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Neuroblastoma: The cancer that strikes little ones

Neuroblastoma is a form of cancer that usually affects children younger than 15. Nearly 90 percent of cases are diagnosed by age 5. Among infants, neuroblastoma is the most common cancer, accounting for 50 percent of all cases in children younger than 1 year.

A neuroblastoma is a malignant tumor made up of neuroblasts (cells from which nerve tissue is formed). About one-third of these cancers start in the abdomen, often around the adrenal glands (small, triangular-shaped glands that sit one on top of each kidney). The rest occur in clusters of nerve cells called ganglia, which are part of the sympathetic nervous system. If the tumor is discovered before the cancer has spread, neuroblastoma is highly treatable. In some cases, these tumors even go away on their own.

Signs of the disease

The signs and symptoms of neuroblastoma depend on the location of the original tumor and the extent of spread to other parts of the body. Usually, this type of cancer is discovered as a large abdominal mass or lump. An affected child may complain of abdominal fullness, discomfort or pain. Masses can occur in other places, such as the neck.

When neuroblastoma spreads, it often goes to the bones. In such cases, a child may complain of pain in the bones. The pain may cause the child to limp or refuse to walk. If the cancer spreads to the backbone, the child may experience weakness, paralysis or numbness.

About one child in four develops a fever. Less common symptoms include persistent diarrhea, high blood pressure (which causes irritability), rapid heartbeat, reddening of the skin and sweating. These symptoms are caused by hormones that are released by the neuroblastoma cells.

If the bone marrow is affected, the child may be weak, bleed excessively from small cuts or scrapes and get frequent infections. Neuroblastoma that has spread to the skin causes blue or purple patches that look like bruises.

Treatment options

In some cases, the entire tumor can be removed surgically, resulting in a complete cure. However, most children with neuroblastoma will need to undergo chemotherapy as well, especially if the disease has spread to the bone marrow, liver, lungs or other organs.

Radiation therapy is also used to treat neuroblastoma. In this treatment, a beam of radiation is aimed at the cancer from outside the body. It can be used to destroy any neuroblastoma that remains behind after surgery. It also works well to shrink tumors, making them easier to remove at the time of surgery, and can help to relieve pain in children with advanced-stage disease.