What is cancer?
A (child’s) body consists of billions of cells. These cells are continuously dividing and creating new cells. New cells provide growth and development. In a healthy body the cell division is in balance: old cells are replaced and there are no more cells created than necessary. This equilibrium is disrupted in cancer. One of the cells goes rampant, it continues to grow and divides rapidly into other cells that keep on growing. This forms a tumour, which can spread or metastasise.
What is neuroblastoma?
A neuroblastoma is a tumour in the autonomic nervous system. This nervous system controls organs such as your intestines, your arteries, your skin, and your pupils too. If you are scared, your autonomic nervous system makes your heart beat faster, and it can also make you sweat or start shaking, it can make you go pale or feel the need to go to the toilet. Neuroblastoma can occur anywhere in the autonomic nervous system (abdomen, chest, neck or pelvis), but they are most common in the adrenal glands. It is not certain how neuroblastomas occur, but children with neuroblastomas are probably born with them. This means that Lennard has probably always had this neuroblastoma, but it was only discovered shortly after his fourth birthday, in June 2014.
How often do neuroblastomas occur?
A neuroblastoma is detected in about 25 children in the Netherlands every year. In the UK, about 100 children are diagnosed with neuroblastoma every year, and in the USA the number of children diagnosed with neuroblastoma is about 700 per year. These children are invariably younger than 6 years old.
What is the treatment for a neuroblastoma ?
A neuroblastoma is usually treated with chemotherapy and surgery, and sometimes with radioactive iodine treatment (1311 – MIBG). If the tumour is very large and has metastasised, as it has in Lennard’s case, the treatment will be very intensive, including large amounts of chemotherapy and a stem cell transplant.
What are the chances of recovery?
In general, the chances of recovery are dependent on the size of the tumour and possible metastasis, but also on the age of the child and the genetic changes in the tumour cell. Babies often have a better chance of recovery than older children. Neuroblastomas that have not metastasised generally provide a good chance of recovery (70 to 90%). Very occasionally a neuroblastoma will even disappear without treatment. But when the tumour has metastasised the chance of recovery is much smaller (25 to 50 %). In addition, the tumour can also have a particular genetic make-up, the “n-myc” gene, allowing the tumour to grow much faster and making it more aggressive. This also has an effect on the treatment and the chances of recovery.