Finding the Best Doctors and Hospitals in India for Neuroblastoma Treatment

Neuroblastoma treatment in India

Neuroblastoma is a cancer of the immature nerve cells (neuroblasts) typically located on the adrenal glands (where there are two), or in the chest, neck, abdomen, or spinal area. It is prevalent mostly in children younger than 5 years.

Neuroblastoma Treatment Options

Differentiation in the treatment is based on the risk stratification (low, intermediate, or high risk) that depends on factors such as age, tumor stage, the status of theMYCN gene, DNA ploidy, and histology.

Low-Risk Neuroblastoma

• Many times self-limiting or eased with little therapy.

Treatment may include:

• Observation only (for very young infants with small tumors).
• Surgery to remove the tumor.

Intermediate-Risk Neuroblastoma

• Needs higher treatment than low risk but prognosis is good.

Treatment may include:

• Tumor resection to the maximum.
• Chemotherapy (before or after surgery).
• Radiation therapy is not common, and it is applied when a tumor cannot be removed completely, or it is leading to complications.

High-Risk Neuroblastoma

• Violent, and needs rigorous multimodal treatment.

Treatment includes:

• Induction Chemotherapy - several programs to downsize the tumor.
• Surgery – removal of residual tumor after chemotherapy.
• High-dose Chemotherapy & Stem Cell Transplant (Autologous HSCT) – substitutes bone marrow that is destroyed by intensive chemo.
• Radiation Therapy - to destroy leftover cancer cells.
• Immunotherapy - Anti-GD2 monoclonal antibodies (e.g., dinutuximab) to augment the immune system with regard to cancer cells.
• Differentiation Therapy -Retinoids (13-cis-retinoic acid) to cause the cancer cells to grow up and cease division.

Neuroblastoma Relapsed or Refractory

The treatment is more difficult. Options include:

• High-dose chemotherapy with stem cell transplant
• Targeted therapy (when there is an ALK gene mutation, then ALK inhibitors are used)
• MIBG (Metaiodobenzylguanidine) Therapy-radioactive iodine-conjugated therapy of the neuroblastoma cells.
• Clinical trials - new immunotherapies, CAR-T cell therapy and precision medicine.

Best hospitals for neuroblastoma in India

Artemis Hospital, Gurgaon

Artemis Hospital has sufficient resources to handle neuroblastoma especially among the children classified as either intermediate- or high-risk patients because their treatment normally includes chemotherapy, surgery, radiation and maybe stem-cell transplantation all of which are provided here. The hospital offers the facilities and multidisciplinary capabilities needed to treat complex pediatric cancers such as neuroblastoma with a centre of excellence in paediatric haemato-oncology/BMT, specific dedicated oncology departments, and child-centred care protocols.

Medanta-The Medicity, Gurgaon

Medanta Gurugram is prepared to manage cases of neuroblastoma providing holistic, child-focused treatment. Their offerings include:

• A specialized pediatric surgery unit with experience in neuroblastoma.
• High-tech diagnostics, precision radiotherapy, and robotic surgery.
• BMT, immunotherapy and targeted therapy functions.
• The use of a multidisciplinary tumor board to provide extensive experience on the planning of the treatment.

All these are backed by the excellent infrastructure, internationally trained experts and a robust emphasis on evidence-based, advanced oncology treatment.

Fortis Memorial Research Institute, Gurgaon

Fortis Memorial Research Institute is fully prepared to handle neuroblastoma with:

• A robust pediatric hematology-oncology and BMT unit.
• Availability of high-end diagnostics such as PET-CT/MRI, MR Linac and Gamma Knife.
• Niche nuclear medicine treatment such as MIBG and neuroblastoma theranostics.
• Well-known multidisciplinary groups with precision oncology, radiation therapy, transplant and supportive services.

Max Hospital, Saket

One of the promising options of neuroblastoma treatment is Max Super Specialty Hospital, Saket, providing:

• Specialized pediatric oncology experience with trained experts in pediatric hematology-oncology.
• Multidisciplinary focus of treatment that involves medical, surgical, radiation and targeted therapy.
• Access to state-of-the-art technology like robotic surgery and advanced radiation delivery systems.
• Critical support infrastructure such as Bone Marrow Transplant facilities and pediatric ICUs for intensive treatment phases.

Factors Affecting Neuroblastoma cancer treatment cost in India

The factors that influence the cost of Neuroblastoma cancer treatment in India include a structured overview as follows. The cost may differ greatly based on the hospital, treatment regimen and patient requirements because neuroblastoma may need multi-modal and prolonged treatment.

