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Thanks for your interest in CAS. Any information you provide will help us expedite your inquiry. Chemist Consultation Substance Identification. By combining data from both types of studies, scientists do their best to make an educated assessment of whether something can cause cancer. Several national and international agencies review the available evidence to try to determine the cancer-causing potential of different substances.

One of its major goals is to identify causes of cancer. The most widely used system for classifying carcinogens comes from the IARC. Over the past several decades, the IARC has evaluated the cancer-causing potential of more than 1, likely candidates, placing them into one of the following groups:. Perhaps not surprisingly, based on how hard it can be to test possible carcinogens, most are listed as being of probable, possible, or unknown risk.

The IARC publishes its findings, including the detailed evidence to support them, in volumes known as monographs. The current version of the RoC includes about substances and exposures, which are listed here. Some state agencies also keep lists of known or probable carcinogens. The American Cancer Society ACS contributes in many ways to evaluating how environmental factors affect a person's likelihood of developing cancer, including:.

In most cases, the ACS does not directly evaluate whether a certain substance or exposure causes cancer. Instead, the ACS looks to national and international organizations such as the NTP and IARC, whose mission is to evaluate environmental cancer risks based on evidence from laboratory and human research studies. Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health care providers who are experts in treating children with neuroblastoma and who specialize in certain areas of medicine.

These may include the following specialists:. Children who are treated for neuroblastoma may have late effects, including an increased risk of second cancers. Some cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include:. Some late effects may be treated or controlled. It is important that parents of children who are treated for neuroblastoma talk with their doctors about the possible late effects caused by some treatments.

Observation is closely monitoring a patient's condition without giving any treatment until signs or symptoms appear or change. Surgery is used to treat neuroblastoma unless it has spread to other parts of the body. Depending on where the tumor is, as much of the tumor as is safely possible will be removed. If the tumor cannot be removed, a biopsy may be done instead.

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:. The way the radiation therapy is given depends on the type of cancer being treated and the child's risk group.

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External radiation therapy is used to treat neuroblastoma. Iodine mIBG therapy is a treatment with radioactive iodine. The radioactive iodine is given through an intravenous IV line and enters the bloodstream which carries radiation directly to tumor cells. Radioactive iodine collects in neuroblastoma cells and kills them with the radiation that is given off. Iodine mIBG therapy is sometimes used to treat high-risk neuroblastoma that comes back after initial treatment. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body systemic chemotherapy. When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas regional chemotherapy.

The way the chemotherapy is given depends on the type of cancer being treated and the child's risk group. High-dose chemotherapy and radiation therapy with stem cell rescue is a way of giving high doses of chemotherapy and radiation therapy and replacing blood -forming cells destroyed by cancer treatment for high-risk neuroblastoma. Stem cells immature blood cells are removed from the blood or bone marrow of the patient and are frozen and stored. After chemotherapy and radiation therapy are completed, the stored stem cells are thawed and given back to the patient through an infusion.

These reinfused stem cells grow into and restore the body's blood cells. Maintenance therapy is given after high-dose chemotherapy and radiation therapy with stem cell rescue to kill any cancer cells that may regrow and cause the disease to come back. Maintenance therapy is given for 6 months and includes the following treatments:.

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack cancer cells with less harm to normal cells. There are different types of targeted therapy:. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.

Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer.

This type of cancer treatment is also called biotherapy or biological therapy. Vaccine therapy uses a substance to stimulate the immune system to destroy a tumor.

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Vaccine therapy is being studied to treat neuroblastoma that has come back after treatment. Lenalidomide is a type of angiogenesis inhibitor. It prevents the growth of new blood vessels that are needed by a tumor to grow. For some patients, taking part in a clinical trial may be the best treatment choice.

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Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

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Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Some clinical trials only include patients who have not yet received treatment.

Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring coming back or reduce the side effects of cancer treatment.

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Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated.

Some tests will be repeated in order to see how well the treatment is working.

Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has recurred come back. These tests are sometimes called follow-up tests or check-ups. There is no standard treatment for stage 4S neuroblastoma but treatment options include the following:. Treatment for recurrent neuroblastoma that is found only in the area where the cancer first formed may include the following:.

Treatment for recurrent neuroblastoma that has spread to other parts of the body may include the following:. Recurrent neuroblastoma that has spread to other parts of the body is treated the same way as newly diagnosed high-risk neuroblastoma. Because there is no standard treatment for recurrent neuroblastoma in patients first treated for high-risk neuroblastoma, patients may want to consider a clinical trial.