The Cancer Center at The Children's Hospital of Philadelphia has a multidisciplinary team of highly experienced professionals who will provide expert diagnosis and treatment of your child's neuroblastoma. In addition, Children's Hospital physician researchers are actively involved in developing new therapies to treat neuroblastoma. For children whose cancer is relapsed or refractory, our Refractory Neuroblastoma Program is comprised of international leaders in neuroblastoma treatment who are able to offer families a large portfolio of clinical trial options and unrivaled support services.
Neuroblastoma is a tumor of nerve tissue that develops in infants and children and can occur in many areas of the body. It develops from the tissues that form the sympathetic nervous system (which controls body functions, such as heart rate and blood pressure, digestion and levels of certain hormones). It most commonly begins in the abdomen in the tissues of the adrenal gland, but it may also occur in other areas. It can spread to the lymph nodes, liver, bones and bone marrow. Children's Hospital doctors have discovered many of the reasons why neuroblastomas occur. Genetic testing for children is available at CHOP, under the direction of Drs. Yael Mosse and John Maris, where there appears to be a family history.
Neuroblastoma is typically diagnosed in babies or young children. The average age for neuroblastoma is about 18 months of age but it is occasionally seen in teenagers or even young adults. It is found slightly more often in boys than in girls. In the United States, about 800 new cases of neuroblastoma are diagnosed each year.
Signs and symptoms will vary depending on the site of the primary tumor or the extent that it has spread (metastasized). The most common primary site is the abdomen. Other primary sites include the chest, neck and pelvis. Neuroblastoma can spread to other areas of the body. If your child has a primary tumor in the abdomen, you may notice bellyaches, weight loss or a bigger abdomen. Some children only complain of general aches and pains.
Your child will need to have a series of tests to help us learn the extent of the disease. Some of the neuroblastoma tests include:
We start by determining whether the disease risk is low, intermediate or high.
Newly diagnosed patients are generally treated according to Children's Oncology Group protocols, many of which were developed by CHOP doctors. However, every child will receive individualized treatment planning and other treatments may be recommended. Drs. John Maris, Yael Mosse and Edward Attiyeh provide comprehensive oversight for all newly diagnosed neuroblastoma patients. Dr. Stephan Grupp regularly focuses on children with advanced disease, and oversees all transplant and stem cell collection aspects of high-risk neuroblastoma patient care.
The majority of patients with neuroblastoma will eventually require surgery. These operations tend to be quite difficult because of the nature of these tumors, which often wrap themselves around delicate structures in the body. At CHOP, surgical oncologists aim to remove as much of the tumor as possible, while preserving all normal organ functioning.
Unfortunately, high-risk neuroblastoma still has a very high rate of non-responsiveness, or recurring/relapsing during or after treatment. Learn more about the innovative ways we treat kids whose disease is relapsed or refractory, through the Refractory Neuroblastoma Program at The Children's Hospital of Philadelphia.
Some children treated for cancer develop complications years later. Our Cancer Survivorship Program provides information about the potential long-term effects of the specific neuroblastoma treatment your child received, including ways of monitoring and treating these effects.
Reviewed by: John M. Maris, MD, The Children's Hospital of Philadelphia
Date: November 2009
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