Sunday, April 17, 2011

Neuroblastoma - Symptoms, Causes, Diagnosis and Treatment

This cancer originates in immature nerve cells and is the most common cancer among children and infants with an estimated 650 new cases annually in United States only. This is a neuroendocrine tumor that arises from neural crest element of the SNS (sympathetic nervous system). Most often it occurs in one of the adrenal glands but can also develop in the nerve tissues of neck, chest, abdomen and pelvis.

Symptoms of Neuroblastoma
This cancer has vague symptoms in its initial stage that makes the diagnosing task really difficult. At later stages it has these signs:
  • Loss of appetite
  • Joint pain
  • Fatigue, weakness
  • Swollen tummy and constipation due to the presence of a tumor, if it affects abdominal region
  • Breathing problems due to tumor in chest nerves
  • Tumor in bone around the eyes can cause noticeable swelling and bruising
  • Pallor from anemia can be caused due to infiltration of the bone
  • Inability to walk, stand or crawl because of the presence of tumor on spinal cord
  • Pain  in legs and hips or limping due to bone lesions in that area
Rare symptoms are:
  • Ataxia ( in 1.3 percent of the cases)
  • Opsoclonus myoclonus syndrome (1.3 percent of cases)
  • Treatment-resistant diarrhea (4 percent)
  • Homer’s syndrome (2.4 percent)
  • Hypertension(1.3 percent of the cases)
  • Transverse myelopathy (tumor spinal cord compression) that occurs in 5 percent of the total neuroblastoma cases.

What are the causes of neuroblastoma?
It is really important to be well-informed about the major causes of this cancer of the nervous system. It is not clearly understood why it affects a person. It can be caused due to various factors such as:
  • Genetic history
  • Exposure to chemicals in some industries
  • Excessive alcohol intake
  • Smoking
  • Drug and some medications taken by the mother during pregnancy
  • Infection
  • Hormones
  • Fertility drugs
  • Hair dyes
  • Atopy
How is neuroblastomy diagnosed?
Several techniques are used to detect this cancer. These are:
  • Imaging
  • Biochemistry
  • Screening
Imaging
Neuroblastoma is diagnosed with the mIBG scan (meta-idobenzylguanidine) that is carried out in 90 to 95 percent of all neuroblastoma patients. mIBG is done on sympathetic neurons which reveals the presence of tumor there.

Biochemistry
There is an increase level of catecholamine or their metabolites in the blood or the urine in 90 percent of the patients affected by neuroblastomy. So it is a strong indication of the presence of this cancer. Dopamine, VMA (vanillylmandelic acid) and HVA (homovanillic acid) are included in catecholamine and their metabolites.

Screening
Healthy infants with no symptoms of neuroblastomy are given a screening test at three weeks, six months and one year in many developed and health conscious countries since 1980. But recently it was not practiced in some parts of the world due to zero reduction in the deaths caused by neuroblastoma. Among the infants, it made diagnosis that would have gone without treatment of any sort. But the children were operated on with surgery or chemotherapy unnecessarily.

How to treat neuroblastomy?
At beginning, when the tumor is not widely spread, this cancer is quire curable with long-term positive results and a high survival rate. These are the options to treat this disease:
  • Chemotherapy
  • Radiation therapy
  • Differentiation agent isotretinoin (also known as 13- cis-retinoic acid)
  • Stem cell transplant
  • Immunotherapy
  • Anti-GD2 monoclonal antibody therapy
The combination of all these is termed as multi model therapy. The treatment depends upon the age of the child, the severity level of the cancer, genetic factors and microscopic appearance.

Related Stories: