Neuroblastoma is a pediatric tumor arising from the neural crest cells which are derived from the ectoderm in the embryo. The cells in the neuroblastoma are poorly differentiated, and the tumor is metastatic in nature. The usual age of presentation is infancy that is less than 1 year. It presents as an abdominal lump along with the associated abdominal symptoms of fullness, distension, etc. It is the most common malignancy to be found in the pediatric age group. The frequent age for diagnosis is the first month of life.
What Happens To Untreated Neuroblastoma?
It is a malignant tumor with poor prognosis and low survival rate. The neuroblastoma carries a very poor probability of being alive in cases when no treatment is given or left untreated. The five-year survival rate drops down to almost nil in untreated cases of neuroblastoma. The three year life period doesn’t go uneventful in untreated cases of neuroblastoma whereas it could have been disease-free for 3 years with treatment in more than 50% of the cases.(1)
The first line of treatment for neuroblastoma is chemotherapy with multiple anticancer drugs. Because the disease is highly metastatic, various anticancer drugs are started synergistically like cyclophosphamide, doxorubicin, etoposide, busulfan, melphalan, etc. The standard treatment accepted for the neuroblastoma is a combination of busulfan and melphalan. Although due to high metastatic nature of the tumor, the prognosis and survival do not improve by much margin. It is probably due to the diffuse nature of the neoplasm and abundance of the neoplastic cells. But the chemotherapy helps in shrinking the size of the tumor, reducing the abdominal symptoms, and sometimes very rarely can convert the metastatic neuroblastoma into benign ganglioneuroma which could be treated easily. The surgical treatment is of less use and found to be helpful in only stage 1 and 2 of the tumor.
But it is observed that the infants which were diagnosed earlier than one year of age even with a diffuse and a malignant form of neuroblastoma had much better prognosis then the infants diagnosed with after one year of age. The reason behind such a difference in the prognosis is not known but it is suspected that the cells of the body are more totipotent in the first year of age and can recover better at an early age. The response of the infants below 1 year to the chemotherapy has been much better than the children who are diagnosed above one year of age. It has been shown by the researchers that how much the time is important in the diagnosis and early treatment to make the life of child event free in coming years although the complete treatment of it has not been yet established.
When To Go To Doctor For Neuroblastoma?
Any symptoms related to the abdomen like the presence of a lump, abdominal fullness, distension, vomiting of greenish disease-free etc. should be presented to the doctor immediately as soon as possible. Usually, it is a large lump which brings the parents of the patients to doctor in the first month of life and diagnosis can be made in the first month itself. As the prognosis changes drastically between the diagnosis of less than one year and more than one year, there should be no delay done in contacting a doctor.(1)
As the importance of early diagnosis and treatment has been established to help the infant, there should be no delay done on the part of parents to present to a doctor.
The ignorance of the parents would prove very costly for their child. The best treatment for the neuroblastoma remains the medical treatment and it is also shown by the studies that the infants below 1 year take the treatment very well and recover faster. The toxicity of anticancer drugs has been found more in patients treated after one year of age. The tumor of neuroblastoma demands immediate attention and parents should be well aware of it.
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