Neuroblastoma is difficult to detect in the early stages and the disease is often not identified until it is more advanced. In addition, the condition usually affects young children under the age of five years who may be too young to "self report" symptoms.
The condition often isn't diagnosed until the cancer has reached stage 4 or an advanced metastatic stage where the likelihood of treatment response is low.
Prognosis is dependent on several factors including:
Patient age at diagnosis - The age of a patient when they are diagnosed significantly impacts on the 5-year survival rate. Children with a localized tumor or children under 18 months of age with advanced disease but favourable tumor characteristics have a significantly greater chance of long-term survival than older children with advanced disease.
These older children have a much lower chance of being cured, even after intensive therapy. Infants diagnosed while they are under 1 year of age have a 90% chance of survival compared with a 66% chance in those diagnosed at age 10 to 14.
General health - Children with poor general health are less able to withstand the adverse effects of surgery, chemotherapy and radiation therapy.
Disease stage at diagnosis - The earlier the stage of disease at diagnosis, the more effective treatment will be and the lower the risk of recurrence.
Cancer features - A cancer that is slow growing and less likely to spread to distant organs is more easily treated and eradicated than a faster growing, aggressive tumor.
High-risk neuroblastomas are more likely to recur after treatment.
Those who survive neuroblastoma may develop certain persistent problems including hearing loss, retardation of growth and development, learning difficulties and thyroid disorder. In addition, children who have been treated with chemotherapy and radiation carry a risk of developing secondary cancers later in life.
Reviewed by Sally Robertson, BSc