What is neuroblastoma?
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:
- fight-or-flight response
- levels of certain hormones
- heart rate
- blood pressure
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:
- adrenal gland
If it progresses, it can spread to bones, lymph nodes, and
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.
Is neuroblastoma inherited?
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.
What are the symptoms of neuroblastoma?
Common symptoms of
- a lump in the neck, chest, or abdomen
- bulging eyes
- dark circles under the eyes
- abdominal swelling
- bone pain
- weakness in the upper or lower extremities
- paralysis of, or an inability to move, the upper
or lower extremities
- painless, bluish swellings beneath the skin
Less common symptoms include:
- a fever
- shortness of breath
- a cough
- high blood pressure
- abnormal bleeding or bruising, including small,
flat, red spots on the skin called petechiae
- a rapid heart rate
- excessive sweating
- involuntary, uncontrolled movements of your
eyes, feet, and legs
Many other conditions can cause these symptoms. They don’t
necessarily point to a diagnosis of neuroblastoma.
How is neuroblastoma diagnosed?
Due to the nonspecific nature of the symptoms of early
neuroblastoma, the disease tends to have progressed to later stages before it’s
Your child’s doctor may diagnose neuroblastoma by using the
- blood tests
- urine tests
- a bone marrow biopsy
- a CT scan
- an MRI scan
- a positron emission tomography scan
- a bone scan
- an ultrasound
is neuroblastoma staged?
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
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:
- The tumor is still restricted to the area of
your child’s body where it first developed. It’s only on one side of their
body. However, cancer cells have been found in lymph nodes on the other side of
- The tumor is in the middle of your child’s body,
and it’s spreading toward both sides of their body. This is due to growth of
the tumor itself or the spread of cancer cells through your child’s lymph
- The tumor can’t be entirely removed during
surgery. It has also spread from one side of your child’s body to the other
side. It may or may not have spread to nearby lymph nodes.
In stage 4, the tumor or cancer cells have spread to distant
parts of your child’s body, such as the:
- distant lymph nodes
- other organs
neuroblastoma behaves differently. It occurs when the following criteria are
- Your child is younger than 1 year old.
- The cancer is on one side of their body. It may
have spread to lymph nodes on that side of their body but not the other side.
- The tumor has spread to their liver, skin, or
- Less than 10 percent of their bone marrow cells
- The cancer hasn’t spread to their bones.
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:
- the stage of cancer
- the tumor’s histology
- the tumor’s biology
- your child’s age
Low-risk and intermediate-risk neuroblastoma
have a good chance of being fully cured. High-risk neuroblastoma is typically harder to cure.
How is neuroblastoma treated?
The treatment for neuroblastoma depends on your child’s age
and the stage of their cancer. It may include:
- radiation therapy
- a stem cell transplant
Many children with neuroblastoma will have more than one
type of treatment. Treatment is typically done in stages and can last several
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
- hair loss
- mouth sores
- a weakened immune system
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
Stem cell therapy
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.
What is the outlook for children with neuroblastoma?
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
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:
- developmental problems
- learning difficulties
- vision problems
- muscle and bone issues
- secondary cancers
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.