Early symptoms of neuroblastoma are similar to other common diseases. However, this disease is not a common disease, but a rare type of cancer that begins to grow while the baby is still in the womb and develops after birth.
Here are some things you need to know to help you be aware of other symptoms,Parents!
Getting to Know Neuroblastoma
Ashira, a toddler who died of neuroblastoma cancer. Photo: youtube screenshot
Neuroblastoma is a rare type of cancer that most often affects children 5 years of age or younger. It is rare in older children.
This disease, according to the pageCancer.org ,said to be starting to form and is often found in embryos or fetuses.
This type of cancer develops when neuroblast cells (immature nerve cells) found in some areas of the body and supposed to form the sympathetic nervous system network instead grow into cancer cells. The term neuro itself refers to nerves, while blastoma refers to cancer that begins in immature or developing cells.
The sympathetic nervous system is a nervous system that functions to regulate the involuntary or uncontrolled work of body organs, by increasing heart rate and blood pressure, constricting blood vessels, releasing hormones, and breathing.
According toMayo Clinic, neuroblasts usually grow first in and around the adrenal glands and on top of the kidneys or in the nerve tissue that runs along the spinal cord in the neck, chest, abdomen or pelvis.
The adrenal glands are triangular-shaped tissues at the very top of the kidneys that are responsible for secreting hormones that regulate heart rate, blood pressure, and other important organ functions.
Like most cancers, neuroblastoma spreads very easily and attacks other parts of the body, such as the lymph nodes, skin, liver, bones, including bone marrow.
This cancer can also develop in other areas such as the stomach, chest, neck, and near the spine, where clusters of nerve cells are located.
Treatment depends on several factors. Some may go away on their own, while others may require some treatment.
Causes of Neuroblastoma
As stated above, this cancer grows because the neuroblasts that are supposed to form nerve tissue divide in uncontrolled numbers.
However, no one knows yet what causes or how neuroblasts fail to grow and develop into cancer. However, 1 to 2 percent of neuroblastoma cases are generally caused by genetic factors .
Many researchers suspect that the presence of abnormal DNA in neuroblasts is the main factor in this abnormality. This DNA abnormality can occur due to the presence of missing or excessive chromosomes.
The National Health Service says it affects around 100 children each year in the UK and is most common in children under the age of five, with an average age of just under one year. Boys are slightly more likely to suffer from the cancer than girls.
Risk Factors
Children with a family history of neuroblastoma are at higher risk of developing the disease in their own bodies. However, familial neuroblastoma is thought to account for a small number of neuroblastoma cases. In most cases of neuroblastoma, the cause is never identified.
Signs or Symptoms
Neuroblastoma in the Stomach
The signs of neuroblastoma in children can vary, depending on where the cancer cells first grow and the area where they spread. If the cancer cells grow in the stomach – the most common area for neuroblastoma – the child will initially be fussy, easily tired, lose appetite, and have a fever. You may not realize your child has neuroblastoma because the symptoms are very similar to other diseases.
In addition, the child will also complain:
- Stomach ache
- An abnormal mass or lump growing under the skin. For example in the abdomen (can also be in the neck, chest or other parts of the body)
- Changes in bowel habits, such as diarrhea or constipation
Neuroblastoma in Chest
Symptoms of neuroblastoma in the chest can include:
- Wheezing
- Chest pain
- Changes in the eyes, including drooping eyelids and unequal pupil size
While lumps usually grow through body tissue and cause children to experience:
- Swollen abdomen, excessive pain in the abdomen and loss of appetite (if neuroblastoma occurs in the abdomen).
- Severe pain or soreness in the bones, dark circles under the eyes, and pale skin (occurs if the neuroblastoma has spread to the bones).
- The body becomes weak, numb, and unable to move limbs, and difficulty walking (occurs when cancer has pressed on the spinal nerves).
- Drooping eyelids, pupils that are not the same size, sweating, and red skin. These symptoms usually appear if there is damage to the nervous system in the body and are commonly called Horner syndrome (this symptom occurs when the cancer is in the neck).
- Difficulty breathing (if the cancer is in the chest).
Take your child to the doctor immediately if Parentsfind any signs or symptoms that are worrying. Also mention any changes in your child’s behavior or habits to the doctor.
Neuroblastoma Stages
Like most cancers, neuroblastoma also has stages of development or stages. These stages will later indicate whether the cancer will spread, and if so, how far it can be seen.
The staging system used for neuroblastoma is:
- Stage L1: The cancer is only in one place and has not spread, and can be removed with surgery.
- Stage L2: The cancer is in one place and has not spread, but cannot be safely removed through surgery.
- Stage M: Cancer has spread to other parts of the body.
- Stage Ms: Cancer has spread to the skin, liver or bone marrow in children younger than 18 months.
Knowing the stage of your child’s neuroblastoma will allow the doctor to decide which treatment is best.
Diagnosis Stages
To make sure your child has neuroblastoma, the doctor will do several examinations and tests. These cancer tests include:
- Urine tests to check for certain chemicals produced by neuroblastoma cells found in the urine.
