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Neuroblastoma : Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors , Complications , Prevention

 What Is Neuroblastoma?

Neuroblastoma is an unprecedented formative years cancer of what’s called the “sympathetic nervous gadget” -- the community of nerves that incorporates messages out of your mind to the relaxation of your body.

The most cancers most often start off evolving around the adrenal glands, those hormone-producing organs that take a seat atop the kidneys and have cells similar to nerve cells. But neuroblastoma can also begin in other areas of the frame where organizations of nerve cells are clustered.

Neuroblastoma is an extraordinary type of cancer that basically impacts babies and younger children.

It develops from specialized nerve cells (neuroblasts) left at the back of a baby's development within the womb.

Neuroblastoma most typically happens in 1 of the adrenal glands located above the kidneys, or within the nerve tissue that runs along the spinal cord inside the neck, chest, tummy or pelvis.

It can spread to different organs, consisting of the bone marrow, bone, lymph nodes, liver and pores and skin.

It affects around one hundred kids every 12 months inside the UK and is most not unusual in children under the age of 5.

The motive is unknown. There are very rare cases wherein kids inside the same family are affected, but usually neuroblastoma does not run in families.

What to Expect Neuroblastoma is a rare form of cancer that develops in nerves and nerve tissue It usually affects children under the age of 5 but can occur at any age Treatment for neuroblastoma typically involves chemotherapy and possibly surgery depending on the location of 

A disease that begins in the nervous system neuroblastoma originates from nerve tissue and is often considered an "orphan" cancer because it is rare and does not have a specific cause Neuroblastoma can arise anywhere along the neural path from the spinal cord to the brain stem and within the sympathetic nervous system that controls involuntary actions such as heart rate blood pressure body temperature and digestive functions.

What Is Neuroblastoma


Explanation of medical terms and concept Neuroblastoma

Neuroblastoma is a cancer that develops from immature nerve cells located in several areas of the body.

Neuroblastoma most commonly originates in and around the adrenal glands, which are similar to nerve cells and are located on top of the kidneys. However, neuroblastoma can also develop in other parts of the body, such as the abdomen, chest, neck, and near the spine - where groups of nerve cells exist.

Neuroblastoma is most commonly found in children aged 5 or younger, but it may rarely occur in older children.

Neuroblastoma can either go away on its own, or it may require multiple treatments. The treatment options for your child's neuroblastoma will depend on several factors.

 

What to Expect Neuroblastoma is a rare form of cancer that develops in nerves and nerve tissue It usually affects children under the age of 5 but can occur at any age Treatment for neuroblastoma typically involves chemotherapy and possibly surgery depending on the location of the tumor.

 

Neuroblastoma is a type of cancer that develops from immature nerve cells It is the most common solid tumor found in infants and children younger than 5 years old Approximately one-third of all neuroblastomas are diagnosed in infants younger than 1 year old The American Cancer Society estimates that about 750 new cases of neuroblastoma will be diagnosed in 2014 with more than 300 deaths The average survival rate for patients with stage I or II disease is almost 90% while the survival rate for patients with stage III or IV disease ranges between 65% and 80%.

Stages of neuroblastoma

Healthcare providers classify neuroblastoma in children based on how advanced the most cancers are and how speedy it’s developing. They also consider whether it has spread (metastasized) to different parts of the frame.

Using this information, carriers decide the most cancers' hazard degree. Then they choose the maximum appropriate remedies. The level of neuroblastoma was decided via how tons of neuroblastoma turned into discovered inside the frame after surgical operation. Now, the International Neuroblastoma Risk Group Staging System (INRGSS) is used. The degree of neuroblastoma is decided by means of how a whole lot of tumor spread is seen on initial imaging studies (along with CT test or MRI, as mentioned beneath), referred to as “picture-described hazard elements.” The INRG tiers of neuroblastoma are:

  • Stage L1: This is the stage with the bottom threat. L1 tumors are limited to one body compartment and features no longer unfold. Also, the tumor does not contain essential structures of the body (no picture-described hazard factors are a gift).

  • Stage L2: In this stage, the tumor is confined to 1 frame compartment, however most cancer cells can unfold to regional lymph nodes, as an example. Also, there's involvement of crucial systems of the frame, which include tumor wrapping around big blood vessels (i.E., at least one photo-defined hazard aspect is gift).

