What is Neuroblastoma?

Neuroblastoma is a type of cancer developing from the nerves, mostly observed in kids below the age of 5, and rarely ever occurs in older children. It grows as a tumour in the nerve tissues of the baby while still inside the womb, and these immature nerve cells are called Neuroblasts. It’s the most common type of cancer in babies below the age of 1. Children who have a family history of Neuroblastoma may be more prone to it than others. However, Neuroblastoma is generally found randomly without a known cause or familial relation.

Apollo Hospitals, Karnataka, has the best paediatric oncologists in the subspecialty of the Hemato-Oncology Department, who work closely with Onco-Surgeons, Radiologists, Haematologists, Pathologists, and other expert Oncologists to ensure appropriate diagnosis and effective treatment for neonatal cancer.

Causes of Neuroblastoma

Cancer develops due to genetic mutations that cause otherwise healthy cells to grow spontaneously without stopping, leading to the mass formation of abnormal cells known as tumours. Similarly, Neuroblastoma begins in the neuroblasts or the immature nerve cells of the foetus during its development in the womb.

These neuroblasts develop and mature into nerve cells and fibres in the foetus. Newborn babies are born with matured neuroblasts, and small amounts of immature neuroblasts may be present, which often disappear on their own. However, these immature neuroblasts sometimes multiply rapidly and become tumours causing Neuroblastoma. The exact root cause of the genetic mutation that causes this change is not known.

It happens by chance in most neonates, but a small fraction of them inherit this risk from their parents.

Symptoms of Neuroblastoma

Symptoms of Neuroblastoma in children vary widely depending upon the location of the tumour as well as the size of the tumour. Each child may show symptoms differently as well.

If the tumour is in the abdomen area, the symptoms observed include the following:

• Pain in the abdomen
• Lump in the abdomen
• Swelling in the abdomen, the legs, or the scrotum
• Loss of appetite or feeling full
• Weight loss

If the tumour has formed in the chest, the symptoms exhibited in such cases may include:

• Lump in the chest
• Drooping eyelids and other changes in the eye
• Swelling in the face, neck, arms, or chest
• Changes in arm or leg movements
• Coughing
• Trouble swallowing or breathing

If Neuroblastoma has spread to other parts of the body, there may be a wide range of symptoms which may include:

• Frequent infections
• Getting bruises or bleeding easily
• Pain in the bones
• Limping
• Enlarged lymph nodes
• Numbness, weakness or inability to move arms or legs
• Lumps on the head
• Bulges or bruises around the eyes
• Feeling tired or weak

Neuroblastoma may also lead to releasing of hormones which may cause paraneoplastic syndrome. The symptoms of paraneoplastic syndrome may include:

• Fever
• Faster heart rate
• Sweating
• Constant diarrhoea
• High blood pressure
• Flushing or redness of the skin

Neuroblastoma may cause symptoms like symptoms of other diseases, leading to difficult diagnosis. To ensure a proper investigation of the cause of symptoms, it is advisable to check with a healthcare provider for a thorough evaluation and assessment of symptoms.

Diagnosis of Neuroblastoma

You may notice lumps in one or more parts of your child’s body, which is when you may visit the doctor. The doctor may begin the diagnosis by asking for the child’s medical history along with a physical examination. Your child may be referred to a paediatric oncologist for proper diagnosis and treatment of cancer.

A few imaging and other tests may be performed by the specialist, which may include:

• Blood & Urine tests: To look for signs of diseases and hormone levels
• Ultrasound
• X-ray of the chest or bones
• CT scan (chest & abdomen) or to assist in a biopsy
• MRI scan: To check the brain and spinal cord condition
• Bone scans: To position the tumour if bone cancer is suspected
• Positron Emission Tomography (PET) scan: To look for cancer cells through the bloodstream when other tests are not able to locate or detect cancer cells
• Metaiodobenzylguanidine (MIBG) scan
• Bone Marrow Aspiration or Biopsy: To see if cancer cells have reached the bone marrow
• Tumour Biopsy: To look for cancerous cells in a tumour. Also helps in the staging of cancer.

Treatment of Neuroblastoma

Treatment for Neuroblastoma may depend upon the stage of cancer and other factors, such as the risks possessed in case of surgery. The forms of treatment available at Apollo Hospital, Karnataka, for the treatment of Neuroblastoma include:

• Surgery: To remove the tumour as much as possible. Surgery may not be possible if the cancer has spread.
• Chemotherapy: Cancer-killing medicine administered through the IV line before or after surgery or as a standalone treatment if surgery is impossible.
• Radiation Therapy: To kill the cancer cells through radiation to stop their growth.
• High-dose Chemotherapy/Radiation with a stem cell transplant
• Immunotherapy
• Retinoid Therapy: Used after high-dose chemotherapy/radiation and stem cell transplant if there is a chance of relapse or recurrence.

Complications

Neuroblastoma may cause certain serious complications if not diagnosed or left untreated. These may include:

• Spinal cord compression: Tumours formed around the spinal cord area may put pressure on the spinal cord, causing compression on the cord, which may cause pain and eventually lead to paralysis.
• Spread of cancer: The cancer may spread to other body parts such as the lymph nodes, liver, bones, etc.
• Symptoms caused by tumour secretions: Neuroblastoma may cause secretion of certain hormones, which may cause symptoms like rapid eye movements, difficulty in coordination, abdominal swelling, diarrhoea, etc.

At Apollo Hospitals, Karnataka, we are committed to providing patient-centric comprehensive healthcare services for cancer and blood disorders with a special focus and care for neonates and children. Our hospital hosts the top paediatric oncologists, pathologists, radiologists, and other interdisciplinary medical specialists who work collaboratively to provide the best cancer care treatment to children and adults alike.

Supported by technologically advanced equipment for minimally invasive surgeries and other forms of cancer treatment for painless treatment and management of various types of cancer. At Apollo Hospitals, Karnataka, we strive to provide our patients with the highest quality of healthcare services to ensure proper diagnosis, treatment, and management of a broad spectrum of diseases.