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Neuroblastoma

Neuroblastoma

Sheba Medical Center in Israel is the largest hospital in the region. With our expert medical professionals, extensive facilities, groundbreaking treatments, we provide neuroblastoma treatment that is unmatched by any other facility around.

Our methods focus on treating the patient, not the disease. Each case is approached with the utmost care by our multidisciplinary team of specialists who use state-of-the-art technology to assist them in diagnosis, staging, and treatment. Since no two cases are alike, our expert doctors come together to build individualized treatment plans for each child diagnosed with neuroblastoma.

At Sheba, you know you’re in good hands with physicians who have trained at internationally renowned cancer centers around the world. Our team of medical professionals also includes nurses, psychologists, social workers, and therapists for complete holistic care. You’ll never have to worry about being in the dark when it comes to your child’s treatment. We aim to support you and keep you fully informed throughout your child’s treatment here at our clinic.

Neuroblastoma - Sheba Medical Center
hemato-oncology

Overview

Neuroblastoma (NB) is a pediatric cancer that originates from immature nerve cells of the sympathetic nervous system, commonly found near the adrenal glands but can also occur in other areas like the chest, neck or spine. This type of cancer predominantly affects children under the age of 5, and it is exceptionally rare in older children.

Neuroblastoma is a complex disease that requires specialized care and treatment approaches tailored to each individual case. Early detection plays a crucial role in improving outcomes for children with neuroblastoma. The diagnosis and treatment of neuroblastoma involve a multidisciplinary approach, involving medical professionals from various specialties working together to provide the best possible care.

Research and advancements in neuroblastoma treatment continue to enhance our understanding of the disease and improve survival rates. By raising awareness, supporting research efforts, and promoting early detection, we can make a significant impact in the fight against neuroblastoma and improve the lives of children and families affected by this challenging condition.

Sheba Medical Center, located in Israel, is renowned as the largest and most esteemed hospital in the region. We take pride in our comprehensive expertise and state-of-the-art facilities that enable us to offer unparalleled treatment for neuroblastoma.

At Sheba, our foremost focus is on the individual patient, not just the disease. Our dedicated team of specialists, comprising doctors, nurses, psychologists, social workers and therapists, collaborates closely to develop personalized treatment plans for each child diagnosed with neuroblastoma. Utilizing advanced technology for diagnosis, staging and treatment, we ensure that every case receives the highest level of care.

With a distinguished medical staff trained at prestigious cancer centers worldwide, we bring an exceptional level of knowledge and experience to our patients. Our commitment extends beyond medical treatment to provide holistic support for both the child and their family throughout the treatment process, providing compassionate care and expert treatment, where your child’s wellbeing is our top priority.

At Sheba, we understand the importance of transparency and open communication. We strive to keep you fully informed and involved in your child’s treatment, providing support and guidance every step of the way.

Symptoms

Neuroblastoma can present with various symptoms depending on the location and extent of the tumor. In 2 out of 3 cases, neuroblastomas have already spread by the time they are detected. This can cause many other symptoms related to cancer spreading to the lymph nodes or bones.




Common signs of neuroblastoma may include:

  • A noticeable lump or mass in the abdomen, chest, neck or pelvis
  • Abdominal pain or discomfort
  • Swelling in the lower extremities or a protruding abdomen
  • Unexplained weight loss
  • Fever
  • Changes in bowel or bladder function
  • Swollen lymph nodes (in the neck, above the collarbone, under the arm or in the groin)
  • Bone pain
  • Weakness, numbness or paralysis in the arms or legs
  • Fatigue, irritability and weakness
  • Frequent infections
  • Excess bruising or bleeding
If the tumor is in the chest or neck, it may cause:
  • Swelling in the face, neck, arms, or upper chest
  • Coughing and trouble breathing or swallowing
  • Eyes that appear to bulge or have bruising
  • Headaches and dizziness
  • Drooping eyelids and small pupils

In some cases, neuroblastoma may cause manifestations due to its effect on hormone production, such as rapid heartbeat, high blood pressure or diarrhea. It is important to note that these symptoms can be caused by other conditions as well, but if any of these signs are present, it is crucial to consult a healthcare professional for a proper evaluation and diagnosis. Early detection and prompt medical attention play a significant role in improving outcomes for children with neuroblastoma.

