Neuroblastoma is a cancer originating from immature nerve cells known as neuroblasts. It predominantly impacts children below the age of 5, although occurrences in older children and adults are possible. This cancer can manifest in various body areas including the adrenal glands, chest, abdomen, or neck, leading to diverse symptoms and complications determined by tumor location and stage. Treatment approaches encompass surgery, chemotherapy, radiation, and immunotherapy. Prognosis hinges on factors like patient age, tumor risk group, and treatment response.
The precise etiology of neuroblastoma remains unclear, although it is thought to stem from genetic mutations occurring during nerve cell maturation. Some of these mutations may be hereditary, while others arise sporadically within the child's cellular makeup. These genetic changes can disrupt the normal growth and function of neuroblasts, leading to uncontrolled proliferation and tumor formation.
Certain risk factors may heighten the likelihood of neuroblastoma development:
Family background: If a parent or sibling has neuroblastoma, the likelihood of developing the condition increases, particularly if it's inherited.
Age: Neuroblastoma predominantly affects children below the age of 5, with instances rare among those over 10 years old.
Gender: Neuroblastoma tends to occur slightly more frequently in boys than girls.
Ethnicity: Neuroblastoma is more prevalent among white children compared to children of other racial backgrounds.
Symptoms of neuroblastoma differ based on the tumor's location, size, and metastasis. Common neuroblastoma symptoms include:
Abdominal discomfort or enlargement
Pain in the chest or breathing difficulties
Presence of a lump or swelling beneath the skin
Fever or loss of weight
Bone discomfort or fractures
Vision issues such as drooping eyelids, unequal pupil size, or protruding eyes
Alterations in skin condition like bruising, rash, or redness
Nerve-related symptoms like numbness, weakness, or paralysis
Certain symptoms might arise from different conditions, hence it's crucial to seek medical advice if they continue or worsen.
Diagnosing neuroblastoma involves evaluating the patient's medical history, conducting a physical examination, and performing various tests and procedures. The doctor typically inquires about symptoms, their duration, frequency, and the patient's family medical history. Additionally, the doctor examines the patient for signs of tumors, including lumps, swelling, or nerve damage.
The diagnostic methods for neuroblastoma may include:
Blood tests: These assess levels of specific substances in the blood, such as hormones, enzymes, or markers, which can indicate neuroblastoma presence or activity.
Urine tests: These evaluate levels of certain substances in urine, such as hormones or metabolites, which may signify neuroblastoma presence or activity.
Imaging tests: Techniques like X-rays, ultrasound, CT scans, MRI scans, or MIBG scans generate images of the body's interior. These help locate and measure tumors and determine if they have spread to other organs or tissues.
Biopsy: This involves extracting a small tissue sample from the tumor or nearby lymph node for microscopic examination. It confirms the diagnosis and identifies tumor cell type and characteristics.
Bone marrow aspiration and biopsy: This procedure collects bone marrow fluid and tissue from the hip or chest bone. Microscopic examination of the sample checks for tumor cell presence in the bone marrow.
Treatment for neuroblastoma is tailored based on the tumor's stage, risk group, and characteristics, along with the patient's age, health status, and preferences. The primary treatment objectives are:
Eliminate or eradicate the tumor and any cancerous cells that might have metastasized to other areas of the body.
Minimize or alleviate the adverse effects and complications associated with both the tumor and the treatment regimen.
Maintain or restore the normal function and appearance of the affected organs and tissues.
Enhance the patient's quality of life and prolong survival.
Potential treatment avenues for neuroblastoma encompass:
Surgical intervention involves the excision of the tumor and adjacent lymph nodes or organs that may be impacted by the tumor. It can be conducted independently or in conjunction with complementary treatments like chemotherapy or radiation.
Chemotherapy employs medications designed to eliminate or inhibit the growth of cancer cells. It may be administered before or after surgery, or as the primary treatment for tumors that cannot be surgically removed or have metastasized. Chemotherapy can be delivered orally, via injection, or through infusion.
Radiation therapy involves the application of high-energy rays or particles to harm or eradicate cancer cells. It can be administered before or after surgery, or serve as the primary treatment for tumors that cannot be surgically excised or have metastasized. Radiation therapy may be delivered externally or internally.
Immunotherapy employs substances that activate the immune system to combat cancer cells. It can be administered following chemotherapy or radiation, or serve as the primary treatment for tumors with a high risk of recurrence or those unresponsive to other therapies. Immunotherapy may be delivered via injection or infusion.
Stem cell transplant involves replacing bone marrow cells that have been harmed or eliminated by intense chemotherapy or radiation. This procedure can be performed after chemotherapy or radiation, or as the primary treatment for tumors with a high risk of recurrence or those resistant to other therapies. Stem cell transplant may utilize the patient's own cells (autologous) or cells from a donor (allogeneic).
Preventing neuroblastoma is challenging since the exact cause of the disease remains unclear. Nonetheless, here are some potential methods to lower the risk of developing neuroblastoma:
Reducing exposure to radiation or chemicals that could harm nerve cell DNA
Ensuring regular check-ups and screening tests for children with a family history of neuroblastoma or other genetic syndromes predisposing to the condition
Promptly consulting medical professionals upon noticing any symptoms or signs indicative of neuroblastoma
