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The symptoms depend on where the cancer is and whether it has spread. It is often hard to diagnose neuroblastoma in the early stages, as initial symptoms are common ones - for example, aches and pains and loss of appetite. The most common symptom when the cancer has developed is a lump or swelling in the child’s abdomen as this is where the cancer usually starts. It can cause constipation and general discomfort and pain.
Other possible symptoms are:
- a lump in the child’s neck, which can make them breathless or cause difficulty swallowing
- a bone pain and difficulty walking if the cancer has affected their bones
- numbness, weakness or loss of movement in the child’s lower body, if the cancer has affected the spinal cord
- anaemia, bruising, bleeding and infections, if the cancer has infected their bone marrow
- blueish lumps in their skin if the cancer has spread to the skin
As with most cancers, the tumour is defined by "stages" which reflect the spread of the disease. There are a number of staging systems, but the most widely used until recently - INSS - is shown first, with the most recent (INRG) in brackets:
STAGE 1 & 2 (L1)
The cancer is in one site and has not spread. It may be possible to remove it completely by operation
STAGE 3 (L2)
The cancer has spread to local structures, but not too distant parts of the body
The cancer has spread to distant parts of the body
This special stage defines a tumour diagnosed in a baby under the age of twelve months. Although it may have spread to the liver or skin, the outlook is fairly good