Neuroblastoma is a rare type of cancer that develops from neuroblast or immature nerve cells in children. In the case of neuroblastoma, neuroblast which should grow and function as nerve cells instead form a lump in the form of a solid tumor.
Neuroblastoma more often occurs in one of the adrenal glands above the kidneys, or in the spinal cord that extends from the neck, chest, abdomen, to the pelvis. This rare cancer can spread quickly to other organs, such as bone marrow, lymph nodes, bones, liver, and skin. Most cases of neuroblastoma occur in children aged 5 years and under.
Symptoms of Neuroblastoma
Symptoms of neuroblastoma can vary, depending on the part of the body that is affected. Early symptoms can be vague and difficult to spot.
Neuroblastoma that attacks the abdominal area is characterized by abdominal pain, constipation, abdominal skin that feels hard to the touch, swollen stomach, decreased appetite, and weight loss.
If this condition occurs in the chest, it can cause symptoms such as chest pain, shortness of breath with wheezing, and changes in the eyes (different pupil size and drooping eyelids).
Meanwhile, if neuroblastoma attacks the spinal cord, the lower body can become weak, numb, or experience movement disorders.
The development of neuroblastoma can be classified into 4 stages, namely:
- Stage 1 Cancer is in one place, has not spread, and can be removed by surgery.
- Stadium2 The cancer has not spread and is still in one place, but is not easily removed by surgery.
- Stadium3 The tumor cannot be surgically removed because of its large size.
- Stadium4 Cancer has spread to other organs.
Causes of Neuroblastoma
Nerve cells and fibers, as well as cells of the human adrenal gland, develop from neuroblast or immature nerve cells. These changes occur as the fetus develops in the womb. After humans are born, there is no more neuroblast the remaining. If it is still there, it will gradually mature or disappear by itself. In the case of neuroblastoma, residual neuroblast The existing ones do not mature or disappear, but continue to grow and form tumors.
Just like other types of cancer, until now experts have not been able to determine the cause that causes the embryo of these nerve cells to not mature and develop into neuroblastoma. However, scientists suspect a defect in the gene neuroblast, which causes it to divide uncontrollably and become a tumor.
Neuroblastoma diagnosis
Doctors will suspect a patient has neuroblastoma based on the existing symptoms and other investigations, such as blood or urine tests. Patients with neuroblastoma have very high levels of catecholamine substances in their bodies. Through blood or urine tests, excess catecholamines can be identified.
To confirm the diagnosis, the doctor will order further examinations, such as ultrasound, CT scan, and MRI. These procedures aim to see the condition of the tumor in the body in more detail. Meanwhile, to see the spread of cancer cells, doctors can perform a MIBG scan (meta-iodobenzyl-guanidine). The radioactive material is injected into the blood to bind to the neuroblastoma cells. With this test, doctors can determine whether the cancer has spread or not.
In addition, doctors can also perform a biopsy, which is taking and testing samples of cancer cells in a laboratory. One of them is aspiration and bone marrow biopsy, which is done if neuroblastoma is suspected to have spread to the bone marrow.
Neuroblastoma Treatment
Doctors will treat neuroblastoma based on the extent of its spread. The recommended treatment methods are surgical removal of the tumor, chemotherapy (destruction of cancer cells using drugs), and radiotherapy (destruction of cancer cells using light radiation).
Operation
Surgery is applied to treat neuroblastoma that has not spread. However, if the tumor grows near a vital organ, for example around the spinal cord or lungs, then this procedure can be dangerous to do. Surgery only aims to remove as much of the tumor as possible, and further treatment in the form of chemotherapy or radiotherapy will be done to remove the remaining cancer cells.
Chemotherapy
If surgery can't be the main option for treating neuroblastoma, for example because it's large enough or has spread, the doctor may recommend the patient undergo chemotherapy. This procedure uses chemicals to stop the growth of cancer cells and shrink them. Once the tumor is reduced in size, surgery can be performed to remove it.
Radiotherapy
The purpose of this cancer treatment method is the same as chemotherapy, which is to destroy cancer cells. But the difference is that radiotherapy uses high-energy rays. In patients with advanced neuroblastoma, radiation therapy can be an alternative if surgery combined with chemotherapy has not been able to eliminate cancer cells.
Another method of treating neuroblastoma is stem cell transplantation.stem cells). This procedure can be done after neuroblastoma sufferers undergo high-dose chemotherapy to kill cancer cells. After the cancer cells die, stem cells will be injected into the patient's body to form new healthy cells.
Another method that can also be used as an alternative is immunotherapy. In this method, monoclonal antibodies are injected into the body of a neuroblastoma patient, to encourage the immune system to attack cancer cells.
Neuroblastoma Complications
Complications that can arise in patients with neuroblastoma include:
- Spread of cancer cells (metastasis). Cancer cells can spread to other parts of the body, such as bone marrow, liver, skin, or bones.
- Paraneoplastic syndrome. Neuroblastoma cells can secrete certain substances that affect normal cells, causing symptoms of paraneoplastic syndromes, such as impaired coordination or rapid eye movements.
- Spinal fracture. This is due to the growth of the tumor to the spine, thus pressing the spinal cord and causing pain or paralysis.
