Neuroblastoma is a cancer of the nerve system. Usually diagnosed in infants and very young children, it frequently develops while the child is still unborn. Some 500 children receive are diagnosed with neuroblastoma in the U.S. every year. It is important to recognize that side effects that affect the child involve symptoms of neuroblastoma as well as the side effects of aggressive treatments for the cancer. By addressing both types of side effects, you will be able to make the child affected by neuroblastoma as comfortable and pain-free as possible.
What Is Neuroblastoma?
Neuroblastoma is a malignant (cancerous) neoplasm that generally begins in the nerve tissue of infants and very young children, often before the child is born. It can remain undetected until it begins to grow and press on the organs and normal tissue that surround it.
There are three types of neuroblastoma: low risk, intermediate risk and high risk. Neuroblastoma, if untreated, continues to grow and may metastasize (move or spread to other parts of the body).
A genetic abnormality is frequently the cause of neuroblastoma, but the cause of that abnormality is, as yet, unknown. Neuroblastoma is slightly more likely to occur in a male child than a female.
What Is a Neoplasm?
A neoplasm is an abnormal tissue or a tumor that is characterized by rapid cellular growth, which can be either benign (a harmless growth) or malignant (cancerous). Neoplasms usually continue to grow and will form a distinct mass of cellular tissue. The neuroblastoma type of neoplasm is always malignant.
Where Are Neuroblastomas Found?
About a third of all neuroblastomas begin in the adrenal gland tissues. The adrenal glands are located near the top of the kidneys, in the abdominal cavity. Adrenal glands secrete fluids that aid normal functions in the child's body, particularly the nervous system.
Other neuroblastomas can occur in the ganglia (nerve cell clusters found throughout the body, and also part of the nervous system). In some cases, neuroblastomas have been detected before birth with the aid of fetal ultrasound.
Symptoms of Neuroblastoma
The symptoms or effects of the growing tumor vary, depending on the location and size of the tumor and how quickly it spreads. These can include an abdominal mass or swelling, tumors evident around the eyes (causing bruising, swelling and uncontrolled eye movement), changes in urination from compression on the bladder or kidneys, and pain, limping, weakness or paralysis (if the tumor involves the bone, bone marrow or spinal cord).
Other symptoms include a chronic cough or shortness of breath (if there is a tumor in the chest), diarrhea, fever, high blood pressure and increased heart rate, loss of appetite, and weight loss.
Treatment for Neuroblastoma
Treatment for low-risk and intermediate-risk neuroblastoma can include surgery (followed by observation), observation alone for certain infants, surgery that is followed by chemotherapy or low-dose chemotherapy, and radiation therapy.
High-risk neuroblastoma may require high-dose chemotherapy, followed by surgery; radiation directed to the tumor site; stem cell transplant; monoclonal antibody therapy (after chemo); and a clinical trial of radiation therapy with radioactive iodine (usually before stem cell transplant).
Side Effects of Treatment
Side effects will vary, depending on what methods are used to treat the neuroblastoma. Some general side effects may include slowed or impaired growth, thyroid problems, secondary cancer and infertility (from chemotherapy drugs). Brain irradiation or total body irradiation may cause difficulty in thinking and thought processing. Side effects of the chemotherapy and radiation are pain, nausea and vomiting; lethargy; loss of appetite; hair loss; and suppression of the immune system.
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