Treatments and Services
What is the Neuroblastoma Program?
Seattle Children’s Neuroblastoma Program cares for babies, children, teens and young adults with cancer that starts in young nerve cells.
We provide expert care for patients:
- Who are newly diagnosed
- Who are already getting treatment
- Whose neuroblastoma resists treatment (refractory)
- Whose neuroblastoma has returned (recurrent)
Our doctors lead national and international research to:
- Improve treatments
- Increase cure rates
- Reduce side effects of therapy for neuroblastoma
What’s special about the Neuroblastoma Program at Seattle Children’s?
Seattle Children’s has many years of experience treating babies, children and teens with neuroblastoma.
- Dr. Julie R. Park is a national leader in caring for children with neuroblastoma and developing new treatments for all stages of the disease. Her research focus is improving care for children with high-risk neuroblastoma, a disease that is very hard to cure.
- She chairs the Neuroblastoma Committee of the Children’s Oncology Group (COG) and has led a national COG trial for high-risk neuroblastoma. COG is an international organization of childhood cancer specialists. They study childhood cancer and work to improve cure rates.
- Seattle Children’s is the only center in the Pacific Northwest that belongs to NANT (New Approaches to Neuroblastoma Therapy). NANT works to find new treatments for patients with neuroblastoma that is not well controlled by treatment or comes back. Our doctors are leaders within the NANT consortium.
- A team of caring experts will focus on your whole child. We don’t just treat their cancer. We care for your child’s medical, physical, learning, emotional and comfort needs. Read more about the supportive care we offer.
Many of our patients with neuroblastoma take part in research studies as part of their medical treatment. These are called clinical trials.
Your child’s team at Seattle Children’s will talk with you about any new treatments that may help your child. Then you can decide whether you want to try them.
To see if there is a clinical trial for your child’s neuroblastoma:
- Search by diagnosis for many clinical trials available through Seattle Children’s and our partners on Fred Hutch’s clinical trials page
- Contact us at 206-987-2106
The newest treatment options are especially important for children and teens with neuroblastoma that does not respond well to early treatment or that comes back. At Seattle Children’s, the options include:
- Phase 1 clinical trials of CAR T-cell immunotherapy, where the child’s own T cells are reprogrammed to recognize and target the cancer. Learn more about clinical trials STRIvE-01 and ENCIT-01.
- A way to get radiation inside your child’s body and into their cancer cells via the bloodstream. Learn more about I-131-MIBG.
Read more about:
- For more than a decade, our Cancer Center has been consistently ranked among the top pediatric oncology programs in the country by U.S. News & World Report. For 2019-20, it has the highest ranking in the Northwest.
- Our 5-year survival rates for a broad range of cancers are higher than the national average.
- Our patients benefit from the work of physician-scientists at Fred Hutch and UW Medicine, our partners in Seattle Cancer Care Alliance (SCCA). The National Cancer Institute has designated our partnership a comprehensive cancer center.
- We care for children and teens all day, every day — not just once in a while. This means everyone on our team has the experience and skills to make a real difference for your child.
- Our patients range in age from newborns up to young adulthood.
- Child life specialists are important members of our team. They work with you and your child to help you relieve tension, ease fears and feel more in control about your family’s hospital experience.
- We know teens and young adults with cancer have different challenges than children and older adults. Our Adolescent and Young Adult Cancer Program (AYA) focuses on their needs. AYA includes a team that works with your teen to help preserve their fertility if treatment might harm their ability to become parents.
- We are committed to your child’s overall well-being – during and after treatment.
- Long after the tumor is gone, we will check on your child’s health. We watch for possible long-term side effects from treatment and suggest ways to stay healthy.
- Read more about our Cancer Survivor Program.
How does Seattle Children’s treat children with neuroblastoma?
Our focus is helping your child beat their disease and thrive. Everyone in the Neuroblastoma Program works to cure your child’s disease, support your family during treatment and provide follow-up care.
Your child’s team includes doctors, nurses and caring experts in child life, nutrition support and other services. Read about the supportive care we offer.
We offer the following treatments, tailored to your child.
Children with neuroblastoma usually have surgery. Doctors will remove as much of the tumor as they safely can. Surgery may be combined with other treatments.
Learn about surgery to treat tumors at Seattle Children’s.
Chemotherapy means giving medicines to kill cancer cells throughout your child’s body. The mix of medicines and how long they are given depend on the type of neuroblastoma your child has.
Researchers are studying new mixes of medicines to find which work best against each type of the disease.
Learn about chemotherapy at Seattle Children’s.
Your child’s doctors may suggest treating your child’s neuroblastoma with radiation therapy.