  • Stage M: In this level, the cancer cells have developed into a couple of body compartments – referred to as “distant metastatic sickness.” This stage carries the very best threat.

  • Stage MS: This is a “unique” class of neuroblastoma, affecting children younger than 18 months of age. In this level, the cancer cells have spread (or metastasized) to either the pores and skin, liver or bone marrow only. Children with degree MS neuroblastoma usually have a first rate diagnosis. Stage MS neuroblastoma is commonly taken into consideration as a low-threat disorder.

Neuroblastoma in children

Neuroblastoma is a cancer that develops in certain types of nerve cells called neuroblasts These are immature nerve cells found in an embryo or fetus and they eventually develop into mature nerve cells Neuroblasts are found in the sympathetic nervous system (the part of the nervous system that controls the body's "fight or flight" response) as well as other parts of the body such as bone marrow lymph nodes and skin.

Symptoms Neuroblastoma

The symptoms of neuroblastoma range from where the cancer is and whether or not it unfolds.

The early symptoms can be vague and difficult to spot, and may without difficulty be mistaken for the ones of extra not unusual formative years conditions.

Neuroblastoma could have distinctive symptoms and signs depending on where it's miles located in the frame.

Neuroblastoma in the abdomenSigns and symptoms may occur when the most common form of this medication is taken, such as drowsiness, changes in mood or energy, and problems with balance.

  • Abdominal pain

  • A lump or mass under the skin that doesn't feel soft when touched.

  • Changes in bowel habits such as diarrhea or constipation can be a sign of a health problem.

Neuroblastoma in the chest may cause signs and symptoms such as:

  • Wheezing

  • Chest pain

  • Changes to the eyes, such as drooping eyelids and an unequal pupil size.

Some signs and symptoms that may indicate neuroblastoma include: A person with neuroblastoma may have:

  • Lumps of tissue under the skin

  • If an eyeball seems to protrude from the socket, that is called proptosis.

  • Your second grader might notice dark circles around their eyes that look a lot like bruises.

  • Back pain

  • Fever

  • Unexplained weight loss

  • Bone pain

When to see a doctor

If you have any concerns about your child, be sure to contact their doctor. Also mention any changes in their behavior or habits.

Causes Neuroblastoma

In trendy, cancers start with changes (“mutations”) in a few cells of someone’s body. The modifications allow those cells to develop out of manipulation. They can shape tumors and often forestall the cells from carrying out what they may be commonly speculated to do.

 

In neuroblastoma, the mutations have an effect on immature nerve cells in an infant nonetheless in the womb. The cells are known as neuroblasts. As the child maintains to grow earlier than beginning, the neuroblasts mature into functioning nerve cells.

In a healthful toddler, the neuroblasts depart absolutely because the apprehensive machine matures. But in toddlers with this circumstance, the mutated neuroblasts stick round and form a tumor.

 

Cancer begins with a genetic mutation that allows abnormal cells to grow and multiply. The abnormal cells form a mass (tumor), which can be harmful to the body.

Neuroblastoma begins when immature nerve cells are created in a fetus's development process.

As the fetus matures, neuroblasts will eventually turn into nerve cells and fibers. Most neuroblasts will mature by birth, though a small number of immature neuroblasts can be found in newborns. In most cases these neuroblasts will mature or disappear. However, in some cases they may persist. A tumor can form when neuroblasts grow abnormally.

It is not clear why the initial genetic mutation that leads to neuroblastoma occurs.

Risk factors Neuroblastoma

A danger factor is something that increases your probabilities of getting a disease together with cancer. Learn extra approximately the hazard factors for neuroblastoma.

Some children with a family history of neuroblastoma may be more likely to develop the disease. However, familial neuroblastoma is thought to account for a very small number of cases of neuroblastoma. In most cases, the cause of the disease is never identified.

Complications

Neuroblastoma may have complications, including:

  • Spread of the cancer (metastasis).Neuroblastoma may spread to other parts of the body, such as the lymph nodes, bone marrow, liver, skin, and bones.

  • Spinal cord compression is when the spinal cord is squeezed.Tumors may grow and press on the spinal cord, leading to spinal cord compression. This can cause pain and paralysis.

