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During treatment for neuroblastoma, most patients and their families are focused on getting through treatment and beating the cancer. After treatment, the focus shifts to long-term effects of neuroblastoma and its treatment, as well as worries about the cancer coming back.
It is normal to want to put neuroblastoma and its treatment behind you and get back to a life that does not revolve around cancer. But getting the right follow-up care offers your child the best chance for recovery and long-term survival.
For several years after treatment, it is important to have regular follow-up exams with the cancer care team. The doctors will watch for signs of cancer and side effects of treatment. Doctor visits will be more frequent at first, but the time between visits may get longer as time goes on.
Checkups after treatment for neuroblastoma include careful physical exams, lab tests and imaging tests (MIBG scans, PET scans, ultrasound, CT scans, and/or MRI scans) to see if there is any tumor remaining. The tests done will depend on the child's risk group, the size and location of the tumor, and other factors. If the tumor comes back or does not respond to treatment, your doctors will discuss the treatment options available.
Because there is a chance that the cancer might return after treatment, it is important to go to all follow-up appointments and to report any new symptoms to your child’s doctor right away. As time goes by, the risk of recurrence goes down. However, routine doctor visits are still important because some side effects of treatment might not show up until years later. A benefit of follow-up care is that it gives you a chance to discuss any questions and concerns that arise during and after recovery from cancer treatment.
Talk with your child’s doctor about developing a survivorship care plan. This plan might include:
As much as you might want to put the experience behind you once treatment is done, it is important to keep good records of your child’s medical care during this time. Eventually, your child will grow up, be on their own, and have new doctors. Gathering these details soon after treatment may be easier than trying to get them at some point in the future.
Ask the cancer care team where and how to get this information. Learn more in Keeping Copies of Important Medical Records.
It is also important to keep health insurance coverage. Tests and doctor visits can cost a lot, and even though no one wants to think of cancer coming back, this could happen.
Neuroblastoma can cause long-lasting side effects. Most of the long-term side effects depend on what kind of treatment a child had, where the tumor was located, and how old the child was when treated. Children who received several kinds of treatment (surgery, radiation, chemotherapy, immunotherapy, etc.) are more likely to have serious long-term side effects.
Because of major advances in treatment, many children treated for neuroblastoma are now surviving into adulthood. Doctors have learned that the treatment can affect children’s health later in life, so watching for health effects as they get older has become an important part of cancer survivorship.
Neuroblastoma survivors may be at risk for several possible late effects from their treatment. It is important to discuss what these possible effects might be with your child’s medical team.
Anthracycline (daunorubicin, doxorubicin) chemo drugs can cause heart problems later in life. Radiation treatments to the chest can also weaken the heart muscle. For some survivors, an echocardiogram (an ultrasound of the heart) to look at the strength of the heart muscle may be recommended every few years to catch and treat problems early.
Radiation treatment to the lungs or treatment with medications like busulfan can cause lung problems. Doctors will watch for any breathing symptoms and may recommend testing called PFTs (pulmonary function tests) to check how well your lungs work after treatment. Exercising regularly, avoiding smoking, and getting vaccines against influenza and pneumococcus can help keep the lungs healthy.
Chemo drugs like cisplatin and radiation to the belly can affect the kidneys. Regular kidney function testing may be recommended by your child’s cancer care team to find and manage any kidney problems after treatment.
Children treated with MIBG radiotherapy or those treated with radiation around the upper chest and neck may be at an increased risk of thyroid problems.
Children who have been treated for neuroblastoma may be at higher risk of developing other cancers later in life depending on their treatment.
After getting certain chemotherapy drugs, such as epipodophyllotoxins (etoposide, teniposide), alkylating agents (cyclophosphamide), or anthracyclines (daunorubicin, doxorubicin), children are at increased risk of developing leukemia from chemotherapy, most commonly acute myeloid leukemia (AML). This is rare but can occur.
Children exposed to radiation may have an increased risk of other cancers later in life. For example, children exposed to thyroid radiation may have a higher risk of thyroid cancer, female neuroblastoma survivors exposed to chest radiation have a higher risk for breast cancer earlier in life, and neuroblastoma survivors treated with radiation to the abdomen (belly) have an increased risk for colon cancer. In people with higher risk of colon and breast cancer due to treatment, early cancer screening is recommended.
Alkylating chemo drugs (cyclophosphamide, melphalan, thiotepa) may also affect sexual development and the ability to have children later in life. Talk to your child’s cancer care team about the risks of infertility with treatment and ask if there are options for preserving fertility. Fertility preservation may be an option even after cancer treatment is completed in some cases. For more information, see Preserving Fertility in Children and Teens With Cancer.
