NEUROBLASTOMA: Childhood Cancer
Neuroblastoma is a tumor of the primitive nerve cells that may arise in the adrenal glands (which are located at the top of the kidneys) and in a chain of nerve tissue that runs along the spine. Most tumors are in the abdomen. Half of these are in one of the adrenal glands. Tumors can start at more than one site in the same patient.
Neuroblastoma is one of the most common "solid" (non-leukemic) tumors in children. It effects one in 7,000. Almost all children who are effected by Neuroblastoma are under five years of age at the time of diagnosis. 50% are under the age of two.
Normal cells from which Neuroblastoma may develop anywhere from the neck to the pelvis. Since the structures from which Neuroblastoma can arise lie deep in the body, the tumor is often very large by the time of diagnosis. The disease may come to the parent's attention in the following ways: 1) The expanding tumor is visible (as in the abdomen) or causes pressure on normal neighboring structures. For example: the chest causing breathing problems, or the pelvis, causing bladder and bowel problems; 2) it interferes with the normal function of the nerve from which it arises, producing, for example, a paralysis of muscle in the eye; 3) production of excessive hormone by the tumor may cause diarrhea and high blood pressure, or 4) widespread disease may appear, for example, in the skin (appearing as bluish bumps) or bone (resulting in pain).
Exploratory surgery of the abdomen or an x-ray of the chest are the most common ways of making a diagnosis. A wide range of tests are performed to determine the extent of the disease so appropriate therapy can be scheduled. This process is known as staging. Then, tests are conducted on blood and urine for substances produced by the tumor to find to what extent these are related to the disease. Servial measurements enable the determination of how much of the Neuroblastoma remains after treatment and whether or not there is a growth present.
For patients with localized disease, surgical removal is often the only form of therapy required. If the disease is extensive, for example, involving both sides of the abdomen, or already widespread, chemotherapy, with or without radiation therapy will be required.
Three-year-old Angela, (her name has been changed to protect her privacy) was a healthy little girl on Canada Day weekend 1999. The family traveled to northern Ontario to visit her great-grandparents. Angela became ill during the visit, but since she had a history of ear infections, her parents weren't too worried. However, as the weekend progressed Angela's condition worsened. She was taken to a nearby clinic. The doctor ordered tests at a nearby hospital. He phoned Angela's parents and asked them to stop by his office. He advised them to take Angela home.
Latest Articles