  • The signs and symptoms that may occur as a result of tumor secretions.Neuroblastoma cells may secrete chemicals that irritate other tissues, causing signs and symptoms called paraneoplastic syndromes. One paraneoplastic syndrome that occurs rarely in people with neuroblastoma is rapid eye movements and difficulty with coordination. Another rare syndrome is when neuroblastoma cells produce a substance that makes the body's cells behave abnormally.The syndrome causes abdominal swelling and diarrhea.

Prevention

It isn’t viable to prevent neuroblastoma. If you or your accomplice had neuroblastoma as a toddler or have a family history of the disorder, talk to your provider. All children identified with neuroblastoma have to receive genetic counseling to look if genetic testing is needed. Genetic trying out can inform you in case your baby has the gene markers for familial (inherited) neuroblastoma. However, it's vital to remember that the inherited form of neuroblastoma may be very uncommon – handiest 1% to 2% of cases. Additionally, some gene mutations that growth the hazard of having neuroblastoma are surpassed down via families – for example, patients with Li Fraumeni syndrome (or a mutation in the p53 gene, which paperwork a tumor suppressor protein) are at accelerated danger for lots varieties of cancers, together with neuroblastoma.

The threat of many people's cancers may be reduced with certain way of life modifications , but at the moment there are no recognized methods to save most cancers in children. 

 

The best recognized hazard elements for neuroblastoma can't be modified. There aren't any recognized life-style-related or environmental causes of neuroblastoma right now.

Diagnosis Neuroblastoma

Most youngsters with neuroblastoma acquire an analysis earlier than age five. In reality, neuroblastoma is the most common cancer in infants. Sometimes, vendors diagnose neuroblastoma in unborn babies at some point of a prenatal ultrasound.

To diagnose neuroblastoma, your baby’s company will do a bodily and neurological examination. A neurological examination checks your toddler’s nerve characteristics, reflexes and coordination.

Tests used to diagnose neuroblastoma include:

These include:

  • Blood and urine tests. 

  • Imaging tests. 

  • Ultrasound. 

  • X-rays. 

  • Other types of scans. 

  • Biopsy.  

  • Physical exam.Your child's doctor will check your child's health by conducting a physical exam. The doctor will ask you questions about your child's lifestyle and behavior.

  • Urine and blood tests.These tests can help identify the cause of any signs and symptoms your child is experiencing. Urine tests may detect high levels of chemicals produced by neuroblastoma cells, which may be responsible for them.

  • Imaging tests.An imaging test may reveal a mass that could indicate a tumor. Imaging tests may include an X-ray, ultrasound, CT scan, and MRI.

  • Removing a sample of tissue for testing. If you find a mass on your child, the doctor may want to take a sample of the tissue for lab testing (a biopsy). Tests on the tissue can reveal what type of cells are involved in the tumor and specific genetic information about the cancer cells. This information helps your doctor determine how to treat your child's cancer. The doctor will create an individualized treatment plan for the child.

  • To take a sample of bone marrow for testing, you will need to remove a piece of bone.Your child may undergo a bone marrow biopsy and bone marrow aspiration procedure to see if neuroblastoma has spread to the bone marrow. A needle is inserted into your child's largest bones to remove the spongy material inside them for testing.Draw out the marrow from a child's hip bone or lower back.

Staging

When neuroblastoma is diagnosed, your child's doctor may order further testing to determine the extent of the cancer and whether it has spread to other parts of the body. Knowing the cancer's stage can help the doctor decide on the best treatment.

Images used to diagnose cancer include X-rays, bone scans, and CT MRI scans.

The stages of neuroblastoma are numbered with Roman numerals that range from 0 to IV. The lowest stage indicates cancer that is limited to one area. By stage IV the cancer has spread to other areas of the body.

Treatment Neuroblastoma

Some toddlers and infants less than 18 months old with either level L1 or Ms neuroblastoma who've no symptoms won't need any remedy, as the most cancers can once in a while go away on its own.

Your doctor will select a treatment plan based on several factors, including your child's age and the stage of the cancer, as well as the type of cells involved. If there are any abnormalities with your child's chromosomes or genes, the doctor will take that into account when making a decision about treatment.

Doctor's use this information to classify neuroblastoma as low risk, intermediate risk, or high risk. Treatment your child receives for neuroblastoma will depend on the risk category.