hemato-oncology

Causes

Neuroblastoma is a rare type of cancer. It is extremely uncommon for a person over the age of 10 to be diagnosed with neuroblastoma, but even in young children, it is considered rare. The exact causes of neuroblastoma, a type of pediatric cancer, are not yet fully understood. However, researchers have identified certain factors that may contribute to its development. Neuroblastoma typically occurs due to genetic mutations or alterations in the DNA of embryonic cells, specifically the neuroblasts that give rise to the sympathetic nervous system. These mutations disrupt the normal growth and maturation of these cells, leading to the formation of tumors.

Risk Factors

While the specific triggers for these genetic changes remain unclear, some risk factors have been identified. Although the vast majority of neuroblastoma cases are not hereditary, in about 1-2% of cases, a child can suffer from inherited genetic mutations, such as those associated with familial neuroblastoma, as well as certain chromosomal abnormalities. Additionally, children with certain birth defects, such as abnormalities of the adrenal glands or neural crest development, may have an increased risk of developing neuroblastoma.

It is important to note that neuroblastoma can occur without any known risk factors, and most cases are sporadic neuroblastoma, meaning they are not inherited. Ongoing research aims to uncover more insights into the causes and risk factors associated with neuroblastoma to improve prevention, early detection, and treatment strategies. Unfortunately, at this time there are no known preventive measures that can be taken to reduce the risk of a child developing neuroblastoma.

Diagnosis

Diagnosing neuroblastoma, a type of pediatric cancer, involves a comprehensive approach to evaluate the presence of tumors and determine the extent of the disease. The diagnosis typically begins with a thorough physical examination, medical history review, and assessment of symptoms.

Diagnostic imaging techniques, such as ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI) and metaiodobenzylguanidine (MIBG) scans, are commonly employed to visualize the tumor and identify its location and size. Additionally, a biopsy is often performed to obtain a tissue sample for laboratory analysis, confirming the presence of neuroblastoma cells. Further tests, including bone scans, bone marrow aspiration and biopsy as well as genetic testing, may be conducted to assess the spread of the disease and determine the specific characteristics of the tumor.

At Sheba, a multidisciplinary team of medical professionals, including pediatric oncologists, radiologists, pathologists, and geneticists, collaborate to ensure accurate diagnosis and staging of neuroblastoma, enabling the development of tailored treatment plans for each individual case. Early and accurate diagnosis is crucial for timely intervention and improving outcomes for children with neuroblastoma.

Staging

Staging is a critical component in determining the extent and spread of neuroblastoma, aiding in the development of appropriate treatment plans. The staging system commonly used for neuroblastoma is the International Neuroblastoma Staging System (INSS), which classifies the disease into different stages based on specific criteria.

Staging involves a combination of imaging tests, such as CT scans, MRI scans and MIBG scans, along with other diagnostic procedures like bone scans and bone marrow aspiration and biopsy. The staging process considers factors such as the size and location of the primary tumor, lymph node involvement and the presence or absence of metastasis.

Neuroblastoma is typically categorized into stages 1 to 4, with further subcategories based on specific characteristics. Staging helps healthcare professionals assess the prognosis, plan appropriate treatment approaches and monitor the response to therapy. Accurate staging is crucial for providing the most effective and tailored care to children with neuroblastoma, ensuring the best possible outcomes.

neuroblastoma prevention

Prevention

Currently, there are no known ways to prevent the development of neuroblastoma, as the exact causes of this pediatric cancer are not fully understood. Neuroblastoma often arises due to genetic mutations or alterations in the DNA of embryonic cells. These changes occur early in a child’s development and are difficult to predict or prevent. However, ongoing research aims to identify potential risk factors and genetic markers associated with neuroblastoma, which may contribute to improved prevention strategies in the future.

It is essential for parents to be aware of any family history of neuroblastoma or other genetic conditions and inform healthcare providers to facilitate early detection and monitoring. Additionally, participating in routine pediatric checkups and promptly reporting any concerning symptoms to healthcare professionals can aid in the early diagnosis and treatment of neuroblastoma. By focusing on early detection, advancements in genetic testing, and ongoing research, efforts are being made to enhance prevention and improve outcomes for children affected by neuroblastoma.

