About Brain Tumors in Children
Brain tumors are the most common solid tumors (an abnormal growth of tissue) in children. Approximately 4,000 children and adolescents in the U.S. are diagnosed with primary brain tumors each year. Primary brain tumors start in the brain and generally do not spread outside the brain tissue. Most central nervous system cancers are brain tumors. Brain tumors, either malignant or benign, are tumors that originate in the cells of the brain.
A benign tumor does not contain cancer cells and usually, once removed, does not recur. Most benign brain tumors have clear borders, meaning they do not invade surrounding tissue. These tumors can, however, cause symptoms similar to cancerous tumors because of their size and location in the brain.
Malignant brain tumors contain cancer cells. Malignant brain tumors are usually fast growing and invade surrounding tissue. Malignant brain tumors very rarely spread to other areas of the body, but may recur after treatment. Sometimes, brain tumors that are not cancer are called malignant because of their size and location, and the damage they can do to vital functions of the brain.
Brain tumors can occur at any age, and those found in infants and children are very different from adult brain tumors, both in terms of the type of cells and the responsiveness to treatment.
The American Cancer Society states that no apparent reason can be found for the development of brain tumors in children. Brain tumors cannot be directly linked to something the parents or child did or did not do.
Both the American Academy of Pediatrics and the National Cancer Institute recommend that children receive cancer diagnosis and treatment at one of the more than 200 medical centers in the U.S. that specialize in pediatric cancers. The organizations cite research studies that show 20% to 40% higher survival rates when children receive care in such specialized centers.
As the only program of its kind in Arizona, The Jaydie Lynn King Neuro-Oncology Program at Phoenix Children's Hospital works to cure the following diseases:
- Primitive Neuro-Ectodermal Tumors (sPNET)
- All grades of Astrocytoma
- Other Low Grade
- Anaplastic Astrocytoma
- Glioblastoma Multiforme
- Optic Pathway
- Diffuse Intrinsic Pontine Glioma
- Atypical Teratoid / Rhabdoid Tumor (AT/RT)
- Primary CNS Germ Cell Tumors
- Other less common tumors including spinal cord tumors
Brain and spinal cord tumors are the second most common cancers (after leukemia) affecting children. They make up about 21 percent of all childhood tumors.
When a child is diagnosed with a brain tumor, we present their case to the Phoenix Children’s Neuro-oncology Tumor Board, a group of physicians from a variety of specialties including radiation oncology, Neuro-oncology, neurosurgery, neuroradiology, pathology and neurology. Together, we decide the best treatment plan for each and every child.
Types of tumors commonly seen in children
- Astrocytomas: Astrocytomas are glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor. Astrocytomas are generally subdivided into high-grade, medium-grade, or low-grade tumors. High-grade astrocytomas are the most malignant of all brain tumors. Astrocytomas are further classified for presenting signs, symptoms, treatment, and prognosis, based on the location of the tumor. The most common location of these tumors is in the cerebellum, where they are called cerebellar astrocytomas. These tumors usually cause symptoms of increased intracranial pressure, headache, and vomiting. There can also be problems with walking and coordination, as well as double vision.
- Primitive neuroectodermal tumors (PNET)/medulloblastoma: Both PNETs and medulloblastomas are in the same family of tumors. PNET can occur anywhere in the brain of a child, whereas medulloblastomas occur in the back of the brain. Both of these tumor types can metastasize (spread) to other parts of the central nervous system (i.e. the spinal cord). PNETs and medulloblastomas are treated very similarly with a combination of surgery, radiation, and chemotherapy, although PNETs tend to be more aggressive overall from medulloblastomas.
- Brain stem tumors: Brain stem gliomas are tumors found in the brain stem. Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls. Brain stem gliomas occur almost exclusively in children; the group most often affected is the school-age child. The child usually does not have increased intracranial pressure, but may have problems with double vision, movement of the face or one side of the body, or difficulty with walking and coordination.
- Ependymomas: Ependymomas are also glial cell tumors. They usually develop in the lining of the ventricles or in the spinal cord. The most common place they are found in children is near the cerebellum. The tumor often blocks the flow of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing increased intracranial pressure. Ependymomas can be slow growing, compared to other brain tumors, but may recur after treatment is completed. Recurrence of ependymomas results in a more invasive tumor with more resistance to treatment. About five percent to ten percent of childhood brain tumors are ependymomas.
- Germ cell tumors: Germ cell tumors comprise less than four percent of brain tumors in children. They most commonly occur in the middle of the brain, specifically near the pituitary and pineal glands. There are two major types of germ cell tumors: germinomas, and non-germinomatous germ cell tumors (NGGCT). Since these tumors are near structures in the brain which secrete hormones, often patients will have decreased amounts of these hormones and require supplementation. Given their location, often these tumors cannot be completely surgically removed and are only biopsied at the time of surgery. Further therapy for these tumors includes radiation, chemotherapy, or both.
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