Late and Long-Term Effects of Neuroblastoma and Its Treatment

Neuroblastoma can cause long-lasting side effects. Most of the long-term side effects depend on exactly what kind of treatment a child had, where the tumor was located, and how old the child was when treated. Children who received 3 or more kinds of treatment (surgery, radiation, chemotherapy, etc.) are more likely to have serious long-term side effects of treatment. For more information see Late Effects of Childhood Cancer Treatment.

Because of major advances in treatment, most 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 more of a concern in recent years.

Neuroblastoma survivors are at risk for several possible late effects of their treatment. It’s important to discuss what these possible effects might be with your child’s medical team.

After treatment, the cancer care team will create a Survivorship Care Plan describing the treatments given and what that tells you about your child's risk of late effects. The plan will also describe how the child should be monitored for these problems. Most children do not experience all the problems they might be at risk for, but it's important to find any problems that do come up early, so they can be treated effectively.

  Late effects after neuroblastoma treatment can include:

  • Hearing loss
  • Problems with bones and muscles, like scoliosis (curving of the spine)
  • Thyroid problems
  • Problems with growth and development
  • Fertility problems
  • Neurological problems
  • Second cancers, including leukemia
  • Emotional or psychological issues

In very rare instances and for unknown reasons, in some children with neuroblastoma the body’s immune system attacks the child’s normal nerve tissue. This can lead to problems such as learning disabilities, delays in muscle development, language problems, and behavioral problems. This is called opsoclonus myoclonus syndrome.

Children whose tumors are in the neck or chest and who have problems with the eyes or with muscle twitches may need further treatment with corticosteroids, intravenous immunogloblulin (IVIG), or other drugs.

Long-term follow-up guidelines

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 to create a child's Survivorship Care Plan.

To learn more, ask your child’s doctors about the COG survivor guidelines. You can also download them for free at the COG website: www.survivorshipguidelines.org. The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Brodeur GM, Hogarty MD, Bagatell R, Mosse YP, Maris JM. Neuroblastoma. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2016:772–792.

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.

Last Medical Review: March 19, 2018 Last Revised: March 19, 2018

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