Factors Affecting Neuroblastoma Treatment Cost in India:

Stage & Risk Category

• Less expensive is low-risk (surgery or observation only).
• The cost is higher in intermediate-risk (surgery + chemotherapy).
• The risk (high-risk multi-cycle chemotherapy, surgery, radiation, stem-cell transplant, immunotherapy) may be 10-15x greater than the care of low risk.

Type of Treatment Modalities Required

• Surgery: Pediatric oncology surgery price varies according to the complexity and hospital type.
• Chemotherapy: Various courses, selection of drugs, supportive medication (growth factors, antibiotics) is cumulative.
• Radiation Therapy: IMRT, IGRT, TomoTherapy, or Proton Beam are more expensive than conventional radiotherapy.
• Bone Marrow / Stem Cell Transplant (BMT/HSCT): A major cost driver, especially for high-risk or relapsed neuroblastoma.
• Immunotherapy: Anti-GD2 monoclonal antibodies (dinutuximab, naxitamab) are costly and have a big impact on total treatment cost.
• Targeted Therapy and MIBG Therapy: ALK inhibitors or radioactive MIBG treatment additional cost to the treatment.

Duration & Complexity of Treatment

• Treatment of neuroblastoma may take between 12-18 months or more where high risk cases are involved.
• The cost increases as the hospitalization, ICU stay, supportive transfusion and follow-up imaging increases.

Hospital & Location

• Metro cities have their own, more expensive, private premium hospitals (Medanta, Artemis, FMRI, Max Saket).
• International accredited hospitals (JCI/NABH) and high-tech hospitals (Proton Therapy, MIBG unit, robotic surgery) normally have higher charges.

Doctor’s Expertise & Team

• Professional fees are contributed by pediatric oncologists, pediatric surgeons, radiation oncologists, transplant specialists and multidisciplinary tumor boards.
• The senior consultants in well-established centers can be more expensive than the junior team of small hospitals.

Supportive & Ancillary Care

• Diagnostics & Imaging: PET-CT, MRI, genetic/molecular testing (e.g., MYCN status, ALK mutation).
• Inpatient: ICU, children oncology ward, infection control measures.
• Post-treatment rehabilitation: Nutrition, physiotherapy, psychological support, long-term monitoring.
• These ancillary yet necessary services have major impact on the overall bill.

Patient Factors

• Age and weight of the child: Influence drug dosing and transplant requirements.
• Response to treatment: Patients who require salvage therapy, more cycles or ICU admission are more expensive.
• Comorbidities and complications: Infections, graft-verified-disease (after BMT) or relapse may increase costs.

International Patients Services

• This can increase the cost imposed on international patients because the hospitals will have to provide extra registration, visa assistance, translators, and logistical services.

Advanced neuroblastoma treatment options

The following is a summary of treatment methods of high-risk or recurring or resistant neuroblastoma, where a combination of standard surgery, chemotherapy and radiation may be inadequate.

Advanced Neuroblastoma Treatment Options:

High-Dose Chemotherapy with Stem Cell Transplant (HSCT / BMT)

• It is employed in the high-risk cases following induction chemotherapy.
• In autologous transplant, the patient gathers his/her own stem cells, followed by the destruction of cancer cells with high-dose chemotherapy, and the re-infusion of stem cells to replace bone marrow.
• Enhances the survival of high-risk children.

Immunotherapy (Anti-GD2 Antibodies)

• Targets GD2, a molecule on neuroblastoma cells.
• Naxitamab (anti-GD2 monoclonal antibodies) D. with cytokines (IL-2, GM-CSF).
• Stimulates the immune system to destroy remnant tumor cells.
• Lessens the risk of relapse and enhances the long-term survival in the high-risk cases.

Differentiation Therapy

• 13-cis-Retinoic Acid (Isotretinoin) used after stem cell transplant.
• This helps neuroblastoma cells develop into harmless nerve cells.
• Prevents recurrence after intensive therapy.

Targeted Therapy

• In the event of ALK mutation occurring in tumor genetics, ALK inhibitors (e.g., Crizotinib, Lorlatinib) should be used.
• Aurora kinase inhibitors, HDAC inhibitors - under clinical trials.
• Tumor-based approach to personalized medicine: depends on the molecular/genetic profile of the tumor.

