Pediatric Brain Tumors
A brain tumor is a growth of abnormal cells in the brain. Brain tumors may be benign (noncancerous) or malignant (cancerous). Regardless of whether they are cancerous, all brain tumors can cause symptoms by producing inflammation and pressing on other parts of the brain. This pressure causes cerebral edema (brain swelling) and increased intracranial pressure (the pressure within the skull). Central nervous system tumors (tumors of the brain and spine) make up ~20 percent of all childhood cancers; they are the second most common form of childhood cancer after leukemia. Brain tumors are the most common solid tumor in children. Approximately 2,000 children in the United States are diagnosed with a brain tumor each year. Several of the more common types of brain tumors in children include medulloblastomas, gliomas and astrocytomas. At Ochsner for Children, our Pediatric Oncologists work with a multidisciplinary team to provide state of the art care to children and young adults diagnosed with brain tumors. This includes pediatric oncologists, pediatric neurosurgeons, radiation oncologists, surgeons and physical therapists. We are very active in research and clinical trials designed to increase cure rates, decrease treatment-related side effects and improve care for long-term survivors.
What are brain tumors?
The different tumor types may require substantially different treatment.
What are the symptoms of brain tumors?
The symptoms of a pediatric brain tumor vary according to the size, type and location of the tumor. Symptoms may occur when a tumor presses on a nerve or damages certain parts of the brain. They may also occur when the brain swells or there is fluid buildup in the skull. The most common symptoms include:
- Headaches (especially first thing in the morning)
- Nausea or vomiting
- Changes in speech, vision or hearing
- Problems balancing or walking
- Changes in mood, personality or ability to concentrate
- Problems with memory
- Seizures or muscle twitching/jerking
- Numbness or abnormal sensations
How common are brain tumors?
Overall, these tumors are rare in children, only affecting 1 in every 20,000 children. However, brain tumors as a group are the most common solid tumor in children, accounting for ~20% of all childhood malignancies. Brain tumors can occur in any age, though certain subtypes, such as medulloblastoma, tend to occur more frequently in younger children.
How are brain tumors diagnosed?
Depending on the type and site of the tumor, a variety of techniques may be used to diagnose brain tumors. These include:
- Biopsy, in which a pediatric neurosurgeon performs a procedure to take a sample of the tumor in order to determine what type of tissue it is and to run special molecular tests.
- Magnetic resonance imaging (MRI), which uses strong magnets and a computer to produce detailed images of the brain and spine, is useful to help plan surgery and treatment of brain tumors.
- Computed tomography (CT) scan, which uses a combination of X-rays and computer to produce images of the body, is useful for evaluating both bones and soft tissues.
- Positron emission tomography (PET) scan, which uses radioactive sugar injected into a vein, is sometimes used to determine if the tumor has spread to other areas of the brain or spine.
- Lumbar puncture, in which a sample of fluid is taken from the base of the spine, is used for certain subtypes of tumors.
- Bone marrow biopsy, in which a small sample of bone marrow is obtained from the hip, is occasionally performed to determine if the tumor has spread to the bone marrow
How are brain tumors staged?
Presently, there is no uniformly accepted staging system for most childhood brain tumors. These tumors are classified and treated based on their histology and location within the brain. Recently, advances in molecular studies have allowed for risk-based classification of some tumors, such as medulloblastoma.
How are brain tumors treated?
Treatment for brain tumors may involve a combination of therapies including surgery, radiation and/or chemotherapy. Treatment options may vary greatly, depending on your child's situation. Our pediatric oncologists work closely with a multidisciplinary team to create a personalized treatment plan that is best for your child.
- Surgery - Surgery is usually the first step in treating children with brain tumors. In some cases, only a biopsy is done. This is often necessary when the tumor is too close to critical structures in the brain, or when the neurosurgeon does not feel the tumor can In other cases, the tumor can be removed completely.
- Chemotherapy - To decrease the size of the tumor, kill tumor that has spread and prevent further tumor spread, your child may receive chemotherapy.
- Radiation therapy - High-energy X-rays or other types of radiation can kill cancer cells or stop them from growing. Radiation therapy is used in certain types of tumors to either shrink the tumor prior to surgery, or to try to prevent the tumor from coming back after surgery.
- Targeted therapy - Newer medicines are now available that target and attack specific cancer cells without harming normal cells. Many of these medicines are still considered experimental.
- Rehabilitation - Rehabilitation after surgery is an important part of your child’s care. Our team of physical and occupational therapists, along with our Child Life Specialists, will work to help your child optimize their function after surgery and adapt to whatever types of lifestyle changes may be necessary.
What clinical trials does Ochsner Hospital for Children offer for brain tumors?
As part of the Children’s Oncology Group, Ochsner Hospital for Children is an active participant in children’s cancer research. We currently have multiple clinical trials available to treat children and young adults with various types of brain tumors.