Alexandrta Scott was eight years old, she was full of courage and started a lemonade selling campaign in aid of cancer research which spread all over the USA. She died peacefully at home in Philadelphia, USA, yesterday.

Many will remember her for the incredible amount of money she managed to raise in aid of cancer research. Others will say it was not so much the money but the way she raised awareness about pediatric cancer.

When Alexandrta Scott was barely one year old she was diagnosed with neuroblastoma. Neuroblastoma is an aggressive childhood cancer.

When Alexandra was four years old, she set up a lemonade stand to raise money for cancer research. The idea caught on so well that soon there were hundreds of people all over the country raising money as well. Almost a million dollars have been raised.

Alexandra's father said "She's taught people just so many things _ that everybody's idea counts, no matter how small it is; not to give up; that everybody can make a difference…..She opened her eyes for the first time that day just before she passed away. She looked out at the trees," Scott said. "In the past she's been in a lot of pain, but at the end she had no pain, which is what she worried about."

WHAT IS NEUROBLASTOMA?

One of the most common childhood cancers, neuroblastoma accounts for 8% of all cases. The word neuroblastoma has three parts that together describe the disease: neuro (nerve) + blast (germ, bud) + oma (tumor). Neuroblastoma, then, is a tumor of the developing nerves or nerve tissues. These solid tumors can start in any of the nerves in the pelvis, chest, abdomen, or neck, but the two most common beginning sites are the abdomen and the tissues around the adrenal glands, which sit on top of each kidney.

Unfortunately, by the time neuroblastoma is diagnosed, the cancer cells have usually metastasized (spread beyond their original location to other parts of the body). Neuroblastoma typically spreads to the bones (including the marrow), lungs, liver or lymph nodes.

By the time they are seen by a doctor, about two-thirds of children with neuroblastoma have metastasized tumors. Neuroblastoma has many symptoms, but the most common is the pain caused by a growing tumor pressing against the nerves, bones, or spinal cord. If the cancer cells have spread to the area behind the eyes, the child may have protruding eyes and/or dark circles.

There are two types of bone marrow transplants used to treat neuroblastoma: autologous and allogeneic. An autologous transplant used the patient's own marrow, an allogeneic transplant uses marrow from a matched donor, usually a sibling. This article focuses on autologous transplants, the most common type of bone marrow transplant used to treat neuroblastoma. The article also discusses autologous peripheral blood stem cell (PBSC) transplants.

Before these transplants are discussed, however, it is important to understand how doctors diagnose neuroblastoma, and how they categorize the stages of neuroblastoma in order to determine the best treatment options. Also, medical professionals continue to conduct clinical trials to determine the best treatment options for neuroblastoma.

DIAGNOSIS AND TREATMENT

Before confirming a diagnosis of neuroblastoma, a physician will always perform special imaging and laboratory tests. For imaging, physicians use computerized tomography (CT) and magnetic resonance imaging (MRI) scans. CT scans use a computer and a series of X-rays to create a three-dimensional image of internal body structures, while. MRI scans use magnetic waves to produce similar images. Laboratory tests include a biopsy, which involves removing (using a special needle) and then examining a small portion of tissue from the body.

To determine the best treatment plan for a patient, the doctor must consider (1) whether the neuroblastoma has metastasized; (2) how fast and how far the tumor has spread; and (3) where the tumor has spread (e.g., bones, lymph nodes, liver). Table 1 lists the stages of neuroblastoma that physicians use to determine treatment options.

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