Neuroblastoma Surgery – Introduction

Before we study the details of the best hospital for neuroblastoma surgery in India, let us first understand what exactly Neuroblastoma is?

The term ‘neuro’ means nerves, whereas the term blastoma means a cancer which begins in developing or immature cells. So, in a nutshell, Neuroblastoma is basically a cancer which arises in very early stage of nerve cell development of embryo or foetus. That is why it is most commonly diagnosed in young children. Its is a rare form of paediatric cancer. Adults too might develop this cancer, but it is in a different form.

In order to know about Neuroblastoma, one must also have knowledge about the sympathetic nervous system, as this is where these tumors begin developing.

What Causes Neuroblastoma?

• The best doctor in India for neuroblastoma surgery, Dr. Bhargava mentions that there are very few known facts that have clearly been able to exactly define the risk factors of neuroblastoma. Yet, some research has been done to differentiate the normal neuroblasts and the neuroblastoma cells.
• When a foetus is growing, the nerve cells in the centre of the adrenal gland (located right above the kidneys) start growing a normal neuroblast. These only grow into mature cells later on. But, when these neuroblasts do not grow into mature cells and rather continue to grow and divide as it is, then they result in Neuroblastomas and further grow in the form of bigger tumors.
• Now, why would neuroblasts not mature is what you must be thinking now!
• So the answer to this is – They start having genetic changes in the DNA inside their cells. These genetic changes result in Oncogenes. Neuroblastoma occurs when the DNA changes result into oncogenes.

Neuroblastoma is the 4th most common cancer found in children, preceded by lymphomas, Central Nervous System tumors, and leukaemia. According to studies, it amounts upto 8% of the total number cancers in children. Lot of these children with neuroblastoma show spread of the disease to other body parts like liver, bone marrow, lymph nodes, and also skin.

Signs and Symptoms of Neuroblastoma

Neuroblastoma can begin in different parts of the body. Its cells can also at times release hormones that tend to affect other body organs. Due to this, neuroblastoma is known to cause several signs and symptoms, some of which are listed below:

• Swelling or lump in belly, though it doesn’t hurt
• Having problem in swallowing or breathing
• Swelling in the face, chest , neck or leg
• Having problems with urinating or bowel movement
• Excessive weight loss
• Bulgy or bruised eye
• Painful bones
• Bluish bumps or lumps under the skin area

Above signs and symptoms may not necessarily be due to neuroblastoma. Still it is advisable to see a doctor if your child complains of any of these.

Early Diagnosis and Detection of Neuroblastoma

Neuroblastomas are often diagnosed after a child is seen by the doctor when he or she complains of above signs or symptoms. If a neuroblastoma or any other type of tumor is suspected, then following tests will be required in order to confirm the diagnosis

• Physical Examination and Medical History
• Blood and Urine Investigations
• Imaging Tests – Ultrasound, CT/MRI, PET CT, MIBG Scan, Bone Scan
• Biopsy/CT guided needle biopsy
• Bone Marrow Aspiration

Not all of the above will be advised by your doctor. It depends upon the child’s medical condition as to what all tests will be required to confirm the diagnosis of neuroblastoma.

Neuroblastoma Surgery in India

After your doctor has considered a range of factors, he or she would then recommend a treatment plan for your child. This plan would involve the following treatment modules:

• Surgery: Neuroblastoma surgery in India is a procedure that is performed to remove a cancerous tumor from the nervous system. The surgery is usually performed on an outpatient basis, which means that the patient does not have to stay in the hospital overnight. The surgery can be done under general anesthesia or local anesthesia, depending on the preference of the patient. The average cost of neuroblastoma surgery in India is about $6,500, which is much cheaper than the average cost of neuroblastoma surgery in the United States. There are several reasons why neuroblastoma surgery in India is so much cheaper than in the United States. First, there is no need for insurance companies to cover the costs of neuroblastoma surgery in India because it is considered to be a cosmetic procedure.
• Chemotherapy: Chemotherapy approach makes use of strong anticancer drugs for stopping the neuroblastoma cells from growing uncontrollably and spreading to other body organs. Chemotherapy sessions for neuroblastoma treatment can last from weeks to some months, depending upon the severity of disease.
• Stem Cell Transplant: High-dose chemotherapy damages bone marrow cells which are responsible for the development of immune cells. Thus, your doctor may suggest stem cell transplant after chemotherapy has been done. Before chemotherapy commences, the healthy stem cells from your child’s bone marrow are extracted and stored in a freezer. Once chemo has been done, then these cells will be injected back into your child’s body, where they begin to rebuild the child’s immune system.
• Radiation Therapy: Radiation therapy for neuroblastoma is a localised therapy that destroys cancer cells by using powerful radiation beams. In neuroblastoma cases, radiation therapy is used by doctors for reducing the risk of disease relapse. It is typically recommended for those patients who have high-risk neuroblastoma.
• Iodine 131-MIBG Therapy: During this therapy, the radioactive blend of iodine 131-MIBG is directly injected into the patient’s body, and the radiation released by it kills the tumour cells.
• Immunotherapy: Immunotherapy is that treatment module which is not very commonly used. This treatment activates the immune system of the patient’s own body to make it attack against the cancerous cells. Immunotherapy is usually recommended for neuroblastomas that do not show significant response to other treatment approaches like chemotherapy and radiation therapy.

After your child’s treatment is done, you need to ensure that no follow-up appointment gets missed and your child is given medications and other essential follow-up support without any fail.

Also note that cancer recurrence is the main concern that bothers every cancer survivor and their family members. Even after going through the best of treatments, the cancerous cells may still find a way back for some patients. This is why it is all the more important not to avoid follow up care instructions and do follow up visits on time.