Neuroblastoma is a solid cancerous tumor in the nerve tissue of your neck, chest, abdomen, or pelvis. It usually originates in your adrenal glands, which sit on top of your kidneys.

• Neuroblastoma accounts for about 7% of all childhood cancer diagnoses.

• It is estimated that 800 - 900 children in the United States will be diagnosed with neuroblastoma each year.

• 90% of children who are diagnosed with neuroblastoma are younger than five years of age and only 3% are older than ten years. Guess that puts you in the minority - how lucky can you get?

Your neuroblastoma has often spread beyond its primary site when you are first diagnosed, usually to your bone marrow (70%) and bones (56%). It can also metastasize (spread) to your lymph nodes, liver, brain and the area around your eyes.

What Does Staging Mean?

Once a neuroblastoma is found, more tests will be done to find out if the cancer has spread from where it started to other parts of your body. Your doctor needs to know the stage or extent of your disease to plan your treatment:

Stage I
Your tumor is able to be completely removed.

Stage II
Your tumor is confined to one side of your body and only the lymph nodes on the same side as the tumor are positive for disease. The tumor can be either totally or partially removed by surgery.

Stage III
Your tumor has crossed over the midline or, if it is one sided, your lymph nodes on the opposite side have disease.

Stage IV
Your disease has spread or metastasized beyond its original site.

So, What Happens Now?

Your treatment options are related to your age at diagnosis, the tumor location and the stage of disease. More than one method of treatment may be used, depending on your needs:

• Surgery is used to remove as much of the cancer as possible. If the cancer cannot be removed, surgery may be limited to a biopsy (when a small piece of tissue is taken and examined under the microscope for signs of cancer).

• Radiation therapy uses high-energy rays to damage or kill cancer cells and shrink tumors.

• Chemotherapy uses drugs to kill cancer cells and shrink tumors. It may be given after the tumor has been surgically removed to kill any remaining cancer cells (adjuvant therapy - after another type of therapy) or before surgery to shrink the cancer (neoadjuvant therapy - before another type of therapy).

• Bone marrow transplantation, a procedure in which healthy bone marrow replaces marrow destroyed by high dose chemotherapy or radiation, may be considered.

Unfortunately, most cases of neuroblastoma are advanced at diagnosis and may have some biological factors known to make treatment difficult. If this is the case, you may be treated with more intensive and higher dose chemotherapy and radiation. High dose therapy is frequently followed by a bone marrow or stem cell transplantation.

What Are My Chances?