Sunday, July 31, 2011

Neuroblastoma:Youngest casualties of cancer

For all the advances that have been made against childhood cancer, it remains the leading cause of disease-related death among children younger than 15, with 1,500 fatalities a year. And while the five-year survival rate has improved in recent decades — to 80 percent, up from less than half 40 years ago — the number of cases is rising, too; it now stands at 10,000, up from 8,000 in 1975.
Interactive Feature
Patient Voices: Childhood Cancer
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David Ahntholz for The New York Times

Max Mikulak
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Michael Stravato for The New York Times

Jaiden Ramirez

More than half of childhood cancers are caused by leukemia or tumors of the central nervous system. They are generally treated the same way as adult cancers, with chemotherapy, radiation and surgery. But other issues in childhood cancer are quite different from those faced by adults.

How do parents temper their emotions, remain clearheaded and determine the best course of treatment? Will the treatment have long-term side effects, and should that matter? How does a child maintain youth and enthusiasm in the face of terrifying and debilitating illness?

Beyond the consequences of the disease itself, cancer can leave deep emotional scars on its patients and their families. It is not easy to explain cancer to a young child, let alone begin a conversation about the possibility of death.

And if a child doesn’t survive, how does a family move on?

On, six people speak from a variety of perspectives about the impact of childhood cancer on their lives. Here are three.

John Carey, Colorado Springs

Now 16, he learned he had Hodgkin’s lymphoma at age 13, and has been in remission for a few months.

I’m glad I got cancer, because it completely changed my outlook on life. I think of things completely differently, and I value life so much more.

The worst part of cancer is probably not being a normal kid and just being in a hospital while all your friends are at school. People don’t really like going to school, but when you’re in the hospital getting chemotherapy or in the doctor’s office or just sitting at home being really, really sick, it’s just not fun.

My cancer is doing pretty well. I haven’t relapsed yet, and we’re so happy for that. I’ve been feeling pretty good and just working my way to a more normal life.

Max Mikulak, San Diego

Melissa Mikulak’s son died from a neuroblastoma on Aug. 31, 2008, at age 7.

Max was told he had “no evidence of disease” when he was 4. We went home and we were ready to plow ahead. We had a great year off. And then he relapsed.

The Monday before he passed away, he was looking great. We were making pancakes for dinner. We thought we had three months left. We thought, “O.K., we’re going to have a great time,” and two days later we learned the cancer had spread into his liver.

It’s been two and a half years since he died, and we’ll always be a family of five. He’ll always be with us.

Never lose hope. Something’s going to happen where someone finds a cure for cancer. Or maybe a cure is not going to be found, but the 18 months that you have with your child could be the best 18 months ever.

Jaiden Ramirez, Houston

Toshia Ramirez’s son Jaiden, 7, has diffuse pontine glioma, an inoperable cancer surrounding his brainstem.

We spend a lot of time on our knees, praying and asking God to let Jaiden be one of the miracles.

Jaiden knows that whatever is in his head is making him sick. He knows that it makes him dizzy, makes him sick to his stomach.

I told Jaiden that there was a possibility that God would take him home with him. So he cried. He said he didn’t want to go live with God; he wanted to stay here with Mommy and Daddy.

And I cried, and I told him, “You know, I want you to stay here too, but ultimately God has the say-so, so we have to abide with his wishes.” We haven’t talked about it again. If he brings it up we talk, and if he doesn’t then we don’t.

source: New york times

After reading this article do any of you who read this site, have a comment to tell the world how neuroblastoma of a child affected your life or if your a survivor, if it made your life better or worse afterwords

Wednesday, July 27, 2011

Neuroblastoma Treatments: Molecular radiotherapy offers hope for children with neuroblastoma

A new treatment option may soon be available for children with neuroblastoma according to research published in the July issue of The Journal of Nuclear Medicine. The study tested the principle that combined positron emission tomography and X-ray computed tomography (PET/CT) may be used to select children with primary refractory or relapsed high-risk neuroblastoma for treatment with a molecular radiotherapy known as 177Lu-DOTATATE. This therapeutic option was found to be viable option for children with neuroblastomas.

Neuroblastoma is a cancerous tumor that develops from nerve tissue in infants and children. Accounting for six to 10 percent of all childhood cancers, it does not always follow the same pattern, with some patients regressing spontaneously and other progressing, despite aggressive therapy. The long-term survival rate for neuroblastoma is below 40 percent.

"We know that peptide receptor radionuclide therapy in adults with somatostatin-positive neuroendocrine tumors has resulted in improved symptoms, prolonged survival and an enhanced quality of life. Since some neuroblastomas express somatostatin receptors, we felt this approach could be beneficial to children as well," said Jamshed B. Bomanji, MBBS, PhD, FRCR, FRCP, one of the authors of the study "177Lu-DOTATATE Molecular Radiotherapy for Childhood Neuroblastoma."

