What is Neuroblastoma?

Neuroblastoma is a rare type of cancer that occurs in the nervous system, generally in infants and young children. The cells that develop in the nervous system and give rise to neuroblastoma are medically called neuroblasts, while the nervous system that controls involuntary body functions is called the sympathetic nervous system. Affecting usually the young children/ infants, Neuroblastoma is one of the most frequently diagnosed cancers in early childhood.

This cancer usually begins in the adrenal glands, which are located above the kidneys, but it may also develop in nerve tissue along the vertebral column in the neck, chest, stomach, or pelvis. Because neuroblasts are present in several areas of the body during fetal development, tumors may arise in different locations. The abdomen is the most common site, followed by the chest and neck.

Neuroblastoma is known for its highly variable behavior. Sometimes the tumor develops slowly and may even get smaller or disappear without treatment, especially in infants. In other cases, the disease may grow aggressively and spread rapidly to other parts of the body, such as the lymph nodes, bones, bone marrow, liver, and skin.

There have been several advancements made in pediatric oncology regarding the diagnosis, therapy, and management of the condition that have greatly enhanced the chances of survival of children with neuroblastoma. Treatment strategies depend on the child's age, staging, and the biological characteristics of the disease.

How does neuroblastoma originate in the sympathetic nervous system?

The nervous system is divided into two major parts: the peripheral nervous system and the central nervous system (CNS). The sympathetic nervous system, which is part of the peripheral nervous system, controls automatic body functions, such as the “fight or flight” response.

During fetal development, immature nerve cells called neuroblasts form and mature into nerve tissue and adrenal gland cells in children; however, certain neuroblasts fail to mature normally, continuing to grow and divide uncontrollably, forming tumors. Such a type of tumor is known as neuroblastoma.

Because neuroblasts migrate throughout the body during development, neuroblastoma can occur in various locations along the sympathetic nerve chain. The tumor may remain localized in one area or spread to distant organs.

The behavior of neuroblastoma varies widely depending on the genetic/hereditary and biological characteristics of the tumor cells.

Where in the body do Neuroblastoma Tumors most frequently grow?

Neuroblastoma can develop in several areas of the body. The most common sites include:

• Adrenal glands: The adrenal glands, existing/situated just above the kidneys, produce hormones that regulate metabolism, blood pressure, and stress responses. A large proportion of neuroblastomas originates here.
• Abdomen: Tumors may develop in sympathetic nerve tissue outside the adrenal glands in the abdomen.
• Chest: Some tumors occur in the chest cavity, particularly along the spinal nerve chain.
• Neck: Neuroblastoma may also develop in nerve tissue in the neck region.
• Pelvis: Less commonly, tumors may arise in the pelvic area.

Because these tumors can grow in deep tissues, they may become quite large before symptoms appear.

What are the Symptoms & Causes of Neuroblastoma ?

Symptoms of Neuroblastoma

The symptoms of neuroblastoma differ/vary depending on the tumor’s location and whether the cancer has spread.

Common symptoms include:

• Abdominal swelling or lump: A tumor in the abdomen may cause a firm mass that can be felt during examination.
• Abdominal pain: Children usually complain of abdominal/stomach pain or discomfort.
• Loss of appetite: Reduced or absent appetite and weight loss may occur as the tumor grows.
• Bone pain: If the cancer spreads to the bones, children may experience bone pain or difficulty walking.
• Fatigue: Children may appear tired or weak due to anemia or the effects of the cancer.
• Swelling of the legs: Tumors pressing on blood vessels may cause swelling.
• Fever: Persistent or unexplained fever may occur.
• Bruising around the eyes: Neuroblastoma that spreads to the bones around the eyes may cause dark circles or bruising known as “raccoon eyes.”
• Breathing difficulties: Tumors in the chest may interfere with breathing.
• Neurological symptoms: Pressure on nerves or the spinal cord may cause weakness or difficulty moving.

Because many of these symptoms can resemble common childhood illnesses, medical evaluation is necessary if symptoms persist.

Causes of Neuroblastoma

Neuroblastoma develops when genetic changes occur in immature nerve cells during early development.

These mutations cause abnormal cells to grow uncontrollably rather than mature into normal nerve cells.

In most cases, the cause of these mutations is unknown.

What are the Risk Factors for Neuroblastoma ?

Although the exact causes remain unclear, certain factors may increase the risk.

Age

Neuroblastoma occurs primarily in children under the age of five.

Genetic Susceptibility

Only a few cases arise from genetic susceptibility.

Family Background

If the child comes from a family with a history of neuroblastoma, there may be an increased chance of developing the disease.

Nevertheless, most cases develop without any genetic cause.

How is Neuroblastoma Diagnosed & Tested ?

