Neuroblastoma: Children

About

Neuroblastoma is a type of cancer that affects children and is the most common cancer in infants, typically occurring in children between the ages of zero and five. It is a cancer of the sympathetic nervous system, which is responsible for producing hormones that regulate the body’s fight or flight response. Symptoms of neuroblastoma include weight loss, tiredness, abdominal pain, and/or a lump in the abdomen, but can vary depending on the size and location of the tumor. Treatment typically includes a combination of surgery, chemotherapy, and radiation, with the aim of removing the tumor and preventing its spread.

Symptoms

The most common symptoms of neuroblastoma in children include abdominal pain or swelling, a lump in the abdomen, unexplained fever or sweating, weight loss, pale skin, tiredness, and frequent infections. Other symptoms include dark circles around the eyes, enlarged lymph nodes, a cough, breathing difficulties, bone and joint pain, difficulty in passing urine, and constipation.

Causes

Currently, the exact cause of neuroblastoma in children is unknown. However, research has identified several potential risk factors that may be involved, including genetic abnormalities, certain chromosomal changes, immaturity of nerve cells, and environmental exposures.

Risk factors

The exact cause of neuroblastoma is unknown, but it is thought to be related to a combination of factors, including genetic, environmental, and lifestyle. The following factors may increase a child’s risk for developing neuroblastoma:

Age: Neuroblastoma usually occurs in children before the age of 5.
Family history: Children with a parent or sibling who has neuroblastoma are at an increased risk of developing the disease.
Genetics: Certain inherited genetic conditions, such as neurofibromatosis and trisomy 18, further increase the risk for neuroblastoma.
Gender: Boys are slightly more likely than girls to develop neuroblastoma.
Premature birth: Premature babies have an increased risk of developing neuroblastoma.
Ethnicity: Neuroblastoma occurs more often in certain ethnic groups, such as African Americans and Hispanics.
Environmental factors: Exposure to certain environmental toxins, such as radiation, may increase the risk of neuroblastoma.

Diagnosis

Neuroblastoma in children is typically diagnosed through a combination of imaging tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans, as well as a physical examination and laboratory tests such as urine and blood tests. Additionally, a biopsy of the tumor may be done to obtain a definitive diagnosis.

Sub-types

Neuroblastoma is an aggressive form of cancer that affects children and is mainly found in infants and young children under the age of 5. It is a cancer of the peripheral nervous system, which includes the nerves that connect the body to the brain and spinal cord.

At diagnosis, patients may have one of five subtypes of neuroblastoma:

Unfavorable Histology (UH): This subtype has a higher risk of recurrence, lower response to treatment and poorer outcomes.
Favorable Histology (FH): This is the only subtype with an excellent prognosis and response to therapy. It typically affects younger children and has better outcomes.
Myc-amplified Neuroblastoma (MN): This is a very aggressive and difficult to treat subtype. It often has a poor outcome and is the most deadly subtype.
Neuroblastoma with Bilaterally Aligned Syndromes (NBAS): This subtype is associated with a variety of syndromes caused by genetic mutations. These syndromes can interfere with normal development and affect a child’s prognosis.
Immunoglobin-Amplified Neuroblastoma (IAN): This subtype is very rare and is more difficult to treat. It is often in the advanced stages at diagnosis and has a poor prognosis.

Treatments

Treatment for neuroblastoma in children usually involves a combination of surgery, chemotherapy, radiation therapy, immunotherapy and stem cell transplant, depending on the specific situation. Surgery is usually the first step in treatment, aiming to remove as much of the tumor as possible. Chemotherapy and radiation therapy are used to kill any remaining cancer cells and limit the growth of the cancer, as well as to shrink the tumor and prepare for surgery if it is necessary. Immunotherapy is used to activate or enhance the body’s natural systems to attack the cancer cells, while stem cell transplants can be used to replace stem cells destroyed by cancer or its treatment.

Some of the most common types of chemotherapy used to treat Neuroblastoma are cisplatin, carboplatin, Lomustine, Etoposide, Cyclophosphamide, and Doxorubicin. Additionally, several drugs have been specifically developed to target neuroblastoma, such as dinutuximab and nivolumab.

Finally, clinical trials are increasingly available for the treatment of neuroblastoma, offering access to untested or newly developed treatments that may be more effective than standard treatments.

Prevention

The best way to reduce the risk of neuroblastoma in children is to be mindful of your child’s health, starting from infancy. Parents should make sure their child’s diet includes plenty of fresh fruits, vegetables, and whole grains, and that they are receiving sufficient nutrition and exercise. Additionally, parents should regularly monitor their child’s development and watch for any unusual activity or symptoms which could indicate the presence of neuroblastoma. Additionally, if possible, parents should avoid exposing their child to environmental toxins and radiation, as these can increase the risk of neuroblastoma. Lastly, it is important to get regular checkups, as early detection and treatment is key to reducing the risk of neuroblastoma.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Neuroblastoma in children. For example, in most cases, girls are more likely to present with localized tumors than boys. Boys more commonly present with more advanced tumors that have already spread to other parts of the body, such as the bone marrow, lymph nodes and liver. This can affect how the cancer is treated, as localized tumors are usually treated with surgery or radiation, whereas more advanced tumors may require a combination of chemotherapy and other treatments such as monoclonal antibody therapy or stem cell transplantation. Additionally, boys are more likely to have tumor-associated genetic mutations that may affect the treatment options available.

Nutrition

A well-balanced nutritional program is crucial for managing Neuroblastoma in children. Good nutrition helps to boost the child’s immune system, supports better management of symptoms, and helps in the recovery process. A nutrition plan should include the right balance of carbohydrates, protein, fats, vitamins and minerals. It should include plenty of fluids to keep the child hydrated and help to avoid dehydration. If the child is having any difficulty eating, the nutritionist may recommend a specialized formula that can provide extra protein, fluid, and calories. Good nutrition also helps to control any side effects of treatment, such as nausea and loss of appetite.

Physical Activity

Physical activity is important for any person, especially for children. In the case of Neuroblastoma, physical activity can have a beneficial effect for children as it can help them both physically and mentally. Physically, activity helps to keep the body strong and healthy, which can help support the body’s ability to fight the disease. Activity can also help reduce stress, anxiety, and fatigue, which are known side effects of the disease. Mentally, physical activity can help improve cognitive and physical development, help increase concentration and mood, and can even help improve the quality of life for children with Neuroblastoma. Ultimately, physical activity can be beneficial for Neuroblastoma patients, as it can have positive effects on the body’s ability to fight the disease and can help improve their quality of life.