerves along nerve fibers in our bodies, called ganglia
3. Nerve-like cells in our adrenal glands (small glands that sit on top of our kidneys).

Since neuroblastoma develops from the sympathetic system, it can be found anywhere along this system. About 40% start in the adrenal glands. Another 25% in ganglia in the abdomen, and the rest in ganglia in the chest, neck or pelvis.

The autonomic nervous system. You can see it controls many organs in our body – The heart, eyes, intestines and others. Neuroblastomas arise from the sympathetic system.

The cause for the rise of tumor from these types of cells isn’t known.

How does it feel?

Neuroblastoma may begin with symptoms that are not specific, such as loss of energy, loss of appetite, fever. Other symptoms depend on where the tumor is located:

1. If it’s in the abdomen – It may cause a swollen belly, abdominal pain or constipation.
2. If it’s in the chest – It may cause breathing problems.
3. If it’s in the vicinity of the spinal cord – It may press it, causing weakness.

The tumor may also spread to the rest of the body and cause different symptoms, such as bone pain if it reaches the bones, or bulging eyes/dark circles around the eyes if it reaches behind them. About 50-60% of children already have metastases in other areas of the body by the time it is discovered.

Neuroblastoma can also release hormones, which cause different things in the body. Examples of these things:

1. Fever
2. Diarrhea
3. High blood pressure
4. Rapid heartbeat
5. Red skin
6. Sweating

How is it discovered?

There are several things that can be done to discover it:

1. Blood test – A high amount of the substances dopamine and norepinephrine are higher in this tumor. These substances are produced by the sympathetic system, and so are higher here.
2. Urine test – The substances found in the blood are broken down by the body into other substances, which are then passed out in the urine. They are called homovanillic acid (HMA) and vanillyl mandelic acid (VMA), and will be higher if a tumor exists.
3. X-rays, CT scan, MRI, ultrasound – They can discover the origin of the tumor in the body. A special scan called MIBG can discover the tumor areas in the body.
4. Biopsy – It’s the only way to be certain that all the hints we got from the other detection methods are really arising from a neuroblastoma. A piece of the tumor is taken out and viewed under a microscope.

How is it treated?

There are many options for treating neuroblastoma. Choosing a certain option depends on the age of the child, the level to which the cancer has advanced before discovery, the location of the cancer in the body, and the way it looks under the microscope.

The treatment can include surgery, chemotherapy, radiation, stem cell transplantation or other types of therapy.

What happens after treatment?

There are many things that can affect the survival of the child with a neuroblastoma, including age, the advancement of the tumor, the way the tumor looks under the microscope. Tumors which are less advanced respond better to treatment.

There is no known way to prevent neuroblastoma. In rare cases, the tumor can be found before birth during an ultrasound. It can also be found accidentally in children during tests to find other diseases. Such early discovery might improve survival (but there are currently no recommendations to search for the tumor in every infant, since this wasn’t found to be helpful).

You can learn more about neuroblastoma by reading the personal story of Paris, at The Strickland Family Blog.

What next?

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