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Your body’s nervous system is divided into the central nervous system, which includes your brain and spinal cord, and the peripheral nervous system. Your sympathetic nervous system is part of your peripheral nervous system. It helps carry messages from your brain to various parts of your body. It controls your:
It also helps carry messages from your brain to various parts of your body.
Neuroblastoma is a cancer that develops in immature cells, or neurons, of the sympathetic nervous system. It develops as a solid tumor. It’s often found in the:
If it progresses, it can spread to bones, lymph nodes, and skin.
While neuroblastoma is a rare cancer in general, it’s the most common type of cancer among infants. According to the Memorial Sloan Kettering Cancer Center, approximately 700 new cases of neuroblastoma are diagnosed each year in the United States. Most of them are diagnosed among young children. It’s usually diagnosed before they reach the age of 5.
Most cases of neuroblastoma aren’t inherited but are the result of a random gene mutation. Approximately 1-2% of neuroblastomas are inherited in an autosomal dominant pattern. This means that you only need a gene from one parent to have the condition. Not all people who inherit such a gene develop neuroblastoma. This is known as "incomplete penetrance." Experts believe that an additional mutation is required to develop neuroblastoma.
Common symptoms of neuroblastoma include:
Less common symptoms include:
Many other conditions can cause these symptoms. They don’t necessarily point to a diagnosis of neuroblastoma.
Your child’s doctor may diagnose neuroblastoma by using the following tests:
After diagnosing neuroblastoma, your child’s doctor will stage their cancer. In other words, they’ll categorize the cancer based on its location and how far it has spread. The stage of your child’s cancer determines their course of treatment, which is why staging is crucial.
Neuroblastoma has four stages:
In stage 1, the tumor is in one area of your child’s body. It hasn’t spread yet, and your child’s doctor can remove it fairly easily.
In stage 2A, the tumor is in one area of your child’s body, but your child’s doctor can’t completely remove it during surgery. Cancer cells aren’t found in the local lymph nodes.
In stage 2B, the tumor is in one area of their body, and your child’s doctor can completely removed it during surgery. However, cancer cells are also found in the lymph nodes near your child’s tumor.
In stage 3, any of the following three situations may occur:
In stage 4, the tumor or cancer cells have spread to distant parts of your child’s body, such as the:
Stage 4S neuroblastoma behaves differently. It occurs when the following criteria are true:
Once your doctor has staged your child’s cancer, they’ll classify it as low, intermediate, or high risk. They’ll determine the risk level based on:
Low-risk and intermediate-risk neuroblastoma have a good chance of being fully cured. High-risk neuroblastoma is typically harder to cure.
The treatment for neuroblastoma depends on your child’s age and the stage of their cancer. It may include:
Many children with neuroblastoma will have more than one type of treatment. Treatment is typically done in stages and can last several years.
During chemotherapy, anticancer drugs are used to kill cancer cells. People usually receive these drugs intravenously, but your child can also get them orally, depending on the specific drug. Side effects can include:
Side effects go away once your child finishes the treatment.
In radiation therapy, high-energy particles or rays, such as X-rays, are used to kill cancer cells. A machine typically aims the particles or rays at the affected area. This type of treatment can cause side effects, such as skin irritation, diarrhea, and fatigue.
Immunotherapy is also called biologic therapy. In this treatment, medications are used to stimulate your child’s immune system to fight disease.
Stem cell therapy is also called a bone marrow transplant. After receiving high doses of chemotherapy or radiation therapy, replacement stem cells may be injected into your child’s bloodstream. Doctors typically reserve this treatment for high-risk children whose outlook with other treatment options is poor.
Your child’s outlook will depend on their cancer’s stage and risk level. According to the American Cancer Society, children with low-risk neuroblastoma have a five-year survival rate that’s higher than 95 percent. Children with intermediate-risk neuroblastoma have a five-year survival rate of about 90 to 95 percent. Those in the high-risk group have a five-year survival rate of about 40 to 50 percent.
If their cancer treatment is successful, they’ll need to attend follow-up appointments to monitor for signs of relapse and potential side effects treatment. For low- and medium-risk cases, the risk of relapse is low. However, checkups are still important. Cancer treatment can cause long-term side effects. Not everyone will experience serious side effects, but they can occur. They can include:
Every child is different. Talk to your child’s doctor about the best treatment options for them. Ask them about the risks of specific treatment options, your child’s treatment schedule, and strategies to prevent, identify, and manage potential complications.
Many cancer centers and hospitals have support groups for children and families that are dealing with neuroblastoma or other cancers. They may provide helpful support and information.
Written by: Jaime Herndon
Medically reviewed on: Mar 30, 2016: Graham Rogers, MD
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