“I am only one,
But still I am one.
I cannot do everything,
But still I can do something;
And because I cannot do everything,
I will not refuse to do the something that I can do.”
Neuroblastoma is an agressive childhood cancer developing from nerve cells called neuroblasts. It is the most common extracranial cancer diagnosed in children under 5 years old, with an incidence of 100 UK cases per annum. 50% of neuroblastoma cases occur in children younger than two years old.
The treatment is particularly long in duration and intensive.
In most cases it is only diagnosed when it has already progressed to a late ‘high risk’ stage.
Even when children are tested clear of neuroblastoma after initial hospital treatment, a high percentage of children with high risk neuroblastoma will relapse and some children will not respond to therapy. When relapse happens there is no standard treatment path to follow, with clinical trials often becoming the best option.
"Due to the nature of the cancer, therapies for high risk neuroblastoma often come from the more intensive end of the cancer treatment spectrum. This can include chemotherapy, surgery, myeloablative radiation, and stem-cell transplants. Around a fifth of high risk neuroblastoma cases, however, will be resistant to initial therapy (refractory). Some children will therefore never reach remission and many of those who do will subsequently relapse. Relapsed neuroblastoma is the most dangerous form of the disease. The recurrence of the disease is often down to minimal residual disease (MRD) which has resisted chemotherapy and radiatiotherapy." (Solving Kids' Cancer)
What are the symptoms?
Initial symptoms often include loss of appetite, tiredness and pain in the bones. Other symptoms vary, depending on where the child's neuroblastoma starts:
if the tumour is in the abdomen, the tummy may be swollen and there may constipation or difficulty passing urine. In some cases, the child's blood pressure is high
if the tumour affects the chest area, the child may be breathless and have difficulty swallowing
if the tumour occurs in the neck, it is often visible as a lump and may affect breathing and swallowing occasionally, there are deposits of neuroblastoma in the skin that appear as small, blue-coloured lumps
if the tumour is pressing on the spinal cord, children may have weakness in the legs and walk unsteadily. If the child is not yet walking, reduced leg movements may be noted. The child may also have constipation or difficulty passing urine
very rarely, children may have jerky eye and muscle movements, and general unsteadiness associated with the neuroblastoma.