There is about 100 or more type of cancers out there, some are well known and others are unheard of. Treatments are out there to help with some cancers and then there are some cancers that haven’t yet been treatable. Today we mainly hear about breast cancer, liver cancer or leukemia. I want to talk about a type of cancer that is not common, neuroblastoma. This cancer is mainly found within children from the ages of a newborn to age five. It’s uncommon to find this cancer in anyone over the age of ten. I’m going to talk about what neuroblastoma is, what it’s caused by, the survival rate, the symptoms, the diagnosis, the stages, and the treatments.
The Life of Neuroblastoma
Neuroblastoma is cancer that starts in the nerve cells in the embryo or the fetus stage. When breaking up the word neuro means nerves and blastoma is cancer that affects developing cells. Neuroblastoma can be found in the adrenal gland 1 out of 3, the sympathetic nerve ganglia 1 out of 4. Neuroblastoma can spread and grow quickly and other times it can grow slowly. It all starts in the neuroblasts, which are immature nerve cells that a fetus makes as it develops. As the fetus matures the neuroblasts eventually turn into the nerve cell and fibers in the adrenal glands. They should eventually mature by birth or they will disappear on their own and if not they form into tumors. Many cases are different, they can range in the stages, the way their body fights it, the treatment that works or doesn’t and how it can be found.
The survival rate depends on the classification of the risk group. There are Low-risk group, intermediate-risk group, and the high-risk group. The low-risk group has a rate higher than 95% in a 5-year survival rate. The intermediate-risk group has about 90-95% survival rate, and the high-risk group has a survival rate of around 40-50%.
If the tumor spread to the spinal cord, there could be a loss of the usage of the legs along with weakness, pain or numbness. With the low level of red blood cells, they could have a fever and anemia. If cancer has spread behind the eyes it could cause the eyes to bulge out with dark circle under them, droopy eyelids, vision problems, changes to the iris or pupil constricted. There may also be high blood pressure or constant diarrhea due to hormones that are released by the tumor. If the child does experience any of the symptoms it may be another medical condition. Some children with neuroblastoma may not experience any symptoms at all.
For doctors to officially diagnose children with neuroblastoma they have to run a series of test to make sure it’s cancer or another medical illness. Many will start with a biopsy of the tumor, which is when a doctor takes a small sample of the tissue for testing. If not possible to get a sample of the tissue, then they may have to op to another test.
Another way to find if there are neuroblastoma cells in the body is by testing the bone marrow, or a blood and urine test. The blood test will look for anemia, low level of red blood cells, and if so they will run more for the liver and kidney along with a blood clotting test. The urine test is to test for catecholamine metabolites. Catecholamine is a hormone that deals with the adrenal gland for the fight-or-flight response.
There is a test to see if there is a change in the oncogene MYCN. Oncogenes can cause normal cells to become cancerous, and the MYCN help with regulating the cell growth and division and the self-destruction. There are also CT scans, MRI, MIBG scans, and PET-CT scan. The CT scan makes a 3D picture of the inside of the body by x-rays from a different perspective of the body that helps show any abnormities or tumors in the body. Before you get a CT scan the body has to be injected with a dye in the veins to provide better detail on the pictures. MRI uses a magnetic field to make images of the brain and spinal cord. This can also show the size of the tumor. MIBG is metaiodobenzylguanidine and is a protein that the neuroblastoma cells consume.
Four Stages of Neuroblastoma
Like most cancer, there are four different stages of neuroblastoma. They all range from 1-4 with one being the lowest and four being the highest. The stage one is when there is a tumor and it can be completely removed by surgery. Along with this, they lymph nodes that are connected with the tumor are removed as well just in case they are cancerous, but the lymph nodes around by are not affected.
Stage 2 is split into group 2A and 2B. Stage 2A is when the tumor is located only in the area of the body when it started to form and can be completely removed during surgery along with the lymph nodes connected to the tumor. The lymph nodes near the tumor are not affected by the tumor. While stage 2B is the same as 2A, they only thing different between them is when surgery comes along the doctors may or may not be able to remove the whole tumor.
In stage three the tumor cannot be removed with surgery and it has spread to nearby lymph nodes or areas near the tumor. It hasn’t spread to another part of the body. Last but not least, stage four. Like stage two, stage four is split between 4 and 4s. Stage 4 is when the tumor has spread to other lymph nodes in other regions of the body. This could be the bones, bone marrow, liver, skin and other organs in the body. In stage 4s the tumor is found in children younger than one, and when it was originally founded but has spread to the skin, liver or/and the bone marrow.
There are many different treatments that doctors can try to help treat a child. Due to the uniqueness of everybody, some treatment may not take the same effect. Because cancer in children are uncommon and everyone is different more than 60% of the children are treated as a clinical trial. On deciding what treatment would be best for the patient depends on the size and location of the tumor if cancer can spread, the risk classification, the child overall health, possible side effects, and the family preferences. Surgery is for the removal of the tumor, and depending on the size and location the removal can take it all out in one surgery. If the surgery isn’t enough to remove the tumor, radiation therapy and chemotherapy will be used to help destroy remaining cancer. There is a possibility of a biopsy to check if it has spread to the liver.
There are many other medications a patient can be given within the risk classification. Some other procedures that can happen is a stem cell transplant, retinoid therapy, and immunotherapy. Stem cell transplant where the bone marrow that is
Therefor, it is important to be aware of the symptoms and to be diagnosed early to prevent the dangers and damage neuroblastoma potentially causes. The sooner one is diagnosed the sooner the doctors can find the right treatment that works for them.