Surgery

Surgeons use surgical tools to remove cancer cells from the head and other parts of the body in children with low-risk neuroblastoma. If the tumor is removed, the child may only need treatment for neuroblastoma once.

The size and location of the tumor will affect whether it can be completely removed. If the tumor is attached to vital organs, such as the lungs or the spinal cord, it may be too dangerous to remove.

Surgical removal of the tumor in neuroblastoma patients in intermediate-risk and high-risk categories may be attempted. Alternatives such as chemotherapy and radiation may then be used to kill any remaining cancer cells.

Chemotherapy

Chemotherapy destroys cancer cells by using chemicals. It targets rapidly growing cells in the body, including cancer cells. Unfortunately, chemotherapy can also damage healthy cells that grow quickly. This can cause side effects such as hair loss and diarrhea. The effects of decoupage will become apparent after it dries.

Some children with intermediate-risk neuroblastoma receive a combination of chemotherapy drugs before surgery to make sure the tumor is completely removed.

Children with high-risk neuroblastoma usually receive high doses of chemotherapy to shrink the tumor and to kill any cancer cells that have spread. Chemotherapy is usually used before surgery and before bone marrow transplant.

Radiation therapy

Radiation therapy uses high-energy beams to destroy cancer cells.

Some children with low- or intermediate-risk neuroblastoma may receive radiation therapy in addition to other treatments if surgery and chemotherapy haven't worked. Children with high-risk neuroblastoma may receive radiation therapy after chemotherapy and surgery to prevent the cancer from coming back.

Radiation therapy affects the area where it is aimed, but some healthy cells may be damaged. Side effects depend on where the radiation is directed and how much radiation is administered.

Bone marrow transplant

Children with high-risk neuroblastoma may receive a transplant using their own stem cells, which are taken from the bone marrow (autologous stem cell transplant).

Before a bone marrow transplant, your child will have a procedure to collect stem cells from their blood. These cells will be stored for later use. After the chemotherapy has killed any remaining cancer cells, the stem cells will be used in the transplant. Your child's stem cells will be injected into your child's body. These cells will help form new healthy blood cells.

Immunotherapy

Cancer treatment may involve the use of drugs that signal the body's immune system to help fight cancer cells. Children with high-risk neuroblastoma may receive immunotherapy drugs that stimulate the immune system to kill the cancer cells.

Newer treatments

Doctors are testing a newer form of radiation therapy to control neuroblastoma. The treatment uses a radioactive form of the chemical metaiodobenzylguanidine (MIBG). When injected into the bloodstream, MIBG travels to the neuroblastoma cells and releases radiation.

After receiving an injection of MIBG, your child will need to stay in a special hospital room until the radiation leaves his or her body. MIBG therapy usually takes a few days. Afterward, your child will need to stay in a different room for several days as the radiation leaves their body in their urine.

Can neuroblastoma cancer be cured?

Neuroblastoma cancer is a rare type of cancer that usually occurs in infants and children Approximately 1,000 to 2,000 children are diagnosed with neuroblastoma every year in the United States according to the American Cancer Society Children who have neuroblastoma develop masses in their adrenal glands or tissues surrounding their kidneys Less frequently tumors can form in any part of the body including the brain and spinal cord Neuroblastoma is often curable if it is found early and treated by specialists who specialize in the types of cancers that affect infants and children The sooner your child's neuroblastoma is diagnosed the better her chances for survival will be For more information about how parents can help.

How long is the treatment for neuroblastoma?

There are two ways to treat neuroblastoma: a full course of chemotherapy and surgery or observation alone The treatment plan depends on the tumor’s location, size , number of tumors and whether it has spread beyond the abdomen.

Can a neuroblastoma be removed?

Neuroblastoma is a common cancer found in children It often occurs in the adrenal gland where it can be removed with surgery However if the tumor has spread to other parts of the body as with Stage 4 neuroblastoma it cannot be completely removed and may extend survival by as little as three months.

Coping and support

When your child is diagnosed with cancer, it's common to feel a range of emotions — from shock and disbelief to guilt and anger. In the midst of this emotional storm, you're expected to make decisions about your child's treatment. It can be overwhelming.

If you're feeling lost, you might try to find your way by looking for things that are familiar.

