Introduction

Neuroblastoma is a rare cancer that affects children. It develops from nerve cells called neuroblasts.

The cancer usually starts in the child's abdomen (tummy). It often develops in the adrenal glands, which are the two small glands that sit above the kidneys, and can spread to other areas such as the bones, liver and skin.

The cause is unknown. There are very rare cases where children in the same family are affected, but it does not generally run in families.

Who is affected?

It usually affects children under the age of five, and can occur before a child is born. It is the second most common solid tumour in childhood.

What are the symptoms?

The symptoms depend on where the cancer is and whether it has spread. It is often hard to diagnose neuroblastoma in the early stages, as initial symptoms are common ones - for example, aches and pains and loss of appetite.

However, the most common symptom when the cancer has developed is a lump or swelling in the child's abdomen, as this is where the cancer usually starts. It can cause constipation and general discomfort and pain.

Other possible symptoms are:

  • a lump in the child's neck, which can make them breathless or have difficulty swallowing
  • bone pain and difficulty walking, if the cancer has affected their bones
  • numbness, weakness or loss of movement in the child's lower body, if the cancer has affected their spinal cord
  • anaemia, bruising, bleeding and infections, if the cancer has affected their bone marrow
  • blueish lumps in their skin, if the cancer has spread to the skin

Outlook

Because early symptoms are vague, neuroblastoma is often not diagnosed until it has spread around the body.

The outlook is generally better if the child is younger and the cancer is low risk (growing slowly) and at a low stage.

Babies with stage 4s neuroblastoma who have no symptoms may not need treatment, as the cancer may go away on its own.

With all other stages of neuroblastoma, the tumour is removed by operation. Depending on the stage, chemotherapy and/or radiotherapy is sometimes used before surgery to shrink the tumour and after surgery to kill any remaining cancer cells.

It is common for the cancer to return after being treated.

More information:

The Neuroblastoma Society

 



Stages of neuroblastoma

As with most cancers the tumour is defined by stages, which reflect the spread of disease. There are a number of staging systems, but the most widely used until recently – INSS – is shown first, with the most recent (INRG) in brackets:

  • Stages 1 and 2 (L1) – the cancer is in one site and has not spread. It can be completely removed by operation.
  • Stage 3 (L 2) – the cancer has spread to local structures, but not to distant parts of the body.
  • Stage 4 – the cancer has spread to distant parts of the body.
  • Stage 4s – this special stage defines a tumour diagnosed in a baby under the age of 12 months. Although it may have spread to the liver or skin, the outlook is fairly good.


Last updated on: 17 / 04 / 2012