One type of radiation uses X-rays. A machine sends beams of light particles through your child’s skin and outer structures into deeper parts of their body. The radiation kills cancer cells and shrinks tumors.
We use different ways to shape and focus the beams. The goal is to give the tumor more radiation while protecting healthy areas.
Protons deliver radiation more precisely than the particles used in X-rays. Protons stop once they reach their target.
With protons, the tumor gets the intended high dose of radiation. The healthy tissue away from the tumor receives even less radiation than with targeted X-ray beams.
Seattle Children’s offers proton therapy at SCCA Proton Therapy. It is the first proton therapy program in the Northwest. Learn about proton therapy.
Seattle Children’s has the ability to give a special form of radiation treatment that gets radiation into your child’s cancer cells via the bloodstream. This type of radiation is called I-131-MIBG therapy.
Radioactive iodine is attached to a chemical called MIBG that targets neuroblastoma tumors. Your child receives this infusion through a vein.
Our doctors have worked with the COG and NANT to make this therapy available to children with high-risk neuroblastoma that does not respond well to treatment or that comes back. Seattle Children’s doctors also are studying whether I-131 MIBG therapy will benefit children who are newly diagnosed with high-risk neuroblastoma.
Children with high-risk neuroblastoma may get very high doses of chemotherapy medicines and a transplant of their own blood-forming (hematopoietic) stem cells. This is called an autologous stem cell transplant.
Treatment for children with high-risk neuroblastoma has changed across North America, as a result of a Phase 3 national COG study that was led by Dr. Park. Adding a second stem cell transplant improved children’s 3-year survival significantly in the COG study.
Our patients who need stem cell transplants get care through Seattle Children’s and our partner in SCCA, Fred Hutch. Learn more about the Pediatric Blood and Marrow Transplant Program.
Targeted therapy is used after stem cell transplant to lower the risk of neuroblastoma coming back. Targeted therapy fights cancer by finding a specific substance (target), such as a protein, on cancer cells.
After stem cell transplant, patients get a type of targeted therapy called monoclonal antibodies. These are manmade versions of antibodies – immune system proteins that fight disease. The antibodies target a substance (GD2) on neuroblastoma cells. The antibody then triggers the immune system to kill the neuroblastoma cells.
Immunotherapy reprograms the body’s infection-fighting T cells to find and destroy cancer cells. Only a handful of hospitals offer this treatment approach for children with neuroblastoma.
Our clinical trial is known as Engineered Neuroblastoma Cellular Immunotherapy (ENCIT). It is an option for children with neuroblastoma that does not respond well to early treatment or that comes back.
Who is on the team?
Providers in our Neuroblastoma Program include:
Our radiation oncologist is highly trained in using high-energy beams to treat cancer, tumors and other diseases.
Our surgeons determine if your child needs surgery and recommend what type will help the most. They perform procedures. Growing bodies are different from adult bodies, so all of our surgeons are board certified or eligible for certification in pediatric surgery.
Advanced practice providers include advanced registered nurse practitioners (ARNPs) and physician assistants (PAs). They work closely with doctors and can practice independently. These providers diagnose and treat patients and can prescribe medicines. Throughout your child’s treatment, they are available to answer questions and share advice. They teach patients and families and give follow-up care after your child leaves the hospital.
Our nuclear medicine technologists prepare radioactive material. It is used to make images of the insides of patients’ bodies. The images help doctors diagnose disease and track treatment.
- Lisa Aldape, CNMT, Nuclear Medicine PET/CT Supervisor
- Marian Abrahamson, CNMT
- Danielle Watkins, CNMT
- Kristin Petkavich, CNMT
- Aileen Corpuz, CNMT
Our radiation safety officer oversees the safe use of radiation to diagnose and treat patients. This includes external radiation and I-131 MIBG therapy. She tests for levels of radiation exposure to protect the safety of our patients and staff.
- Barb Michieli, MS
The social work team at Seattle Children’s gives emotional and practical support during your child’s treatment. They help your family get the resources you need.
Megan Choitz, MSW, coordinates care between the neuroblastoma medical team, families and the community.
You can contact the Cancer and Blood Disorders Center at 206-987-2106 for an appointment, a second opinion or more information.
Scheduling an Appointment
- To make an appointment, you can call us directly or get a referral from your child’s primary care provider.
- We encourage you to coordinate with your pediatrician or family doctor when coming to Seattle Children’s.
- How to schedule an appointment at Seattle Children’s.
- If you already have an appointment, learn more about how to prepare.
- Learn about resources such as useful links, videos and recommended reading for you and your family.
- Providers, see how to refer a patient.