WHAT YOU NEED TO KNOW:

What is neuroblastoma? Neuroblastoma is a type of cancer that causes developing nerve cells to become tumors. The tumors usually develop in glands near the kidneys called adrenal glands. Tumors may develop along your child's spine, or in his abdomen, chest, neck, or pelvis. A tumor may start in one place and metastasize (spread) to another. Neuroblastoma usually affects children younger than 5 years but can affect children up to 10 years old. The cause is not known. Your child may have an increased risk if other members of his family had neuroblastoma.

What are the signs and symptoms of neuroblastoma? Signs and symptoms depend on where a tumor is located.

• A lump or swollen area in the abdomen or neck
  
  
• Abdominal pain, no appetite, weight loss, or vomiting
  
  
• Swelling in the face, neck, or chest
  
  
• Chest pain along with a cough or wheezing
  
  
• Bone pain
  
  
• Drooping eyelid, small pupils, or dark circles under his eyes
  
  
• Swollen legs or a swollen scrotum (boys)
  
  
• Problems urinating or having a bowel movement
  
  
• Trouble moving his arms or legs

How is neuroblastoma diagnosed? A tumor may be found on an ultrasound before the baby is born. Neuroblastoma tumors are usually found years later during a routine physical exam. Some tumors are found because the child has signs or symptoms that need to be treated. Your child may need any of the following:

• Blood tests may be used to check your child's bone marrow or how well his kidneys are working. Blood tests may show signs of material the tumor has produced.
  
  
• An x-ray, ultrasound, PET, CT, or MRI scan may show the tumor. Your child may be given contrast liquid to help the tumor show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.
  
  
• A biopsy may be used to take a sample of a tumor to be checked for neuroblastoma. A sample of your child's bone marrow may also be taken to see if the cancer has spread to his bone marrow.
  
  
• A bone scan may be used to see if cancer has spread to your child's bones.

How is neuroblastoma treated? Neuroblastoma sometimes goes away on its own. If your child needs treatment, he may need more than one of the following:

• Surgery is used to remove the tumor. Your child may need more than one surgery if the cancer spread to other parts of his body.
  
  
• Chemotherapy or radiation may be used to kill the cancer cells. Radiation may also be used to shrink the tumor so it will be easier to remove during surgery later.
  
  
• Immunotherapy is medicine given to help your child's immune system fight the cancer.

What can I do to manage my child's symptoms?

• Have your child rest often. He may be more tired than usual.
  
  
• Give your child pain medicine as directed. Prescription pain medicine may be given. Ask how to give this medicine safely. Your child's healthcare provider may suggest NSAIDs to help decrease swelling, pain, or fever. These medicines are available without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from your child's healthcare provider.
  
  
• Do not give aspirin to your child. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.

When should I seek immediate care?

• Your child has severe watery diarrhea or a swollen abdomen.
  
  
• Your child has muscle weakness or trouble moving his arms or legs.
  
  
• Your child's eyes are moving quickly, and he has problems walking straight.

When should I contact my child's healthcare provider?

• Your child has new or worsening pain that does not get better with pain medicine.
  
  
• You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.