Treatment

The treatment of neuroblastoma involves a comprehensive and multidisciplinary approach tailored to each individual case. The treatment plan depends on several factors, including the child’s age at diagnosis, stage and extent of the disease, genetic characteristics, and overall health.

Surgery is often the initial step in treatment, aiming to remove as much of the tumor as possible. In some cases, complete surgical resection may be achieved, resulting in a favorable prognosis. However, for tumors that cannot be completely removed, additional treatments are necessary.

Chemotherapy is commonly used to target cancer cells throughout the body. It may be administered before surgery to shrink the tumor or after surgery to eliminate any remaining cancer cells.

Radiation therapy utilizes high-energy beams to destroy cancer cells and is typically employed following surgery or in cases where the tumor has spread to other areas. It helps prevent the recurrence of neuroblastoma and may be combined with chemotherapy.

Immunotherapy is a promising treatment approach that stimulates the body’s immune system to recognize and destroy neuroblastoma cells. This may include the use of monoclonal antibodies or immune checkpoint inhibitors.

Targeted therapy specifically targets the genetic abnormalities present in the tumor cells. These treatments aim to disrupt the growth and survival of cancer cells and they are often used in conjunction with other therapies.

At Sheba Medical Center, our experienced team of pediatric oncologists, surgeons, radiation oncologists and other specialists collaborate to develop personalized treatment plans for children with neuroblastoma. We leverage the latest advancements in treatment options, including precision medicine and innovative therapies, to provide the best possible outcomes for our young patients.

Our comprehensive approach focuses not only on treating the cancer but also on providing supportive care, including pain management, psychological support and rehabilitation services, to improve the quality of life during and after treatment.

Prognosis

The prognosis for neuroblastoma varies depending on several factors. These factors include the child’s age at diagnosis, stage and extent of the disease, presence of specific genetic markers, and the response to treatment. Neuroblastoma has a wide range of outcomes, from cases with excellent long-term survival rates to more aggressive forms with a poorer prognosis.

For low-risk neuroblastoma cases, the prognosis is generally favorable, with high chances of long-term survival. In contrast, cases of high-risk neuroblastoma have a more challenging prognosis and may require intensive and prolonged treatment. However, advancements in treatment approaches, including multimodal therapies and targeted therapies, have significantly improved outcomes for high-risk neuroblastoma.

Survival rates can also vary based on the age of the child at diagnosis. Younger children, particularly those under the age of 1, tend to have better outcomes compared to older children. Additionally, the response to initial treatment, such as the degree of tumor shrinkage, plays a critical role in determining the overall prognosis.

At Sheba Medical Center, we are committed to providing the highest level of care and employing the latest treatment options for neuroblastoma. Our multidisciplinary team of experts works collaboratively to develop personalized treatment plans that aim to achieve the best possible outcomes for each child. By leveraging our expertise, state-of-the-art technologies, and ongoing research, we strive to optimize prognosis, enhance survival rates, and improve the quality of life for children affected by neuroblastoma.

A holistic approach

Neuroblastoma is a complex pediatric cancer that requires a multidisciplinary approach for diagnosis, treatment, and ongoing care. Advances in medical research and treatment options have significantly improved outcomes for children affected by neuroblastoma.

At Sheba Medical Center, we are at the forefront of neuroblastoma management, offering cutting-edge technologies, personalized treatment plans and comprehensive support services. Our team of experts is committed to providing the highest standard of care, from accurate diagnosis and tailored treatment to long-term follow-up and survivorship programs. If you or your loved one is facing a neuroblastoma diagnosis, we encourage you to reach out to us for a consultation. Together, we can explore the best options for your specific case and provide the utmost support throughout the journey towards improved health and well-being.

We welcome all cases, including the rarest and the most challenging. From your initial inquiry through the long-term follow-up care, we are here for you.

Request a consultation

Sheba Medical Center provides innovative, personalized medical care to patients from around the world. We are the largest, most comprehensive hospital in the Middle East and dedicated to providing advanced and compassionate medicine for everyone. We welcome all cases, including the rarest and the most challenging. Our medical teams collaborate to provide the best possible health outcomes. From your initial inquiry through the long-term follow-up care, we are here for you.

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