Fever and stomach pain aren’t unusual in childhood. But when your child also has a lump or unexplained weight loss, they could be early warning signs of neuroblastoma. Neuroblastoma is a rare pediatric cancer.
Hearing your child has cancer brings lots of questions. That’s when families come to UVA Health Children’s. Our pediatric cancer specialists (oncologists) guide families from diagnosis through survivorship. We can help support you every step of the way.
Treatment for Neuroblastoma
Depending on the tumor’s location, size, and how far it’s spread, different treatment options are available. Your child’s care team will help your family decide on the best course of action.
Generally, treatment plans involve some mix of surgery and chemotherapy.
Surgery
We’ll remove as much of the tumor as we can. Often, this can be done using minimally invasive techniques. This helps your child heal more quickly and reduces the stress on their body.
If we can’t remove the whole tumor, we’ll still remove as much as we can. Reducing the tumor’s size can make it easier to treat.
For many children with neuroblastoma that’s very contained or low risk, surgery may be enough to treat the cancer effectively.
Chemotherapy
Chemotherapy uses strong medicines to kill cancer cells. If cancer has become more widespread, chemo can help kill early cells before they grow.
There are many different ways of taking chemo and different regimens available. We’ll talk through them with you. Our goal is always to use the smallest effective dose of these medications. We’ll also help you manage side effects.
Often, surgery will be followed with a several-month-long chemotherapy regimen. This helps make sure the cancer doesn’t return.
Follow-Up Care
After treatment, your doctor will order many of the same diagnostic tests your child went through at the beginning of care. This establishes how effective treatment was and will help the doctor for setting up your child’s follow-up care.
Because cancer can return, we’ll schedule periodic check-ins. Through our survivorship program, we can help your family deal with cancer’s aftereffects.
Does My Child Have Neuroblastoma?
Neuroblastoma is a rare condition. It’s unlikely that your child has it. But if they have any of these symptoms, a visit to your pediatrician can help your family get answers and relief. And if needed, they can help you get specialist care quickly.
What Is Neuroblastoma?
Neuroblastoma is a cancer that develops in immature nerve cells. Because of this, it usually affects children. Most of the time, it’s diagnosed before the age of 5. It’s very rare to find it in a child older than 10.
While this cancer can originate in any part of the body, usually it's first found in the abdomen. Abdominal swelling and pain are the earliest symptoms for many children.
Early Symptoms of Neuroblastoma
- Abdominal pain and swelling
- Fever
- Weight loss
- Feeling tired or weak (fatigue)
- Night sweats
- Bone pain
- A lump or mass
- Drooping eyelids
How Is Neuroblastoma Diagnosed?
Diagnosing neuroblastoma can be very challenging. The symptoms aren’t specific. But usually, it’s the abdominal pain that brings families in. Many times, children are first seen by a digestive health specialist (gastroenterologist). These doctors may order additional tests.
Urine Test
Levels of hormones in your child’s urine can be measured for important clues about their health. One category of these, catecholamines, can be elevated with neuroblastoma.
Imaging for Tumors
Sometimes tumors aren’t large enough to feel, but we can still see them with imaging. We may use tools like:
- X-ray
- Ultrasound
- Computed Tomography (CT) scans
- Magnetic resonance imaging (MRI)
These imaging techniques let us see what’s going on inside your child’s body. And we can find abnormalities and masses. Once we’ve found the neuroblastoma, we can begin discussing treatment options.
Advanced Imaging
We have 2 more imaging techniques that are useful for finding and staging cancers. While these are very similar, they have different strengths and weaknesses. Your doctor may recommend only 1 or both.
Though these scans use radioactive tracers, they’re an incredibly low dose and very safe.
PET (positron emission tomography) scan
For a PET scan, a small amount of radioactive tracer is sent into your child’s body so it can bind with cancer cells. Then, 24 hours later, we scan to see where these tracers have ended up. That can tell us where the neuroblastoma is.
123I-MIBG scan
MIBG is a chemical specific to neuroblastoma. By using a radioactive tool that links to it, we can see where there are neuroblastoma cells in the body. This can be helpful if we aren’t sure if the neuroblastoma has spread. It can also be useful when other tests tell us it’s there, but we haven’t located it yet.
Biopsy
Ultimately, a biopsy can offer us a lot of information about your child’s neuroblastoma. In addition to giving us a definitive diagnosis, biopsy also allows us to genetically test the cancer itself.
This can help us target treatment and select options that are the most successful.