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Diagnosis & Treatment

Neuroblastoma

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How Is Neuroblastoma Diagnosed?

Diagnosis

To diagnose neuroblastoma, the doctor will perform various tests and exams. These may include:

  • Physical exams will be done to ask about medical history, assess general health, and check for signs of neuroblastoma, including swelling, lumps, or weakness in the arms and legs.
  • Urine and blood tests may show certain substances that are signs of cancer.
  • Imaging exams, including computerized tomography (CT) scans and magnetic resonance imaging (MRI) scans, are done to obtain detailed images of areas inside the body, helping to detect tumors and inform a treatment plan.
  • Biopsies involve taking a tissue sample for examination under a microscope to confirm a diagnosis of neuroblastoma. Testing the biopsy sample can help determine the cancer stage.
  • Bone marrow analysis may be done to see if neuroblastoma has spread to the bones.
  • MIBG (metaiodobenzylguanidine) scan is a specific scan for neuroblastoma that can show if the cancer has spread. This type of imaging uses metaiodobenzylguanidine, a radioactive substance easily absorbed by neuroblastoma cells, to show where neuroblastoma is located within the body. In some cases, a positron emission tomography (PET) scan is done instead of an MIBG scan.

How Is Neuroblastoma Treated?

Treatments

Treatment for neuroblastoma depends on the child’s age and the cancer stage, risk category, and tumor location. Treatment may include surgery, chemotherapy, radiation therapy, immunotherapy, or other cancer treatments.

Neuroblastoma treatments include:

  • Observation – Children with low-risk neuroblastoma may not need treatment right away. Tumors in children younger than 6 months old may go away without treatment. 
  • Surgery – Some children with low-risk neuroblastoma only need surgery to remove the tumor. Children with intermediate-risk neuroblastoma usually have surgery to remove the tumor and any cancer cells that have spread to lymph nodes; in these cases, chemotherapy is done before or after surgery.
  • Chemotherapy – Chemotherapy with anticancer drugs is used in children with intermediate-risk and high-risk neuroblastoma. They may receive chemotherapy before surgery to shrink the tumor or after surgery to kill any cancer cells remaining in the body. The number of cycles of chemotherapy needed will depend on how the tumor responds to treatment and other factors.
  • Radiation therapy – Radiation is used to treat the specific part or parts of the body with neuroblastoma tumors and is done in combination with surgery and chemotherapy. External beam therapy (EBT), or external radiation therapy is often used, in which beams of X-rays or other types of energy are generated outside the body and delivered to the precise location of the tumor. 
    • I-131 MIBG therapy – I-131-MIBG (iodine-131-metaiodobenzylguanidine) therapy uses MIBG, which is absorbed by neuroblastoma cells, along with radioactive iodine to directly target cancer cells. This therapy is administered via IV and does not affect normal tissue.
  • Antibody therapy – This form of immunotherapy targets and kills the cancer cells while reducing the side effects that other treatments can cause. Antibody therapy is used for cases of neuroblastoma that persist and do not respond to other treatments. The U.S. Food and Drug Administration (FDA) approved the antibodies dinutuximab and naxitamab to treat children with persistent high-risk neuroblastoma. Other antibodies for neuroblastoma are being studied in clinical trials. 
    • Vaccines for neuroblastoma – Currently being evaluated in clinical trials, certain vaccines may be used after cancer treatment in patients who are clear of neuroblastoma, helping the immune system identify and destroy neuroblastoma cells that can develop in the body after chemotherapy.

FAQs

FAQs

Treatment for neuroblastoma depends on the patient’s risk group. The risk group depends on the stage of the neuroblastoma, the child’s age, and the tumor properties. Very low-risk, low-risk, and intermediate-risk neuroblastoma are likely to be cured. High-risk neuroblastoma may be hard to cure.

Yes, a person can be diagnosed with neuroblastoma as an adult, but it is rare, and little is known about the cancer and its treatment in adults.

Prognosis for children with neuroblastoma depends on their age and risk group. The prognosis is often expressed as a five-year survival rate, which refers to the percentage of people who are alive five years after their diagnosis. The five-year survival rate for children with low-risk neuroblastoma is higher than 95 percent. The five-year survival rate for children with intermediate-risk neuroblastoma is between 90 and 95 percent. The five-year survival rate is around 50 percent for children with high-risk neuroblastoma.

Relapse, the return of cancer cells in patients who have already received treatment, occurs in about half of children with high-risk neuroblastoma who received treatment and had an initial remission.

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Trust NewYork-Presbyterian for Neuroblastoma Treatment

At NewYork-Presbyterian, our pediatric oncologists, surgeons, and oncology nurses have the expertise and compassion to treat children with neuroblastoma. If your child has signs and symptoms of neuroblastoma and they don’t go away or get worse, contact us to make an appointment with one of our experienced pediatricians, who will refer you to a specialist if needed.