Research Assessment #8

Date:​ February 8, 2018

Subject:​ Pediatric Oncology – Neuroblastoma

MLA citation:

Matthay, Katherine K. “Neuroblastoma: Biology and Therapy.” ​Oncology​, vol. 11, no. 12, 1

Dec. 1997, www.cancernetwork.com/brain-tumors/neuroblastoma-biology-and-therapy.

Assessment:

In preparation for my final product, I wanted to learn more about the specific research

interest of my mentor: neuroblastoma. While I am still unsure of what exactly it is that I will be

creating as my product, I know that specific research about neuroblastoma is on the list of

possibilities as it is what she specializes in and therefore a logical choice for my own research as

well. In addition to this, in order to gain the most from my mentorship I want to be on the same

page as my mentor. In other words, I do not want her to feel as though she has to explain every

little thing to me, as I am educated on that which we are studying, and the best way to be

educated is to research. Therefore, for this research assessment I chose to search for a general

academic article about neuroblastoma so that I could learn what exactly it is (beyond what I can

find at the top of the page in a simple internet search) and begin to think about potential products

and research.

Neuroblastoma is the “most common extracranial solid tumor of childhood, accounting

for 15% of cancer-related deaths” (Matthay). These tumors mostly occur in young children, most

of them occurring in children under the age of two and almost all of them before the age of ten.

They derive from cells of the sympathetic nervous system, which includes neurons in the spinal
cord, ganglia, and nerves in the center of the adrenal glands. There are no definitive

environmental risk factors that contribute to it, however it has been linked to factors such as

“maternal exposure to alcohol, neurally active drugs, diuretics, and hair coloring and from

paternal exposure to electromagnetic fields” (Matthay).

While this is beyond the scope of my work in pediatric oncology, neuroblastoma is most

consistently reported to be accompanied by a mutated distal short arm chromosome 1, namely its

deletion in 70% of cases. In 30% of cases, MYCN proto-oncogene amplification is also found.

These two are the only two found consistently. In addition to these, there are several cellular

markers that can also indicate the presence of neuroblastoma, however, once again, they are

beyond the scope of the practical research that I will be doing.

As neuroblastoma is the most common in infancy, newborn urinary screening is

considered the most cost-effective way to detect the tumor. The most common symptoms that

lead to diagnosis include “pain due to either primary tumor or to bone and bone marrow

involvement, an abdominal mass, weight loss, anorexia, and irritability” (Matthay). Primary

tumors originate in the abdomen in approximately 70% of patients, often in the adrenal gland as

mentioned earlier and also frequently in the chest. Bone marrow and bone are then the most

common sites of metastases (Matthay). In order to best plan treatment, three main staging

systems have been used, all of which have prognostic value. Now, however, an international

consensus group has synthesized the three systems to develop the International Neuroblastoma

Staging System (INSS) which is currently used. Then, treatment is tailored to the extent of the

disease and biological risk in each individual patient. Patients are divided into risk groups based

off of these factors, as there is no consistent correlation between the success of little treatment
versus aggressive treatment in patients across different standard stages. Now, research is working

to find new kinds of more effective treatment for the patients who struggle with just

chemotherapy and the other standard treatments.

Overall, I feel as though I have gotten a solid understanding of what neuroblastoma is

from several perspectives. Not only do I understand what it is in itself, but I also have a better

grasp now of the treatment that goes along with it, which is much more specific to what I will be

doing/seeing in the hospital with Dr. Watt. While I am not exactly sure how this can be applied

to my final product, I know that I can use it to further my learning in the hospital and get more

from every visit, as now I will not be clueless. I will also be able to ask Dr. Watt questions of a

much higher caliber, and I will be able to further tailor my interests to line up with hers and the

opportunities that I will be receiving in the hospital. Looking forward, I will use what I learned

in this research assessment to decide upon a final product with Dr. Watt and see what more I can

learn about neuroblastoma specifically within the limitations of the hospital, and from then on

tailor my research as we get closer to final products!