Various treatment options are available for neuroblastoma. The treatment option is chosen on the basis of severity of disease and the best treatment is one that provides maximum benefit with least side effects.
What Is The Best Treatment For Neuroblastoma?
Treatment for neuroblastoma is done on the basis of severity of disease and the risk of disease in which the patient is categorized. If the disease is not metastasized, surgical removal of the tumor is enough in most cases. If the tumor gets metastasized, the combinatorial treatment approach is implemented comprising use of various treatment options such as chemotherapy, radiation therapy, surgery, and immunotherapy. In patients with high-risk neuroblastoma, retinoid therapy is used to prevent recurrence after stem cell transplant and high-dose chemotherapy.
Treatment of neuroblastoma is done on the basis of severity of disease and the extent of the spread of the tumor to various body tissues. Following are the conventional treatment options available for neuroblastoma:
Chemotherapy: Because of the advancements in this therapy, the survival rate in neuroblastoma is increased. Drugs used in chemotherapy include etoposide, cisplatin, vincristine, and cyclophosphamide3.
Radiation Therapy: Radiation therapy is sometimes used along with surgery. However, because of its side effects on children, it is used only when its use is essential.
Surgery: If the disease is not metastasized, surgery alone is useful in most cases. Nearby lymph nodes are also evaluated for cancer during surgery.
Retinoid Therapy: Retinoid therapy is used to reduce the risk for chance recurrence after high-dose chemotherapy and stem cell transplant4.
Immunotherapy: Immunotherapy includes use of monoclonal antibodies to specifically attack the cancer cells.
Diagnosis Of Neuroblastoma
Diagnosis of neuroblastoma is difficult in the early stages mainly because of two reasons. First, in more than 90% of cases, the condition occurs in infants who are not able to express the symptoms in a well-defined manner and thus parents and doctors are unable to understand the situation the child is going through. Second, initial symptoms of neuroblastoma are irritability, fever and poor appetite. These symptoms are non-exclusive to neuroblastoma and may occur due to the common disease encountered by the patient in infancy. In most cases, diagnosis of the disease can only be done after the symptoms indicating neuroblastoma appears.
In rare cases, neuroblastoma is diagnosed even in the fetal stage during an ultrasound, which is done to detect any birth defects, to identify the fetal age or to evaluate the day of delivery. Following are some of the diagnostic technique used for neuroblastoma:
Physical Evaluation: The doctor will perform a physical evaluation of the child. The parents may be asked the questions regarding the behavior of child1 and if there is any loss of appetite. The doctor may also look for any abdominal swelling or any growth or tumor which may be present on the skin.
Blood And Urine Tests: Many cells in the body secretes catecholamines. However, the concentration of these chemicals is not high and thus remains non-detectable in urine or blood. However, neuroblastoma cells secrete an excess quantity of catecholamines, and they can be detected through urine or blood tests2. Other blood tests include total blood cell count, kidney function tests and liver function tests.
Imaging Techniques: Various imaging techniques are used to detect the presence and extent of spread of the tumor. Ultrasound is done to detect the presence of tumor during the preliminary examination and provides valuable information especially if the tumor is present in the abdominal region. While MRI proves to be beneficial in the tumor of the brain and spinal cord, CT scan is used to detect the presence of tumor in the abdomen, chest and pelvic region.
Biopsy: Tissue is taken from the tumor and analyzed for the presence of cancerous cells. Evaluation of the tumor tissue for cancer is conclusive evidence for the presence of cancer.
Treatment for neuroblastoma includes chemotherapy, radiation therapy, surgery, retinoid therapy, and immunotherapy. The option is chosen on the basis of categorization of the patient in a particular risk group.
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