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What is neuroblastoma?
Neuroblastoma is a type of cancer that can form tumors in the nerves of the sympathetic nervous system. The sympathetic nervous system includes the spinal cord and the nerves that branch off from it to the rest of the body.
The most common area for neuroblastoma to start is in the adrenal glands. Neuroblastoma tumors can also form anywhere along the sympathetic nervous system, which runs from the neck to the pelvis.
Neuroblastoma is one of the most common cancers in childhood, and is the most common cancer in infants. Nearly half of neuroblastoma cases are in children younger than two years old.
No one is sure what causes neuroblastoma. Unlike other cancers, neuroblastoma is not usually passed along in families or connected to clear environmental causes.
Our approach to neuroblastoma
If a child shows signs of neuroblastoma, a health care provider will usually perform urine tests or other exams to confirm a diagnosis. In 9 out of 10 cases of neuroblastoma, urine tests find high levels of hormones called catecholamines and the metabolites they break down into, dopamine, homovanillic acid (HVA), and/or vanillylmandelic acid (VMA).
We select different treatments based on what stage, or type, of neuroblastoma the patient has. The new International Neuroblastoma Risk group staging system divides neuroblastoma patients into different groups, based on their condition.
The factors we look at to determine the type of treatment include:
- Whether the cancer is only in the area where it started or has spread (metastasized) to other parts of the body
- Age of the patient
- How long the cancer has been in the body and how much it has progressed
- Microscopic tests of the cancer cells
- DNA and other tests
These factors tell us how much risk the patient has and how intense the therapy should be.
In some cases, all we need to do is continue to watch the patient to make sure the neuroblastoma is not getting worse. Neuroblastoma has the ability to change on its own from a malignant (or bad) cancer to a benign (or harmless) cancer.
In other cases, we treat the patient using different therapies at once, including, as needed:
- Radiation therapy
- Stem cell transplant
- Targeted drug therapy or biologic therapy