There are several types of neuroblastoma treatment, and those that are chosen typically depend on which risk group the patient is in. For some low risk patients, watchful waiting may be appropriate as the cancer can resolve on its own. Surgery is also often a good option for low as well as medium risk patients, though it may need to be combined with radiation or chemotherapy. Intermediate and high risk patients are often treated with chemotherapy, radiation, or both. Newer therapies, such as monoclonal antibody therapy, stem cell transplant, and 13-cis retinoic acid, may also be appropriate for high risk patients, as well as participation in clinical trials.
One type of neuroblastoma treatment is watchful waiting, which involves not giving treatment and closely monitoring the disease for any changes. This is sometimes the best approach in infants for whom treatment may cause more harm than good. The condition has also been known to go away without treatment in some cases, so close observation to ensure it is not getting worse can allow time to see if this may happen.
Surgery to remove tumors is often part of neuroblastoma treatment. Ideally, the entire tumor can be removed and then watchful waiting is used to ensure there is no recurrence. If all of the cancer cannot be taken out, a biopsy may need to be done, and then chemotherapy can be used to kill the rest of the cells.
Radiation is another option for neuroblastoma treatment. This type of treatment is particularly useful in cases where the tumors are causing significant problems and not responding to other treatments. Radiation may be delivered externally via a targeted beam or internally using radioactive seeds, depending on the patient's condition.
Many patients with neuroblastoma are given chemotherapy as part of treatment. It may be used before surgery, to shrink large tumors, or it can be given after surgery to kill any remaining cancer cells. Sometimes chemotherapy alone is enough to treat certain low risk patients.
Some newer types of neuroblastoma treatment are also available, and are often used in combination with more traditional techniques. Stem cell transplants can be used to replace cells destroyed by chemotherapy or radiation. An injection of monoclonal antibodies can be given to target and kill the cancer cells. 13-cis retinoic acid is a drug that can help slow a tumor's growth. Patients may also wish to participate in clinical trials that can introduce them to newer treatments.