Early diagnosis of neuroblastoma is important for determining the best treatment strategy.

Doctors may use several tests to confirm the diagnosis.

Physical Examination

Doctors will check the child for lumps and swelling that could be an indication of the tumor.

Imaging Tests

These tests/check-ups will help the doctor determine the tumor's position and size.

The imaging tests that doctors use include:

• Ultrasound
• Computed Tomography (CT) scan
• Magnetic Resonance Imaging (MRI)

These check-ups/tests provide detailed images of internal structures.

MIBG Scan

An MIBG scan uses a radioactive substance that is absorbed by neuroblastoma cells. This test helps detect tumors and determine whether the cancer has spread.

Biopsy

A biopsy removes a small sample of tumor tissue for examination under a microscope.

This test confirms the diagnosis and helps identify specific biological characteristics of the tumor.

Bone Marrow Tests

Bone marrow aspiration and biopsy become necessary to determine whether the cancer has spread to the bone marrow.

Laboratory Tests

Blood and urine tests may detect substances produced by neuroblastoma cells, such as catecholamines.

These markers help support the diagnosis and monitor treatment response.

How is Neuroblastoma Staged ?

Staging reveals the situation, describing how far the cancer has spread in the body.

The stage of neuroblastoma is determined using imaging studies, biopsy results, and other tests.

Stages generally include:

• Localized disease: Cancer is confined to the original tumor site.
• Regional disease: Cancer has spread to local or nearby lymph nodes or tissues.
• Metastatic disease: Cancer has extended/spread to distant organs such as the bones, liver, or bone marrow.
• Special infant stage: Some infants have a unique stage in which tumors may spread but still respond well to treatment or even regress spontaneously.

The stage of the disease plays a major role in determining treatment options.

In addition to staging, doctors classify neuroblastoma into risk groups based on factors such as:

• Age of the child
• Tumor stage
• Genetic features of tumor cells
• Tumor biology

Patients are generally categorized into low-risk, intermediate-risk, or high-risk groups.

This classification helps guide treatment decisions.

How is Neuroblastoma Managed & Treated?

Treatment for neuroblastoma depends on the stage and risk classification of the disease.

Treatment plans need a combination of therapies.

Surgery

Surgery is commonly used to remove localized tumors.

If the tumor can be safely removed, surgery may be the only treatment required for low-risk cases.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells.

It may be used:

• Before surgery to shrink tumors
• After surgery to eliminate remaining cancer cells
• As primary treatment for advanced disease

Radiation Therapy

Radiation therapy needs high-energy beams to destroy cancer cells.

It may be used when tumors cannot be completely removed or when cancer spreads to certain areas.

Stem Cell Transplantation

For high-risk neuroblastoma, high-dose chemotherapy followed by stem cell transplantation is considered an effective option to replace damaged/impaired bone marrow with healthy stem cells.

Immunotherapy

Immunotherapy encourages the immune system to attack cancer cells.

Certain immunotherapy drugs target proteins on neuroblastoma cells, helping the immune system destroy them.

Targeted Therapy

Targeted therapies focus on specific genetic changes within tumor cells.

These treatments help block signals that promote tumor growth.

Differentiation Therapy

Some treatments encourage immature cancer cells to mature into normal nerve cells, slowing tumor growth.

Supportive Care

Children receiving treatment can benefit from supportive care such as:

• Nutritional support
• Pain relief
• Infection prevention
• Psychosocial support

These things will make the child feel more comfortable.

What is the survival rate and long-term outlook for Neuroblastoma?

The outlook for children with neuroblastoma varies depending on several factors.

These include:

• Age at diagnosis
• Stage of the disease
• Tumor genetics
• Response to treatment

Children with low-risk neuroblastoma often have excellent survival rates. High-risk disease is more difficult to treat, but advances in therapy continue to improve results.

Regular medical check-ups and follow-ups are necessary to monitor for recurrence and manage the long-term effects of treatment.

What does living with Neuroblastoma look like?

A diagnosis of neuroblastoma can be overwhelming for families. Children undergoing treatment may face physical and emotional challenges.

Support from healthcare providers, family members, and support groups is important during treatment and recovery.

Children who successfully complete treatment require ongoing follow-up care to monitor growth, development, and long-term health.

Why choose Tender Palm Super Speciality Hospital for Neuroblastoma Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Neuroblastoma treatment in Lucknow, India, at an affordable cost. We have a team of experienced pediatric oncologists and surgical specialists who provide accurate diagnosis and both non-surgical and surgical treatment options including surgical resection, chemotherapy, and immunotherapy. Our Pediatric Oncology and Surgical Care team has decades of experience in successfully treating Neuroblastoma in Lucknow, India.

To seek an Expert consultation for Neuroblastoma Treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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