46 children a day are diagnosed with cancer.
7 kids die every day from cancer.
Did you know?
Neuroblastoma is a tumor of nerve tissue that develops in infants and children and can occur in many areas of the body. It develops from the tissues that form the sympathetic nervous system (which controls body functions, such as heart rate and blood pressure, digestion and levels of certain hormones). It most commonly begins in the abdomen in the tissues of the adrenal gland, but it may also occur in other areas. It can spread to the lymph nodes, liver, bones and bone marrow. Juliana's tumor originated in her left kidney, causing her to be hypertensive. It never metastasized, but it was also found around her aorta, Celiac and SMA arteries and began to wrap around the blood vessel of her right kidney.
Neuroblastoma may be considered a malignant manifestation of aberrant sympathetic nervous system development. Until recently, however, little was known about the genetic basis of this disease. As has been shown for many human cancers, a subgroup of cases display autosomal dominant inheritance. It was recently reported that activating mutations in the tyrosine kinase domain of the ana-plastic lymphoma kinase (ALK) oncogene account for most cases of hereditary neuroblastoma. These germline mutations encode for single-base substitutions in key regions of the kinase domain and result in constitutive activation of the kinase and a premalignant state. Mutations resulting in oncogene activation are also somatically acquired in 5 to 15% of neuroblastomas.
Who can be diagnosed with Neuroblastoma?
Neuroblastoma is typically diagnosed in babies or young children. The average age for neuroblastoma is about 18 months of age but it is occasionally seen in teenagers or even young adults. It is found slightly more often in boys than in girls. In the United States, about 650 new cases of neuroblastoma are diagnosed each year. It has rapidly progressed in the last 5 years.
What are the signs and symptoms of Neuroblastoma?
Signs and symptoms will vary depending on the site of the primary tumor or the extent that it has spread (metastasized). The most common primary site is the abdomen. Other primary sites include the chest, neck and pelvis. Neuroblastoma can spread to other areas of the body. If your child has a primary tumor in the abdomen, you may notice bellyaches, weight loss or a bigger abdomen. Some children only complain of general aches and pains. In Juliana's case, her symptoms were loss of appetite, hypertension, rapid weight loss and lethargy. If you think something just "isn't right" with your child - get it checked out immediately.
How is Neuroblastoma "officially" diagnosed?
Your child will need to have a series of tests to help learn about the extent of the disease. Some of the neuroblastoma tests include:
We do not expect you to know what these tests mean, but your doctors use this information to determine the best treatment for your child.
What are the "stages" of Neuroblastoma?
The tests used to diagnose neuroblastoma can also be used to determine the stage of the disease. Stage is a term that refers to the location and extent of cancer tumor(s) and cells. Treatment of neuroblastoma can differ widely depending on the stage. The tumor stages outlined below are based on a tumor-staging system used by experts worldwide.
The tumor is confined to the area in which it arose (i.e., there has been no spread, or metastasis) and can be completely removed by surgery.
The tumor is confined to the area in which it arose, but cannot be completely removed by surgery.
The tumor is confined to the area in which it arose. It may or may not be possible to completely remove the tumor by surgery. Neuroblastoma cells are present in the lymph nodes adjacent to the tumor.
The tumor cannot be completely removed by surgery and has either:
- spread from one side of the body to the other and may also have spread to nearby lymph nodes;
- remained confined to the area in which it arose, but spread to lymph nodes on the other side of the body; or
- remained confined to the middle of the body and spread to lymph nodes on both sides of the body.
The tumor has spread to distant lymph nodes, bone marrow, bone, liver, or other organs (except as defined by stage 4S).
Stage 4S is applicable only to children who are younger than one year. The tumor is confined to the area in which it arose, as in stages 1 and 2, but some cells have spread to the liver, skin, or bone marrow.
How is newly diagnosed Neuroblastoma treated?
You'll need to determine whether the disease risk is low, intermediate or high.
Newly diagnosed patients are generally treated according to Children's Oncology Group protocols. However, every child will receive individualized treatment planning and other treatments may be recommended.
How is relapsed or refractory neuroblastoma treated?
Unfortunately, high-risk neuroblastoma still has a very high rate of non-responsiveness, or recurring/relapsing during or after treatment. There is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma. Patients may want to consider a clinical trial. For information about clinical trials, please visit our Clinical Trials tab.
Check for U.S. clinical trials from NANT or NCI's list of cancer clinical trials that are now accepting patients with neuroblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from NANT  or NCI Web site. 