Neuroblastoma is a cancer and the second most common malignant growth in children, after brain tumors. In Germany, about 150 children are affected by a neuroblastoma every year, with the survival rate depending heavily on the stage of the tumor.
What is neuroblastoma?
A neuroblastoma is a solid, malignant tumor that arises from abnormal cells of the sympathetic nervous system. This nervous system controls, among other things, the heart and circulation or the intestinal activity. See percomputer for Liver Diseases Explanation.
If the immature cells of this nervous system degenerate, a neuroblastoma forms. The degeneration of immature cells begins prenatally. The tumor occurs most frequently in the adrenal medulla (about 50 percent of all cases) or on both sides of the spine in the so-called sympathetic trunk. If this sympathetic trunk is affected, the tumor can develop along the entire spine, ie in the abdomen, chest or neck area.
Neuroblastomas can be limited to the site of origin or they can spread, ie form metastases. Metastases are not limited to any single site, and may appear in the lungs, kidneys, brain, or lymph nodes. Neuroblastomas have the trait of resolving spontaneously in some cases, for which doctors have not been able to find a reason until now.
In over 50 percent of all cases, neuroblastomas occur within the first 15 months of life, with boys being affected more often than girls. The risk of developing neuroblastoma decreases with age. However, adolescents and adults can also rarely be diagnosed with neuroblastoma.
Neuroblastomas are caused by the degenerated cells of the sympathetic nervous system. Since the degeneration often occurs before birth, gene mutations and spontaneous chromosome changes can be the reason for the cell change.
Genetic inheritance has not yet been proven, but there are families in which neuroblastomas occur more frequently (about 1 percent of cases). Nutrition during pregnancy, stress and environmental factors have not yet been proven to be causes of cell degeneration.
Symptoms, Ailments and Signs
- in the neck area: Horner’s syndrome in 15 to 20 percent
- in the chest area: shortness of breath
- in the abdominal area: abdominal pain, back pain, urinary tract, intestinal problems
- pain, pallor, fever and weight loss
- possibly high blood pressure or diarrhea
diagnosis and course
Many patients with neuroblastoma initially have no symptoms at all. These occur later with advanced tumor growth or metastasis. If symptoms occur, they are usually dependent on the location of the tumor.
Stomach pain, fever, diarrhea, sore throat, tiredness and a general feeling of illness can occur. However, since these are all non-specific symptoms, the doctor has to use various tools such as magnetic resonance imaging, X -rays, computed tomography and laboratory tests for diagnosis.
If a tumor is discovered, further examinations can clarify whether individual organs are affected. A definitive confirmation of the diagnosis is obtained through a histological examination of the tumor.
An MIBG scintigraphy, in which a radioactive substance is injected into the patient’s bloodstream, is performed to detect or rule out the formation of metastases.
Neuroblastoma leads to many different symptoms and complications. As a rule, the further course of this disease depends very much on its cause and the affected region of the body. For this reason, it is usually not possible to make a general prediction about the further course.
In most cases, those affected suffer from diarrhea and high blood pressure. It can also cause fever and weight loss. Neuroblastoma often leads to abdominal and back pain and can have a very negative effect on the patient’s digestion. Furthermore, the course of this complaint depends very much on the time of diagnosis, so that the disease does not always progress positively.
In the extreme stage, the patient dies from the symptoms of neuroblastoma. Furthermore, it is not uncommon for the parents and relatives of the child to be affected by neuroblastoma and suffer from psychological problems. There are no special complications in the treatment of this disease. However, a positive course cannot always be guaranteed. The life expectancy of the patient may also be significantly reduced by the neuroblastoma.
When should you go to the doctor?
If children show abnormalities and health changes, special care is required. Since neuroblastoma is a tumor disease, a doctor’s visit is recommended at the first sign of an irregularity. The sooner a diagnosis can be made, the better the chances of recovery. Otherwise, in severe cases, the child may die prematurely.
A doctor is required in the event of restricted breathing, shortness of breath or interruptions in breathing activity. If the child complains of abdominal pain, general malaise or back pain, it is advisable to see a doctor. In the case of disorders of the digestive tract, a decrease in play activities or other behavioral problems, a doctor’s consultation is indicated. Diarrhea or refusal to eat are signs of health problems. Pale appearance, increased body temperature, and change in weight are worrisome and should be seen by a doctor. If there are any abnormalities in the area of the face or neck, these must be examined. a visual impairment, Changes in the retina or a pigment disorder are warning signs of the organism for an existing disease. A doctor’s visit should be initiated as soon as possible to investigate the cause.
If existing symptoms persist for several days or if they increase in intensity, a doctor must be consulted immediately. An ambulance must be called in the event of an acute health condition.