In the study, eight children with relapsed or primary refractory neuroblastoma were imaged with a 68Ga-DOTATATE PET/CT scan. If the disease sites showed 68Ga-DOTATATE uptake greater than the liver, the child was considered eligible for the molecular radiotherapy. Therapy with 177Lu-DOTATATE was determined to be suitable for six of the children and was administered appropriately.

After completing treatment with 177Lu-DOTATATE, five children had stable disease by the response evaluation criteria in solid tumors. The treatment was feasible, practical and well-tolerated in the small group of patients with high-risk neuroblastoma. As a result, the researchers plan to evaluate 177Lu-DOTATATE formally in a phase I-II clinical trial to evaluate toxicity and response.

"Molecular imaging has contributed a new diagnostic technique to map the full extent of disease. This mode of treatment has great potential for children whose treatment options are limited, as neuroblastoma often becomes resistant to chemotherapy and success is limited by poor bone marrow reserve," noted Bomanji.


Friday, July 22, 2011

Neuroblastoma Awareness: Cancers may increase diabetes risk

Childhood cancer survivors are at much greater risk of developing diabetes than their siblings, especially if their treatment involved radiation of the abdomen or total body, a new study reports.

At highest risk were adults who survived acute myeloid leukemia after total body irradiation, done in conjunction with a bone marrow transplant, the study found. Those survivors were almost 24 times as likely as their siblings to develop Type 2 diabetes as adults. Children with this form of leukemia who did not undergo total body irradiation were three times as likely as their siblings to develop diabetes.

Cancer survivors who had been treated with radiation to the abdomen were also at higher risk for diabetes, with neuroblastoma survivors at 9.2 times greater risk, and survivors of both Hodgkin's lymphoma and Wilms' tumor, a type of kidney cancer, at 2.7 times greater risk.

Many of the survivors are not obese, but radiation might have altered the way they deposit fat and contribute to their risk, said Dr. Kevin C. Oeffinger, director the Program for Adult Survivors of Pediatric Cancer at Memorial Sloan-Kettering Cancer Center and senior author of the study. The findings appeared in The Archives of Internal Medicine.

Dr. Oeffinger suggested cancer survivors watch their diets and get plenty of physical activity.


Tuesday, July 19, 2011

Neuroblastoma Treatments:Fatty Oil may be next treatment for cancer

DHA (docosahexaenoic acid), an omega-3 fatty acid found in cold water fatty fish and fish oil supplements, may be the next treatment for cancer. A new study shows that DHA and its derivatives have the ability to kill neuroblastoma cancer cells.

DHA is essential for the proper functioning of the adult brain and for the development of the nervous system and vision during the first six months of life. Along with eicosapentaenoic acid (EPA), the other main omega-3 fatty acid in cold water fatty fish, DHA helps lower the risk of heart disease. Although humans naturally produce small amounts of DHA, people must get the DHA they need from diet or supplements. The University of Maryland Medical Center notes that most people in the Western world do not get an adequate amount of omega-3 fatty acids from their diet.

Researchers with the new study, which was conducted at the Karolinska Institutet in Stockholm, Sweden, administered DHA to neuroblastoma cells from the nervous system and analyzed them for byproducts as the DHA broke down. They then examined the impact of both DHA and its derivatives on the growth of cancer cells. They discovered that DHA killed the cancer cells, and that the derivatives were even more effective at destroying cancer.

Helena Gleissman, PhD, co-author of the study from the Childhood Cancer Research Unit of the Karolinska Institutet, notes that “Ultimately, we hope that we can be able to cure more children with neuroblastoma, and possibly other cancers,” including medulloblastoma, colon, breast, and prostate cancers, among others.

Neuroblastoma is a cancer that often begins in early childhood, according to the National Institutes of Health. This form of cancer develops in the nerve tissues and usually begins in the adrenal glands, although it can also start in the neck, chest, or spinal cord. It can even begin before a child is born. Physicians usually do not find the cancer until it has spread to other parts of the body.

Results of the new study are “good news for those looking to stop cancer,” says Gerald Weissmann, MD, editor-in-chief of The FASEB Journal. Until now, researchers have known that DHA has the ability to prevent and treat various diseases. “Now we see that DHA or one of its byproducts might serve as the starting point for a new class of anti-cancer drugs,” notes Weissman.

Gleissman H et al. The FASEB Journal 2010; 24(3)
National Institutes of Health
University of Maryland Medical Center