“Cancer” has been a terrifying word for most people for many years. It refers to one of the diseases that continue to pose a great challenge to medicine today. There are many types of tumor that can appear in our body, and it is possible for them to arise in any type of tissue and at any age.
One of these types appears in neuroblasts, immature cells of the nervous system. We are talking about neuroblastoma, a rare cancer which generally appears in the child population, being one of the most common in infants and children under four years of age (in fact it is the most common before two years of age).
The term neuroblastoma refers to a rare type of cancer, but which is nevertheless the most common in childhood before two years of age. It is a type of embryonic tumor in which there is accelerated, uncontrolled and infiltrative growth of the precursor cells of neurons and glia: neuroblasts.
These cells are formed during the gestation of the individual, appearing and forming part of the neural plate to later develop and differentiate during fetal development until they form the cells of our nervous system (both neurons and glia). In other words, They are the precursors of our nerve cells
Although most neuroblasts transform into nerve cells during fetal development, occasionally some children can maintain some of them, even after birth, immature. They usually disappear over time, but sometimes for some reason They can grow uncontrollably and become tumors
They generally appear in the ganglia or nerve bundles of the autonomic nervous system, although this may mean that they can appear practically anywhere in the body. The areas in which it most commonly appears are in the adrenal glands (being its most common point of origin), abdomen, spinal cord or thorax.
One of the difficulties of this disease is that the symptoms that can arise are initially very non-specific, making it easy to confuse it with other alterations or even go unnoticed. In fact, in many cases they are only observed when the tumor has already grown, so it is relatively common. that is only detected once and has even metastasized
The most common thing is that alterations in appetite, fatigue and weakness appear. There is also usually fever, pain and gastric alterations. Other symptoms will depend largely on the area in which the tumor appears. For example Headaches, dizziness or vision problems are common if there is brain involvement, bruising in the eyes or the existence of inequality between both pupils in terms of size. In addition, problems appear when urinating, moving, maintaining balance, as well as tachycardia, bone and/or abdominal pain or respiratory problems are also common.
The stages of neuroblastoma
As in other cancers, in neuroblastoma the existence of a series of phases and stages can be observed in which the tumor can be located according to its degree of malignancy, location and infiltration into other tissues. In this sense we can find:
What are your causes?
The causes of the appearance of neuroblastoma are currently unknown, although it is proposed the existence of genetic problems that may cause this problem to arise. In fact, in some cases there is a family history, so one could speak of a certain transmissibility in some cases (although it is not the majority).
Treatment
Treating a neuroblastoma successfully depends on the presence of certain variables, such as the location of the tumor, the stage it is in and its level of spread, the age of the minor or resistance to previous treatments.
In some cases, treatment may not be required, since it has been observed that sometimes the tumor disappears on its own or transforms into a benign tumor. For the rest of the cases, removal of the tumor may be sufficient, but Chemotherapy and/or radiotherapy may also be required (especially in those cases where there is some dissemination) to cure the disease or reduce its growth rate.
In cases where chemotherapy is carried out in an intensive manner, which stops cell growth, it is common that the patient’s own stem cells are collected prior to this for later reintroduction into the body once the chemotherapy is completed. A bone marrow transplant can also be done from the minor himself (extracting it before applying the treatment). On those occasions when the tumor is resected, immunotherapy can subsequently be carried out by injecting antibodies that allow the patient’s own immune system to fight and destroy the remains of tumor cells.
But regardless of how effective a treatment may or may not be, it must be taken into account that it is a type of tumor that especially affects young children, which must be done taking into account what undergoing certain treatments may mean for a minor. Surgical interventions, relatively frequent visits to the doctor, check-ups, injections, the use of therapies such as radio or chemotherapy or possible hospital stays can be extremely aversive for the minor and generate great fear and anxiety.
It is necessary to try to make the minor’s experience as least traumatic and aversive as possible. To do this, different techniques can be applied, such as the Lazarus technique of emotional enactments, allowing, for example, the child to visualize himself as a superhero with whom he identifies and who through treatment is fighting evil.
Psychoeducation of parents is also important, since it allows them to raise the issue, clear up and express doubts and feelings, learn strategies to try to manage the situation and in turn contribute to ensuring that the parents’ emotional reactions do not generate negative anticipations and a higher level of fear. and anguish in the minor. It would also be useful to go to support or mutual help groups, in order to learn about other cases and share experiences with people who have suffered from the same problem.
Forecast
The prognosis of each case can vary greatly depending on various variables. For example, It is possible that in some cases the tumor can become a benign tumor or even disappear on its own, especially when it occurs in very young children.
However, in many other cases, if it is not treated or detected late, metastasis may occur. In fact, in the vast majority of cases, the diagnosis is made when this has already occurred.
The treatment is generally effective in non-disseminated tumors, although when there is already metastasis the treatment is usually much more complex. One aspect to take into account is that The younger the child, the less likely it is that there will be recurrences in the future
Regarding survival, generally in patients with low risk (stages 1 and 2) the prognosis is very positive after treatment, with a 95% survival rate. Those with an intermediate or moderate risk (2-3) also have a very high survival rate (more than 80%). However, unfortunately in patients with high risk (there is dissemination, the tumor being in stage 4) the survival rate is reduced to 50%.
