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 it is, and whether it is slow or fast growing.

Neuroblastoma is a cancer that grows in the cells of the body’s nerves, and comes from a type of cell called a neuroblast. Often the tumour develops in the adrenal glands, which are in the abdomen (tummy) near the kidneys, or around the spinal cord in the neck, chest, abdomen or pelvis.

Neuroblastoma usually affects children under 5 and is rare in children over 10.

Watch this video from Cancer Australia about what it can be like to have cancer as a child:

What are the types of neuroblastoma?

There are many types of neuroblastoma and each one behaves differently. Some spread quickly, and some grow slowly. Sometimes, in very young children, the tumour just goes away by itself. Sometimes the cancer cells stop dividing and the tumour is benign (not cancerous). 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 it is, whether it has spread, and whether it is producing hormones. Symptoms may include:

• a painless lump or swelling in the tummy or neck
• swelling in the legs, upper chest, neck or face
• an enlarged tummy
• stomach pain
• problems breathing or swallowing
• weight loss
• not eating or feeling full quickly
• bulging eyes or dark circles around the eyes
• problems going to the toilet
• pain in the bones
• bluish bumps on the skin
• a drooping eyelid and a small pupil in one eye
• weakness
• not being able to feel or move one part of the body

Remember that each of these symptoms can be due to other conditions and they don’t necessarily mean your child has neuroblastoma. If you are worried about your child’s symptoms, see your doctor.

How is neuroblastoma diagnosed?

There are different tests to diagnose neuroblastoma. The first is a urine test to look for raised levels of a hormone called catecholamine, which can indicate a child might have neuroblastoma.

Other tests may include blood tests, CT, MRI or PET scans, x-rays, bone scans and bone marrow tests. The diagnosis is usually confirmed by taking a biopsy of the tumour, where a small piece of tissue is removed for analysis in the laboratory.

Based on the results of these tests, a medical team will calculate the stage of the tumour. This means how big it is and whether it has spread. The tumour can be:

• Stage 1 – small and unlikely to spread
• Stage 2 – likely to grow and spread
• Stage 3 – has already spread to the lymph nodes, or is very likely to spread
• Stage 4 – has already spread to distant parts of the body

Once the stage is known, the medical team can work out how to treat the neuroblastoma and what the outlook for the child is likely to be.

How is neuroblastoma treated?

If your child has neuroblastoma, they will be looked after by a team of health professionals known as a multidisciplinary team. Specialists they 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); surgeons; nurses; social workers; rehabilitation therapists; psychologists; and other specialists.

The best treatment will depend on the type of tumour, where it is, how quickly it’s growing, and how your child reacts to the treatment. Most children will have a combination of treatments. Options include:

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 conducted on emerging treatments for neuroblastoma that harness the body’s immune system to attack cancer cells.

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

Resources and support

• The Cancer Council in your state or territory offers information and support for people with cancer. Call 13 11 20.
• Neuroblastoma Australia has information about neuroblastoma and the latest advances in treatment.
• 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.
• Cancer Australia has links to support organisations for children with cancer and their families. It can also help you find clinical trials that your child could join and a list of children’s hospitals in Australia.
• 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.