Treatment & Therapy
After the diagnosis of neuroblastoma, treatment planning should begin as soon as possible. The stage of the tumour, the age of the patient and possible metastasis formation must be particularly taken into account. A distinction is made between the following stages:
- The tumor is confined to the site of origin and is fully operable.
- The tumor can be operated on, but a residual tumor can still be detected.
- The tumor cannot be operated on, but the lymph nodesmay already be affected.
- There are metastases in the brain, liver, bone marrow or other organs.
- Criteria according to 1. and 2., but the patient is less than 18 months old and there are few or no metastases. Here the tumor can regress spontaneously.
Treatment for neuroblastoma usually consists of a combination of chemotherapy and surgery. Often, tumors can only be surgically removed after reduction by radiation. In other cases, the neuroblastoma is first removed and then the radiation of any malignant residual tissue that may still be present begins. Other therapy methods can also be used concomitantly to treat neuroblastoma.
These include MIBG therapy, stem cell transplants or treatment with retinoic acid. Each individual case requires individual treatment, which is primarily determined by the stage of the tumor. In stage 1, for example, it may be advisable not to use radiation therapy after the surgical removal, but to wait and see.
If the tumor has already spread and formed metastases in other organs, high-risk therapy consisting of surgery, radiotherapy and chemotherapy is usually used. It can last up to 2 years.
Outlook & Forecast
In principle, the course of a neuroblastoma should be regarded as individual. In addition to the stage of development, the patient’s age has proven to be decisive for the course of the disease and prognosis in the case of neuroblastoma. The prognosis is better in young patients or those in the early stages of the disease. About 75 percent of patients with a diagnosed neuroblastoma survive the following fifteen years. In low-risk patients, the survival rate is even higher – it is even over 95 percent.
The prognosis for high-risk patients is much worse. Here the rate after five years is only 30 to 40 percent. Even if the tumor has been completely removed, some patients will relapse (recur) after a certain period of time. The majority of recurrences occur within the first few years following therapy.
For this reason, patients should definitely undergo regular check-ups, especially within a period of ten years after the end of therapy. In addition to a physical examination, this also includes laboratory tests and examinations via imaging methods. In this way, a possibly recurring neuroblastoma can be identified at an early stage.
So far, there is no targeted way to prevent neuroblastoma. Since this disease occurs mainly in children and young people, parents have a special responsibility here. This includes creating a good, stable and harmonious environment for those affected.
According to current scientific knowledge, neuroblamstoma cannot be prevented. Neuroblastomas are usually discovered by accident, which is why doctors have been trying to find a reliable early detection method for years. In addition to marker tests, a neuroblastoma screening was therefore developed in Germany and Canada. However, it cannot yet be said whether this really improves early detection.
After intensive care treatment of the tumor, rehabilitation and aftercare of the patient begins. Regular check-ups and patient consultations are carried out as part of tumor follow-up care. In detail, follow-up care includes a thorough physical examination, laboratory tests and imaging tests such as ultrasound and X-rays. If necessary, other imaging methods can be used, for example to examine certain parts of the body or to identify side effects and interactions of medication.
Close monitoring enables early detection of any recurrences. Possible concomitant diseases or consequences of the therapy are also identified and treated as part of the follow-up care. Accompanying this, the aftercare includes therapeutic care for the patient and his relatives.
Affected children in particular must be given comprehensive care in the clinic. As part of the follow-up care, the people involved are given the necessary contact points and measures to optimally process the illness. The treating doctor accompanies both the examinations and the care of the patient.
Follow-up can last for several years. As long as no complications arise, the intervals between the examinations are gradually extended. In the event of complications such as recurrences or concomitant diseases, therapy must be resumed. Follow-up care is usually discontinued in the event of major complications.
You can do that yourself
Since children and young people are increasingly affected by this disease, parents have a special responsibility. It is extremely important to create a good, harmonious and stable environment for those affected. The children should be seen and included as full members of the family.
It is important, however, that prescribed treatments are carried out regularly. Supportive homeopathic preparations or other natural products can also be taken in consultation with the doctor in order to alleviate the course of the disease or to relieve the body. A lifestyle that is close to “normal” will make everyday life easier for patients. This includes meeting friends, going to school and doing lots of things that bring joy. Of course, the attending physician must approve this, taking into account the stage of the disease.
Otherwise, you should pay attention to healthy and high-quality food, sufficient rest and sleep as well as appropriate exercise in the fresh air to provide the body with good things. Many sufferers find it pleasant to go to a self-help group. In this way, they can exchange ideas with other affected people and encourage one another. Anyone wishing to take advantage of psychological support will also benefit from this. This helps sufferers to accept the disease and live with it.