What is neuroblastoma?

Neuroblastoma is a cancer that affects young children.

The outlook for a child with neuroblastoma depends on:

• the type of tumour
• where the tumour is
• whether the tumour is slow or fast growing

Neuroblastoma cancers grow in the cells of the body’s nerves. They start from a type of cell called a neuroblast.

Often the tumour develops in the adrenal glands. Adrenal glands are in the abdomen (tummy) near the kidneys.

At other times the tumour develops around the spinal cord in the neck, chest, abdomen or pelvis.

Neuroblastoma usually affects children under 5 years old. It is rare in children over 10 years.

What are the types of neuroblastoma?

There are many types of neuroblastoma and each one behaves differently.

Doctors will classify the type of neuroblastoma based on:

• how the cancer cells look under the microscope
• the location of the tumour
• whether the tumour has spread to other parts of the body

Based on these criteria, the neuroblastoma will be classified as low, intermediate or high risk.

Children with low-risk disease usually have very good outcomes. In other cases, the tumour is very aggressive and cannot be cured.

What are the symptoms of neuroblastoma?

The symptoms of neuroblastoma depend on:

• where the tumour is
• how large the tumour is
• whether the tumour has spread
• whether the tumour is making hormones

Symptoms may include:

• a lump or swelling in the abdomen, neck or chest, or under the skin
• swelling in the legs, upper chest, neck or face
• tummy pain, not eating or feeling full quickly, usually with weight loss
• problems going to the toilet
• jerky, uncontrolled eye movements, or bulging eyes or dark circles around the eyes
• weakness or paralysis
• pain in the bones or other unexplained pain

Some children may also have trouble breathing or swallowing.

In some cases, neuroblastoma makes certain hormones that can cause:

• diarrhoea
• high blood pressure
• rapid heartbeat
• sweating
• flushing (blushing) of skin

Remember that each of these symptoms can be due to other conditions and they don’t necessarily mean your child has neuroblastoma.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes neuroblastoma?

Researchers don’t completely understand what causes neuroblastoma.

In rare cases, neuroblastoma can run in families and be associated with certain genetic conditions.

When should I see my doctor?

If you are worried about your child’s symptoms, see your doctor.

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How is neuroblastoma diagnosed?

Your doctor will:

• ask about your child’s symptoms and overall health
• perform a physical exam

There are different tests to diagnose neuroblastoma. The first is a urine (wee) test to look for raised levels of a hormone called catecholamine. Catecholamine levels can indicate your child might have neuroblastoma.

Other tests your child may have include:

• blood tests
• a bone scan
• a biopsy, where a small piece of tissue is removed for analysis in the laboratory
• bone marrow aspiration and biopsy

Your child may also have some imaging tests, including:

• x-rays
• CT scan
• MRI scan
• PET scan
• MIBG scan

These tests can:

• diagnose a neuroblastoma
• work out the size and location of the tumour
• show if the tumour has spread to other parts of the body

If your child has neuroblastoma, they will be looked after by a team of health professionals known as a multidisciplinary team.

Specialists your child might see include:

• paediatric oncologists (doctors who specialise in treating children’s cancer)
• medical oncologists (doctors who specialise in medicines to treat cancer)
• radiation oncologists (doctors who specialise in using radiotherapy to treat cancer)
• paediatric surgeon (doctors who specialise in operating in children)
• nurses who specialise in caring for children with cancer

Other healthcare professionals your child might see include:

• your child’s regular doctor
• social workers
• rehabilitation therapists
• psychologists
• cancer care coordinators

How is neuroblastoma treated?

The treatment will depend on:

• the type of tumour
• the location of the tumour
• how quickly the tumour is growing
• how your child reacts to the treatment

Some children won’t be treated at first, but they will be closely monitored and treated if any symptoms develop.

Most children will have a combination of treatments.

Surgery

Surgical treatment aims to remove all or part of the tumour.

Chemotherapy

Anti-cancer medicines are used to destroy the cancer cells. Your child could have a combination of different medicines.

Radiotherapy

High-energy x-rays are used to destroy cancer cells.

Bone marrow transplant

This is usually done along with chemotherapy or radiotherapy. It’s also called a stem cell transplant.

Immunotherapy

Some trials are being done on emerging treatments for neuroblastoma that use the body’s own immune system to attack cancer cells.

Can neuroblastoma be prevented?

We don’t completely understand what causes cancer in some children. However, if a child develops cancer, it’s not because of something they, or their parents did to cause it. No one is to blame if a child develops cancer.

Complications of neuroblastoma

If your child has low-risk disease, they might not be treated at first or only have surgery. In this case the long-term complications are usually minimal.

If your child has intermediate- or high-risk neuroblastoma, they will be treated with chemotherapy or radiotherapy plus surgery. In this case, your child may be at risk of developing complications linked to the treatment used.

Talk to your doctor about possible treatment side effects and complications.

Resources and support

For information on neuroblastoma and support, try the following resources.

Information on neuroblastoma

Neuroblastoma Australia has information about neuroblastoma and the latest advances in treatment.

Cancer Australia has information on children’s cancer and links to support organisations for children with cancer and their families.

Family and financial support

The Children’s Cancer Foundation provides family support and information about the latest treatments.

Kids with Cancer Foundation Australia provides financial assistance to children with cancer and their families.

Canteen's and Camp Quality's online community Parenting through cancer provides free expert advice, counselling and a chance to connect with other parents in similar situations.

Redkite is a national organisation that provides emotional support, financial assistance, information and resources to families who have a child with cancer.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.