What side effects your child experiences depends on where the radiation is directed and how much radiation is administered. Radiation therapy primarily affects the area where it's aimed, but some healthy cells may be damaged by the radiation. Children with high-risk neuroblastoma may receive radiation therapy after chemotherapy and surgery, to prevent cancer from recurring. Radiation therapy uses high-energy beams, such as X-rays, to destroy cancer cells.Ĭhildren with low-risk or intermediate-risk neuroblastoma may receive radiation therapy if surgery and chemotherapy haven't been helpful. Chemotherapy is usually used before surgery and before bone marrow transplant. Unfortunately, chemotherapy also damages healthy cells that grow quickly, such as cells in the hair follicles and in the gastrointestinal system, which can cause side effects.Ĭhildren with intermediate-risk neuroblastoma often receive a combination of chemotherapy drugs before surgery to improve the chances that the entire tumor can be removed.Ĭhildren with high-risk neuroblastoma usually receive high doses of chemotherapy drugs to shrink the tumor and to kill any cancer cells that have spread elsewhere in the body. Chemotherapy targets rapidly growing cells in the body, including cancer cells. ChemotherapyĬhemotherapy uses chemicals to destroy cancer cells. Other treatments, such as chemotherapy and radiation, may then be used to kill remaining cancer cells. In intermediate-risk and high-risk neuroblastoma, surgeons may try to remove as much of the tumor as possible. Tumors that are attached to nearby vital organs - such as the lungs or the spinal cord - may be too risky to remove. Whether the tumor can be completely removed depends on its location and its size. In children with low-risk neuroblastoma, surgery to remove the tumor may be the only treatment needed. Surgeons use scalpels and other surgical tools to remove cancer cells. What treatment or combination of treatments your child receives for neuroblastoma depends on the risk category. Your child's doctor uses this information to categorize the cancer as low risk, intermediate risk or high risk. Factors include your child's age, the stage of the cancer, the type of cells involved in the cancer, and whether there are any abnormalities in the chromosomes and genes. Your child's doctor selects a treatment plan based on several factors that affect your child's prognosis. By stage IV, the cancer is considered advanced and has spread to other areas of the body. The stages of neuroblastoma are indicated by Roman numerals that range from 0 to IV, with the lowest stages indicating cancer that is limited to one area. Imaging tests used to stage cancer include X-rays, bone scans, and CT, MRI and MIBG scans, among others. Knowing the cancer's stage helps the doctor decide what treatment is most appropriate. Once neuroblastoma is diagnosed, your child's doctor may order further testing to determine the extent of the cancer and whether it has spread to distant organs - a process called staging.
In order to remove bone marrow for testing, a needle is inserted into your child's hipbone or lower back to draw out the marrow. Your child may also undergo bone marrow biopsy and bone marrow aspiration procedures to see if neuroblastoma has spread to the bone marrow - the spongy material inside the largest bones where blood cells are formed. Removing a sample of bone marrow for testing.This information helps your child's doctor devise an individualized treatment plan. Specialized tests on the tissue sample can reveal what types of cells are involved in the tumor and specific genetic characteristics of the cancer cells.
If a mass is found, your child's doctor may want to remove a sample of the tissue for laboratory testing (biopsy). Removing a sample of tissue for testing.Imaging tests may include an X-ray, ultrasound, computerized tomography (CT) scan, metaiodobenzylguanidine (MIBG) scan and magnetic resonance imaging (MRI), among others. Imaging tests may reveal a mass that can indicate a tumor. Urine tests may be used to check for high levels of certain chemicals that result from the neuroblastoma cells producing excess catecholamines. These may indicate the cause of any signs and symptoms your child is experiencing. The doctor will ask you questions about your child's habits and behaviors.
Your child's doctor conducts a physical exam to check out any signs and symptoms. Tests and procedures used to diagnose neuroblastoma include:
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