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Neuroblastoma is a cancer of immature cells in the nervous system, occurring most commonly in children. Although it can occur in many places throughout the body, it is most often found in the nerve tissue of the adrenal glands, near the kidneys. It may also develop in the chest, neck or pelvis.
The disease is often only detected after it has spread to other parts of the body to cause noticeable symptoms. It tends to spread most often to the lymph nodes, bones and bone marrow, liver and skin. Occasionally neuroblastoma is formed before birth and can be detected with a fetal ultrasound.
The survival rate of neuroblastoma in Australia ranges from 40% (for the highest risk neuroblastoma) up to 95% (for low-risk or intermediate-risk neuroblastoma).
It is not known which environmental factors increase a child’s risk of developing neuroblastoma, and therefore how to prevent the disease.
However, cancer researchers have found some inherited gene mutations that appear to play a role in the development of neuroblastoma in children. In these children with an inherited mutation, the cancer tends to occur at a younger age.
The symptoms of neuroblastoma depend on where the tumour is growing and impacting on nearby tissues.
Symptoms can include a lump in the abdomen, neck or chest, bone pain, difficult breathing, weakness or an inability to move a body part and easy bruising or bleeding.
A range of other signs can result when the cancer is growing in other parts of the body and it should be noted that these symptoms are not unique to neuroblastoma and should always be investigated further.
To diagnose neuroblastoma, a physical examination will be done, and a full medical history taken. If there are signs of a possible tumour, other tests will be done such as biopsies, blood and urine tests, and imaging tests such as x-rays, ultrasound, CT or MRI scans.
The cancer will be diagnosed according to a “Stage” ranging from 1-4. These stages indicate how contained the cancer is within the body, and help to determine a treatment plan.
Treatment for neuroblastoma may take a year or more, and may involve a combination of surgery, chemotherapy, radiotherapy and stem cell rescue processes, depending on how far the cancer has spread. Particular substances that assist the body to make more white blood cells may be used to support the treatment process.
How well a child responds to treatment will depend on a number of factors, including their age (generally younger children respond better to treatment), where the tumour started, how much it has spread, and specific changes in the genes of the cancer cells.
If the cancer comes back after treatment (known as ‘recurrence’) further measures will be required.
Ongoing research is aimed at developing better treatments and long-term care for children diagnosed with this disease.
Long term follow up care is needed for all children treated for neuroblastoma. Follow-up may include a variety of laboratory tests and imaging tests, such as PET scans, CT scans, and/or MRI scans.
Depending on the type of therapy a child was given during treatment for neuroblastoma, certain long-term side effects will be looked for, as well as the possibility of secondary cancers.