- Scan or photograph several parts of the body using X-ray, CT-scan, MRI, ultrasound, or bone scan to see the neuroblastoma area of various parts of the body in detail.
- mIBG scintiscan ( iodine-131-meta-iodobenzyl-guanidine ) scan , a two-dimensional imaging procedure that involves injecting a substance taken from neuroblastoma cells to determine the spread of cancer cells in the body.
- Biopsy, a tissue test that involves taking a sample of cells from the tumor tissue to be examined under a microscope so that the type of cancer can be identified. The sample is usually taken under general anesthesia using a special needle. A bone marrow biopsy may also be done to see if there are cancer cells in the bone marrow.
Once all of these tests are complete, the doctor can usually determine the location, size, stage of the cancer, and how far the cancer has spread to other parts of the body.
Complications
Complications that may be caused by neuroblastoma include:
- Spread of cancer (metastasis). Neuroblastoma can spread (metastasis) to other parts of the body, such as the lymph nodes, bone marrow, liver, skin and bones.
- Spinal cord compression. Tumors can grow and press on the spinal cord, causing spinal cord compression. Spinal cord compression can cause pain and paralysis.
- Tanda dan gejala yang disebabkan oleh sekresi tumor. Sel neuroblastoma dapat mengeluarkan bahan kimia tertentu yang mengiritasi jaringan normal lainnya, menyebabkan tanda atau gejala yang disebut sindrom paraneoplastik. Salah satu sindrom paraneoplastik yang jarang terjadi pada orang dengan neuroblastoma menyebabkan gerakan mata yang cepat dan kesulitan dengan koordinasi. Sindrom langka lainnya menyebabkan pembengkakan perut dan diare.
Pengobatan Neuroblastoma
Some cases of neuroblastoma require treatment. However, some types of this cancer can go away on their own.
Age factors, tumor characteristics, and the spread of cancer in the child’s body are the 3 main things that doctors consider in treating this disease.
Based on these three factors, there are three groups of neuroblastoma to distinguish the treatment pattern. Namely the mild, intermediate , and high-risk types.
Children in the first two categories have a greater chance of recovery than those at high risk. Usually the sufferers are babies under 18 months old with stage L1 or Ms status who have no symptoms. They do not need any treatment, because cancer can sometimes go away on its own.
Meanwhile, about 1.5% of children with neuroblastoma are in the high-risk category which is very difficult to cure. Therefore, treatments such as surgery, radiation therapy, and chemotherapy are also carried out – stem cell or bone transplantation can also be additional therapies.
- Surgery: To remove tumors/cancer.
- Chemotherapy : This may be the only treatment needed or may be given to shrink the cancer before surgery.
- Radiotherapy: It can sometimes be used after surgery to destroy any remaining cancer cells in the affected area.
- High-dose chemotherapy followed by stem cell transplantation – where stem cells from the child are collected, frozen and stored before intensive chemotherapy, and given back afterwards.
- Immunotherapy: Where drugs that directly target neuroblastoma cells are given, although this is not yet used routinely.
Some doctors also recommend retinoid therapy, a subclass of vitamin A that is intended to stimulate neuroblastoma to grow into normal nerve cell tissue. For this reason, retinoids are commonly used to prevent cancer cell growth after treatment.
There is also the latest treatment, namely tumor vaccination and immunotherapy with monoclonal antibodies . The method is by injecting certain fluids into the body to increase the child’s chances of survival. Especially if the cancer has not spread to other parts of the body and the diagnosis is known before the child is 1 year old.
Unfortunately, children with high-risk neuroblastoma are very difficult to cure, even standard cancer therapies do not work for them. Or if they are cured, there is a chance of a relapse.
Neuroblastoma treatment also often causes other problems such as growth disorders, to disorders of other body organ functions. For example, immune disorders, where the body’s immune cells attack normal nerve cell tissue. As a result, the child may have difficulty speaking, experience language or behavioral disorders .
When Your Little One Suffers from Neuroblastoma
Which parent’s heart doesn’t feel miserable hearing that their child has cancer. But nothing is impossible, by continuing to hope for healing from the Almighty and trying, your child can definitely recover.
You can help your little one recover by taking part:
- Undergoing clinical trials.
- Undergoing the entire series of care and treatment.
- Get support from family, close friends, and the neuroblastoma cancer community. It is important for you to join this community so you can get the latest information and moral support from fellow parents of sufferers.
- Ask your child’s doctor about any trials related to this disease and include your child in them.
- Discuss with your child – if he/she is able to discuss – about his/her illness and the treatments he/she will undergo. Do it slowly, and give a picture one by one.
- Also discuss with his other siblings (if any) about his condition. Explain that all of the parents’ attention is focused on him, so that they are not jealous and envious.
- Take care of your health! Healthy parents will certainly be able to be the strongest support for their little ones.
Hopefully the information regarding neuroblastoma can help, Parents .
Republished with permission from theAsianParent Indonesia