  • Gather all the information you need. Learn as much as you can about neuroblastoma so that you feel comfortable making decisions about your child's care. Talk with your child's health care team. Keep track of the questions you ask at each appointment. Visit your local library and look for information on the internet. Consult websites about neuroblastoma to get more information. Visit the National Cancer Institute for more information. The American Cancer Society also has information about cancer.

  • Get help from your friends and family. Find friends and family who are willing to be supportive of you as a caregiver. They can accompany your child to doctor visits or sit by their bedside in the hospital when you can't be there. When you're with your child, your friends and family can help out by spending time with your other children. Helping around the house is a good way for children to spend their time.

  • Help children with cancer by using resources that are available to you.Look for resources that are specifically designed for families of kids with cancer. Talk to your clinic's social workers about what is available. Support groups made specifically for parents and siblings can put you in touch with people who understand what you are going through. Your family may be eligible for summer camps that provide temporary housing.Use other supports to hold the paper down. Hold the paper down with glue, tape, or other support.

  • Do your best to maintain normalcy.Cancer treatment can be difficult for small children. To help your child cope, try to keep a normal routine as much as possible. This will help them feel less anxious.
    Make sure to schedule appointments so that your child will have a set nap time each day. Have regular meals. Allow your child some time to play when he or she feels up to it. If your child needs to be hospitalized, try to bring items from home that will make him or her feel more comfortable.
    Talk to your health care team about other ways to comfort your child during treatment. Some hospitals have recreation therapists or child-life workers who can provide more-specific ideas on how to help your child cope.

Preparing for your appointment

If your child has any signs or symptoms that make you worried, please make an appointment with your family doctor or pediatrician. You may be referred to a doctor who specializes in digestive problems (gastroenterologist), respiratory problems (pulmonologist), or problems affecting the brain and nervous system. A neurologist is a doctor who specializes in diagnosing and treating neurological disorders.

Appointments are often brief and you'll likely need to cover a lot of ground. It's a good idea to be well-prepared for your child's appointment. Here are some tips on getting ready and what to expect from their doctor.

What you can do

  • Be aware of any pre-existing restrictions that may need to be followed before your appointment.When you make the appointment, be sure to ask if there are any restrictions that need to be put in place such as restricting your child's diet.

  • Keep a list of any symptoms your child is experiencing.Include any unrelated items in your appointment. Appointments are for the purpose of completing a specific task, not for leisurely browsing.

  • Write down key personal information,If you are making a journal, it is important to include any major stresses or recent life changes.

  • Make a list of all medications,Make sure that the vitamins or supplements your child is taking are compatible.

  • Take a family member or friend along.If you forget some of the information during your appointment, a friend or family member can help you remember it.

  • Write down questions to ask your child's doctor.

You will only have a limited amount of time with your child's doctor, so it is important to prepare a list of questions in advance. List the questions that are most important to you in case time runs out. Some basic questions to ask the doctor about neuroblastoma may include:

  • What could be causing my child's symptoms or condition?

  • What are some other possible explanations for my child's symptoms or condition?

  • What kinds of tests does my child need?

  • What is the child's condition likely to be--temporary or chronic?

  • What is the best course of action?

  • What are some other ways to do what you're suggesting?

  • My child has other health problems. How can they best be treated together?

  • What are some guidelines my child needs to follow?

  • Should my child see a doctor? How much will it cost and is my insurance likely to cover it?

  • What kind of printed materials do I need to take with me? What websites do you recommend visiting?

  • What will determine whether I should schedule a follow-up visit?

Ask any questions that you don't understand about your child's doctor visit. Don't hesitate to ask questions at any time.

What to assume out of your infant's doctor go to. Your baby's medical doctor will ask approximately your toddler's fitness and well-being, and can carry out a bodily examination. The medical doctor may additionally order exams to help diagnose the cause of your toddler's signs.

Your doctor may ask you some questions. Being prepared to answer them may allow more time to cover points you want to address.Your doctor may ask you some questions.

  • When did your child start having symptoms?

  • Do your child's symptoms have been continuous?

  • How serious are your child's symptoms?

  • What might help improve your child's symptoms?

  • What are the possible side effects of treatment?

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Neuroblastoma  : Causes, Types, Symptoms, Diagnosis ,Treatment , Risk factors  , Complications , Prevention

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