Overview
Brain tumors affect nearly 1,500 to 2,000 children in the U.S. every year. They are diagnosed most often between the ages of three and eight, but can occur at any age. A brain tumor results from an abnormal growth of tissue in the brain and is classified by the way brain tumor cells appear under a microscope. Tumors can be more or less malignant. Malignant brain tumors tend to grow rapidly and can spread to the spinal cord. For the most malignant tumors, there is still no standard treatment, but innovative treaments are being used at the Children's Cancer Hospital. For the least malignant tumors, surgery alone may be sufficient treatment.
Pediatric brain tumors are usually found early because the brain regulates vital functions such as memory, learning, hearing, sight, smell and emotion, and when these vital functions are disrupted, signs appear quickly.
Types
Astrocytomas are the most common brain tumors seen in children. The cells have a star-like shape and can form on any part of the brain or spinal cord:
Cerebellar astrocytomas form in the lower back part of the brain and account for 15-25% of all brain tumors.
Low-grade astrocytomas may be located in the posterior fossa and can often be surgically removed without additional therapy.
Anaplastic astrocytomas (grade III) look abnormal and grow rapidly.
Glioblastoma multiforme (GMB) are grade IV tumors and are very aggressive.
Ependymomas account for 9% of all brain tumors and occur in the lining of the brain or develop along the spinal cord. These tumors are usually benign and grow very slowly.
Primitive neuroectodermal tumors are highly malignant and behave aggressively. They are most often found in the frontal, temporal or parietal lobes of the brain.
Choroid Plexus tumors are rare cancers of gland tissues that produce cerebrospinal fluid.
Atypical Teratoid-Rhabdoid tumors (ATRT) are highly aggressive tumors that occur mostly in very young children.
Symptoms
- Headache
- Vomiting
- Seizures
- Blurred vision and impaired speech
- Mood changes
- Poor coordination; difficulty with balance
- Weakness or tingling in the arms and legs
- Increased head circumference and bulging fontanel ("soft spot") in infants
Tests & Procedures
Brain Tumors are diagnosed by computerized tomography (CT scan), magnetic resonance imaging (MRI) and tissue examination. A CT scan will reveal brain abnormalities and an MRI will detect tumors beneath the bones of the skull. Microscopic examination of tumor tissue (biopsy) will identify cancer cells. A physician may order further tests using lumbar puncture, withdrawing bone marrow, biochemistry and a bone scan to see if the tumor has spread beyond the brain. At M. D. Anderson, sedation may be used for younger children who are unable to stay still for these tests.
Treatment
Treating a brain tumor requires a multidisciplinary approach, starting with surgery to remove the tumor and followed by chemotherapy and/or radiation therapy if necessary. Before surgery, children are often given steroids to reduce swelling in the brain and anticonvulsant medications to prevent seizures. Neurosurgeons (a specialist in childhood brain surgery) will remove as much of the tumor as possible and remove a tissue sample for analysis. They will also create a pathway for chemotherapy drugs and radiation.
Chemotherapy is the standard treatment for children under 3 because radiation therapy may affect the developing brain. Chemotherapy may be cancer-killing drugs taken daily, an injection into a blood vessel or muscle once a week or infusion through IV for several days at a time each month. For young children, chemotherapy is often used to eliminate or delay the need for radiation therapy.
Radiation therapy directs high-dose X-rays to kill the tumor cells and shrink the tumor. It is usually given daily for 6 - 8 weeks.
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