Neuroblastoma: symptoms, diagnosis and treatment options

1. NEUROBLASTOMA Information on symptoms, diagnosis and treatment options

2. INTRODUCTION TO NEUROBLASTOMA • Cancer of the sympathetic nervous system which affects approximately 600 children a year and the average age of diagnosis is 3 yrs. • Stage IV Neuroblastoma is very aggressive and chances of survival are 30%. NB has one of the highest rates of relapse among any cancers, and when it does come back, chances of survival are 5%

3. SING AND SYMPTOMS OF NEUROBLASTOMA Signs and symptoms of neuroblastoma vary depending on what part of the body is affected. Symptoms of neuroblastoma in the abdomen are: • Abdominal pain • A mass under the skin that isn't tender when touched • Changes in bowel habits, such as diarrhoea • Swelling in the legs

4. SING AND SYMPTOMS OF NEUROBLASTOMA Symptoms of neuroblastoma in the chest are: • Wheezing • Chest pain • Drooping eyelids and unequal pupil size • Enlarged liver • Fatigue

5. SING AND SYMPTOMS OF NEUROBLASTOMA Other signs of neuroblastoma include:  • Lumps of tissue under the skin • Eyeballs that seem to protrude from the sockets • Dark circles, similar to bruises, around the eyes • Back pain • Unexplainedweight loss • Bone pain

6. TESTS AND DIAGNOSIS OF NEUROBLASTOMA If your doctor suspects neuroblastoma, he may suggest the following tests and procedures to diagnose neuroblastoma: • Full body check-up: Your child's doctor conducts a physical exam to check out any signs and symptoms. • Urine and blood tests: These tests may identify the cause of any signs and symptoms your child is experiencing. Urine tests may be used to check for high levels of certain chemicals that result from the neuroblastoma cells producing excess catecholamine.

7. TESTS AND DIAGNOSIS OF NEUROBLASTOMA • Imaging tests: Imaging tests such as X-ray, ultrasound, computerized tomography (CT) scan, metaiodobenzylguanidine (MIBG) scan and magnetic resonance imaging (MRI) may reveal a mass that can indicate a tumour. • Removing a sample of tissue for testing: If a mass is found, your child's doctor may want to remove a sample of the tissue for laboratory testing which is medically known as biopsy. This helps the doctor devise an individualized treatment plan. • Removing a sample of bone marrow for testing: Your child may also undergo bone marrow biopsy and bone marrow aspiration procedures to see if neuroblastoma has spread to the bone marrow.

8. TREATMENT OPTIONS FOR NEUROBLASTOMA  The doctors are very selective in choosing the treatment plan because it can affect your child’s prognosis. There are various treatment options for neuroblastoma, including: • Surgery:Oncologists use various surgical tools to remove cancer cells. In children with low-risk neuroblastoma, surgery to remove the tumour may be the only treatment needed. • Chemotherapy: Chemotherapy uses chemicals to destroy cancer cells. This therapy attacks rapidly growing cells in the body, including cancer cells. Children with moderate neuroblastoma often receive a combination of chemotherapy drugs before surgery.

9. TREATMENT OPTIONS FOR NEUROBLASTOMA  • Radiation therapy:Radiation therapy uses high-energy beams to execute cancer cells. Children with low to moderate risk of neuroblastoma may receive radiation therapy if surgery and chemotherapy haven't been helpful. • Stem cell transplant: Children with high-risk neuroblastoma may receive a transplant using their own blood stem cells. • Immunotherapy: This therapy uses drugs that work by stimulating your body's immune system to help fight cancer cells.

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