Nerve cancer in children - medical experts

Nerve cancers are tumor diseases that affect the central nervous system or the autonomic nervous system. The most common tumor of the nervous system in children is neuroblastoma. This is a malignant neoplasm in the area of the sympathetic / autonomic nervous system.

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What is nerve cancer?

In medicine, nerve cancer refers to all tumor diseases that affect the central nervous system or the autonomic nervous system.

There are different types of nerve tumors, for example glioblastoma, astrocytoma, ependymoma, neurocytoma and neuroblastoma.

Neuroblastomas are malignant tumors in the sympathetic nervous system. It is the third most common type of cancer in children and occurs in 7 to 8 percent of children. Brain tumors, another type of nerve cancer, are the second most common type of cancer in children (after leukemia).

The sympathetic nervous system is part of the autonomic nervous system. @ bilderzwerg / AdobeStock

The causes of nerve cancer in children

The exact causes are not yet known. Heredity is ruled out for most cancers of the nervous system. Nevertheless, there are families in which neuroblastomas occur more frequently. It is possible that genetic changes, known as mutations, play a role in their development.

Brain tumors occur more frequently after radiotherapy of the skull in childhood, for example to treat leukaemia. Some cancers often occur in connection with congenital malformations such as neurofibromatosis type 1 or tuberous sclerosis.

The symptoms

As nerve cancer can occur in the adrenal medulla, chest, head or neck, the symptoms vary greatly:

• Urinary retention: a tumor in the abdomen can put pressure on the abdominal organs, causing urinary retention.
• Bruising around the eyes: In the case of tumors in the head area.
• Shortness of breath: In the case of tumors in the lung area.
• Headaches, swelling of the lymph nodes and high blood pressure
• Severe headaches or back pain
• Dizziness, nausea, vomiting: In tumors of the central nervous system, especially the brain. Nausea and vomiting occur independently of food intake, usually in the morning and when lying down there is an urge to vomit.
• Concentration disorders
• Changes in character
• Feeling of pressure in the head: due to increasing pressure inside the skull.
• Hydrocephalus and increased head circumference: If the outflow of cerebrospinal fluid (CSF) is disturbed,hydrocephalus can develop. In babies and small children with an open fontanel, the head circumference increases due to the pressure. In medicine, this is referred to as macrocephalus.

With hydrocephalus, more fluid (cerebrospinal fluid) accumulates in the brain. @ Pepermpron / AdobeStock

The non-specific signs of cancer of the nervous system also include

• Tiredness
• Weakness and rapid exhaustion
• Persistent fever without any other recognizable cause
• (Nightly) sweating
• Loss of appetite
• Weight loss

Diagnosis of nerve cancer in children

If a tumor of the nervous system is suspected, the doctor will carry out various examinations. These include imaging procedures such as computer tomography (CT) or magnetic resonance imaging (MRI).

A tissue sample (biopsy) can also confirm the diagnosis. In the case of neuroblastoma, a puncture of the bone marrow is also essential. This is the only way the doctor can determine whether the tumor has already affected the bone marrow.

The treatment of nerve cancer

The treatment of nerve cancer in children depends on the type of tumor, its location and its size. Whether metastases are present also plays a role. If possible, the attending physician will surgically remove the malignant solid tumor.

• Surgery: In the earlier stages of the disease, the focus of treatment is on surgical removal of the tumor.

• Chemotherapy: If the tumor is too large, has metastases or is difficult to access, chemotherapy is used.

• Combination therapy: Depending on the tumor, doctors prefer a combination therapy. This consists of surgery, chemotherapy and radiotherapy. In many cases, the first step is surgery and the second step is simultaneous chemotherapy and radiotherapy.

• Palliative treatment: If removal of the tumor is not possible because too much healthy brain tissue is lost in the process. Patients then receive palliative treatment to alleviate pain and discomfort.

Chances of recovery and consequential damage

The course and prognosis depend on the type of tumor, its location, size and the child's state of health:

• Neuroblastomas

Localized and limited neuroblastomas have a 5-year survival rate of over 90 percent. However, if there are metastases, only 20% of children are still alive 5 years after diagnosis. In contrast to other tumors, however, neuroblastoma has a high spontaneous recovery rate of up to 80 percent.

• Brain tumors

The figures for brain tumors also vary. Children with a so-called low-malignant glioma have a very good prognosis. Low-malignant gliomas grow relatively slowly and cause fewer symptoms. In the case of highly malignant gliomas, however, there are patients for whom there is no cure. They die from their disease. Highly malignant gliomas are aggressive and spread quickly throughout the body.

• Consequential damage

After surviving cancer, symptoms may remain: For example, damage from the operation is possible. Some people are paralyzed or have other movement disorders. Speech disorders can also remain. Aftercare is essential in many cases. Regular check-ups are also carried out to detect recurrences at an early stage.

Which specialists are experts in nerve cancer in children?

Neuropaediatrics, also known as pediatric neurology, is a medical specialty that deals with nerve cancer in children. A doctor who specializes in these diseases is called a paediatric neurologist or neuropaediatrician.

After studying medicine and completing his specialist training as a paediatrician, a prospective neuropaediatrician undergoes three years of specialized training.

Another medical specialty that deals with nerve cancers in children is pediatric oncology. After studying medicine, a prospective pediatric oncologist must complete training as a specialist in hematology and oncology. This takes 72 months. Further training in the field of pediatric oncology is then required.

Doctors from different specialties work together to treat nerve cancer in children quickly and effectively. Close cooperation with the pediatrician is therefore necessary.

The neurological clinical pictures are often complex and require comprehensive care. Collaboration with occupational therapists, speech therapists or physiotherapists can be useful to prevent or counteract consequential damage.