Children treated with platinum chemotherapy, such as cisplatin and carboplatin, are at increased risk of developing hearing problems. A test called an audiogram will likely be done during and after treatment to assess any damage from chemo. Hearing is very important for young children in speech and social development. If hearing has been affected by chemotherapy, your cancer team may recommend seeing a hearing specialist, called an audiologist, to discuss hearing aids.
Bones, muscles and other soft tissues of the body may not grow well after treatment with radiation. Doctors will monitor how the body grows and develops, with special attention to areas that were treated with radiation. In some cases, scoliosis, or a curve in the spine, can develop after treatment, which may need close monitoring with x-rays, bracing, or, in rare, cases surgery to correct.
Several treatments for neuroblastoma can affect organs like the thyroid, bones, and hormones responsible for normal growth and development. Because these things may be impacted by treatment, close attention to how your child grows, develops, and progresses through puberty will be an important part of their care after treatment is done.
Several treatments for neuroblastoma can affect organs like the thyroid, bones, and hormones responsible for normal growth and development. Because these things may be impacted by treatment, close attention to how your child grows, develops, and progresses through puberty will be an important part of their care after treatment is done.
Once treatment is finished, a number of emotional concerns can come up. Some of these might occur many years after treatment and can include:
It is normal to have some anxiety or other emotional reactions after treatment, but feeling overly worried, depressed, or angry can affect many aspects of a young person’s growth. It can get in the way of relationships, school, work, and other aspects of life. With support from family, friends, other survivors, mental health professionals, and others, many people who have survived cancer can thrive despite the challenges they have had to face.
Parents and other family members, especially siblings, can also be affected, both emotionally and in other ways. Some common family concerns include financial stresses, job loss or relationship stress during treatment, and worry about cancer returning. Social workers and other professionals at cancer centers can help families access help for these issues. Reach out to your child’s cancer center for help when needed.
To learn more about helping children with neuroblastoma and their loved ones cope during and after treatment, see Childhood Cancer.
To help increase awareness of late effects and improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines are used by your child’s doctor to create a survivorship care plan specific to your child and their treatment. They can help you know what to watch for, what types of screening tests should be done to look for problems, and how late effects can be treated.
To learn more, ask your child’s doctors about the COG survivor guidelines. You can also read them on the COG website: www.survivorshipguidelines.org. The guidelines are written for health care professionals, but patient education on some late effects of treatment is available (as “Health Links”) on the site as well.
To learn more about some of the possible long-term effects of treatment, see Late Effects of Childhood Cancer Treatment.
If your child has (or has had) neuroblastoma, you probably want to know if there are things you can do that might lower the risk of it growing or coming back, such as having them eat a certain type of diet or take nutritional supplements. Unfortunately, it is not yet clear if there are things you can do that will help.
As your child gets older, adopting healthy behaviors such as not smoking, eating well, getting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. However, we do know that these types of behaviors can have positive effects on your child’s health that extend beyond their risk of cancer.
So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of neuroblastoma progressing or coming back. This does not mean that there are no supplements that can help, but it is important to know that none have been proven to do so.
To learn more, see Are Dietary Supplements Safe?
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Dome JS, Rodriguez-Galindo C, Spunt SL, Santana VM. Chapter 92: Pediatric solid tumors. In: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA. Elsevier; 2020.
Laverdiere C, Liu Q, Yasui Y, et al. Long term outcomes in survivors of neuroblastoma: A report from the childhood cancer survivor study. J Natl Cancer Inst. 2009: 101;1131-1140.
Park JR, Hogarty MD, Bagatell R, et al. Chapter 23: Neuroblastoma. In: Blaney SM, Adamson PC, Helman LJ, eds. Pizzo and Poplack’s Principles and Practice of Pediatric Oncology. 8th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2021.
Shohet JM, Nuchtern JG, Foster JH. Treatment and prognosis of neuroblastoma. UpToDate. 2025. Accessed at https://www.uptodate.com/contents/treatment-and-prognosis-of-neuroblastoma on March 24, 2025.
Wilson CL, Brinkman TM, Cook C, et al. Clinically ascertained health outcomes, quality of life, and social attainment among adult survivors of neuroblastoma: A report from the St. Jude Lifetime cohort. Cancer. 2020;126(6):1330-1338.
Last Revised: June 26, 2025
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