Radiation Therapy Advances

• The IMRT (Intensity-Modulated Radiation Therapy) and the Proton Beam Therapy have accurate radiation and little harm to the surrounding organs.
• MIBG (Metaiodobenzylguanidine) Therapy:
• Radioactive iodine (I-131) bound to MIBG, which is specifically localized to the neuroblastoma cells.
• Apply to recurrent or progressive neuroblastoma.
• Occasionally used together with stem cell transplant to improve the effect.

CAR T-Cell Therapy (Experimental / Clinical Trials)

• T-cells of the child are genetically engineered to activate neuroblastoma-specific antigens (such as GD2).
• In clinical trials, but still in experimental stage.

Theranostics & Novel Nuclear Medicine

• Luetium-177 labeled (Lu-177 DOTATATE or GD2-targeted radionuclides).
• Combine diagnostic imaging + therapy for personalized precision oncology.

Supportive & Integrative Approaches

• Nutritional optimization, infection prevention, pain and symptom control, psychosocial support.
• Important in enhancing the quality of life and in the long treatment courses.

Top oncologists for neuroblastoma in India

Dr. Rahul Naithani

Dr. Rahul Naithani is a dynamic and accomplished clinical hematologist renowned for his hematologic oncology and bone marrow transplantation expertise. 

Dr. Ashok Kumar Vaid

Dr. Ashok K. Vaid, is a distinguished and certified Hemato Oncologist in Gurgaon, India, who has had the unique distinction of starting one of the largest Stem Cell Transplant programs in the private sector in north India. Dr Vaid currently serves as Chairman, Medical Oncology and Hematology and Stem Cell Transplant at the Medanta Cancer Institute, Gurugram, India. He brings over 30 years of clinical expertise with special interest in Cancer Genomics, Immunotherapy Guidance and Precision Onco-therapeutics, in addition to Dendritic Cell Therapy, and Stem Cell Transplant.

Dr. Vinod Raina

Dr. Vinod Raina, best oncologist in Gurgaon is known as premier Medical Oncologist in India & has 40 years of unblemished experience. His speciality area is Chemo and he is the first person in India to opt for high dose chemo. First peripheral blood BMT was also done by him in India. Furthermore, Dr. Raina has the relevant experience in management and treatment of all types of cancer that includes – Breast cancer, Lung cancer, Gastro intestinal cancer, Urological cancer, Gynaecological cancer, Lymphoma and Myeloma. His accomplishments also include doing well over 400 BMTs to add to the available management of several types of cancers.

Dr. Ankur Bahl

Renowned medical oncologist Dr. Ankur Bahl has over 15 years of experience. Multiple myeloma, lymphoma, breast and lung cancer, gastrointestinal tumors, gynecological tumors, head, neck, and brain cancers, are among the conditions for which he provides treatment.

Dr. Rayaz Ahmed

Dr. Rayaz Ahmed, doctor in max hospital, is one of the most experienced haematologists in India with more than two decades of experience in the touch and management of all kind of haematological diseases. Dr. Ahmed is a professional in the new approaches to the cure of blood disorders such as stem cell therapy and bone marrow transplant. 

Neuroblastoma chemotherapy treatment in India

One of the pillars of treatment, particularly intermediate and highly-risk neuroblastoma is chemotherapy. It can be used:

• Preoperative (neoadjuvant) - to reduce tumor.
• Follow-up surgery (adjuvant) - to destroy the residual cancer cells.
• As induction therapy – first step in high-risk protocols.
• As part of relapse/refractory treatment – with newer agents.

Standard Chemotherapy Protocols in India

The international protocols that are normally adhered to in Indian hospitals include:

• COG (Children’s Oncology Group, USA) protocols
• SIOPEN (European) protocols
• Adapted versions that were localized to the Indian settings.

Typical regimens include:

• Induction chemotherapy: 4–8 cycles (for high-risk cases)
• Consolidation: high-dose chemo with autologous stem cell transplant (ASCT)
• Maintenance: isotretinoin (13-cis-retinoic acid) with or without immunotherapy.

Chemotherapy Process in India

• Pre-test: Blood Analysis, Imaging (MRI/PET/CT), Bone Marrow.
• Chemo cycles: Administered through the IV infusion or central line/port. The cycles take 3-5 days long with repetition after every 2-3 weeks.
• Hospital stay: Certain drugs require in-patient hospitalization in order to monitor them, but others may be day-based.
• Supportive care: Antiemetics, antibiotics, blood transfusions, growth factors (G-CSF) to minimize the complications.

Neuroblastoma treatment in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

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• Complete transparency
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• Assistance in selecting India's top hospitals for Neuroblastoma treatment.
• Expert paediatric oncologists with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
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• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
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