Neuroblastoma is a pediatric cancer that mainly affects children under the age of 5. It can be considered a rare cancer when compared to some types of adult tumors. However, if we only consider tumors affecting children, neuroblastoma accounts for approximately 10% of all cases, and is responsible for 15% of cancer deaths worldwide.
Tumors, in general, originate when cells in our body accumulate mutations in their DNA. Every time our cells divide they need to open and duplicate segments of DNA, in a process that is very well regulated by an arsenal of enzymes capable of repairing any errors in duplication. If the errors are not repaired, they can generate alterations in the DNA, which are mostly called mutations. The relationship between this process and cancer is that successive mutations that accumulate during life, can cause the cell to transform and start multiplying in an uncontrolled way, thus allowing the formation of a tumor.
"But how could a child get cancer if it hasn't had time to accumulate these mutations yet?"
There are two main reasons why this happens:
A child can inherit mutations from its parents, and therefore has a high chance of developing cancer from its embryonic stage.
The child can acquire such mutations during her/his embryonic phase or early in life.
The very name NEUROBLASTOMA refers to its embryonic origin, where the term "neuro" refers to the nerves of our nervous system, and "blastoma" indicates that it is a cancer originating from immature or developing cells.
In the case of children who develop the disease, the mutations affect cells known as neuroblasts and Schwann precursor cells. As already mentioned, these cells are embryonic, and therefore have the function of forming new mature cells that will be active after birth and even into adulthood. In neuroblastoma, the affected cells will make up parts of the Sympathetic Nervous System (SNS) and also part of the adrenal gland. Even the location of these organs coincides with the main sites of NB, with the SNS located along the entire spine and the adrenal gland located in the abdominal cavity, just above each kidney.
When embryonic cells cannot mature because of mutations in essential parts of their DNA, these cells start to multiply unrestrainedly, thus giving rise to the disease we know as neuroblastoma. Usually the degree of maturation of these cells is directly related to the prognosis of the disease, with more mature cells presenting a greater chance of cure (or even spontaneous regression) and cells with a lower degree of maturation being related to a worse prognosis for the disease.
"Finally, one must always remember that cancer is a diagnosis and not a sentence, new treatments are in development every day and there are many physicians and hospitals in the country extremely trained to treat the disease. Always consult clinical support before making any assumptions about the development of the disease and only perform treatments under medical supervision."
AutHor: Ronaldo Figueira de Oliveira
Edition: Selene Elifio Esposito e Fernanda de Almeida Brehm Pinhatti
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