DEAR MAYO CLINIC: My 4-year-old niece not too long ago was recognized with neuroblastoma after not feeling properly for a couple of weeks. Her dad and mom observed her stomach was swollen, in order that they took her to the physician after it did not resolve by itself. I’d by no means heard of this manner of most cancers earlier than. What is neuroblastoma? Do kids usually have surgical procedure to deal with this most cancers? What can we count on?
ANSWER: Neuroblastoma is a kind of most cancers that happens virtually solely in kids and develops from irregular nerve cells. It is the commonest most cancers in infants beneath 1 yr previous and makes up almost 10% of cancers in kids. Neuroblastoma typically occurs in a single of the adrenal glands, which sit on high of the kidneys. However, it can also happen in the chest and stomach close to the backbone.
Sometimes kids are born with neuroblastoma, and it could even be detected earlier than beginning on an ultrasound. Most generally, it’s discovered when kids have a mass of their stomach. They additionally is likely to be drained, have fevers and not eat as a lot as regular. Sometimes it could trigger weak spot from being too near the spinal twine.
There are a number of tests and procedures used to diagnose neuroblastoma. Children often have imaging checks similar to a CT or MRI scan to search for neuroblastoma. They additionally could have a urine research to search for substances that may be launched by the tumor, referred to as homovanillic acid (HVA) and vanillylmandelic acid (VMA). Patients often want a metaiodobenzylguanidine (MIBG) scan that appears particularly for neuroblastoma and helps decide if most cancers has unfold to different body areas.
Before beginning remedy, kids could bear a biopsy process so a pathologist can have a look at the tumor beneath a microscope and affirm the prognosis. The tumor pattern additionally is shipped for particular genetic testing to assist establish the greatest remedy technique. A bone marrow biopsy additionally could also be carried out to make sure the neuroblastoma has not unfold to the bone marrow.
Neuroblastoma has a novel staging system that establishes whether or not a affected person ought to be categorized inside a low, intermediate or high-risk group. The danger group helps decide what remedy kids with neuroblastoma ought to obtain.
In some infants and younger kids, neuroblastoma may be watched and could go away by itself. Surgery could also be beneficial for different kids as the first remedy or after chemotherapy is run to shrink the tumor.
Surgery for neuroblastoma typically may be performed minimally invasively, which helps kids have much less ache and get well quicker after their operation. Sometimes further surgical procedure is required to take away neuroblastoma that has unfold to different areas of the body. Some neuroblastoma tumors can wrap round essential blood vessels or different constructions, requiring expert surgical groups to take away them with out inflicting injury.
Other therapies for neuroblastoma, apart from surgical procedure and chemotherapy, could embrace radiation remedy to kill most cancers cells, stem cell or bone marrow transplant, and immune remedy. Children who want remedy past surgical procedure often have a kind of long-term IV positioned, referred to as a central line, to allow them to get IV medicines and verify blood work with out frequent pokes. Treatments for neuroblastoma typically require kids to be hospitalized.
Because neuroblastoma is uncommon and requires a tailor-made strategy to remedy, it’s essential for youngsters to obtain care from a multidisciplinary crew with experience on this illness. Seeking remedy from a middle, similar to Mayo Clinic, that offers clinical trials is also vital so kids with neuroblastoma can entry new potential remedy discoveries. Mayo Clinic participates in cooperative medical analysis trial networks, together with the Children’s Oncology Group, and is designated by the National Cancer Institute as a complete most cancers middle.
Though every person is totally different, neuroblastoma most cancers may be successfully handled. Babies and youthful kids are extra probably than older kids to remain cured of neuroblastoma long run. — Dr. Stephanie Polites, Surgery, Mayo Clinic, Rochester, Minnesota