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Treating Pediatric Brain and Spinal Cord Tumors

  • These two types of tumors make up the second most common form of childhood cancer after leukemia
  • Treatment often includes surgery, radiation, chemotherapy, and targeted immunotherapy
  • The goal is to remove the tumor and not affect areas related to functions like speech and movement
  • Involves cardiac surgery, interventional cardiology program

Overview

It can be scary to receive a brain tumor diagnosis for your child. Tumors can put pressure on certain parts of the brain and affect how it functions. After leukemia, malignant pediatric brain and spinal cord tumors are the second most-common form of childhood cancer. At the same time, tumors can also be benign, or noncancerous. 

Many childhood brain tumors occur in the back compartment of the brain. The rest of the brain tumor occur in one of the two cerebral hemispheres of the brain or in the spinal cord. Boys are more likely than girls to develop such tumors, with more cases are seen in children under 7 years old. 

At Yale Medicine, our doctors make an effort to use treatments with the least amount of side effects for patients. "The treatments will make them live longer, but we want to make sure that they maintain a good quality of life," says Yale Medicine hematologist and oncologist Asher Marks, MD

What kinds of brain and spinal cord tumors are commonly found in children?

The most common childhood tumors are low-grade gliomas and medulloblastomas.

A glioma grows from central nervous system cells called glial cells, while medulloblastomas form in the brain's cerebellum, the lowest part of the brain.

What are the symptoms of pediatric brain and spinal cord tumors?

Childhood tumors can have a frustratingly wide variety of symptoms.

Factors that may influence symptoms include the location of the tumor, a child's age, and how quickly the tumor grows. Symptoms also may appear suddenly or gradually worsen over time.

Because the brain plays a key role in so many complex functions, a brain tumor can have many effects. In very young children, the first signs could be:

  • Loss of appetite
  • Ongoing irritability
  • Developmental delays

Parents or teachers of school-age kids may notice:

  • Memory problems
  • Diminished learning ability
  • Behavioral or emotional problems

A tumor can cause increased pressure on parts of the brain, which might lead to headaches, nausea and vomiting, blurred vision, drowsiness, or seizures.

It's important to note that most childhood headaches, for example, are not due to a brain tumor and many of the above symptoms are common signs of other medical conditions. But a tumor could be the cause if the above symptoms appear in combination with one another, and/or if they persist or get worse.

As with brain tumors, spinal cord tumors also have a wide range of symptoms. However, a spinal cord tumor may be suspected if a child displays:

  • Loss of coordination in the arms and/or legs
  • Numbness or weakness
  • Bladder or bowel problems

How are pediatric brain and spinal cord tumors diagnosed?

Several tests may be used to determine whether a child has a brain or spinal cord tumor.

These tests can include a physical exam, careful examination of the child's health history, and a neurological exam. Doctors may also use a magnetic resonance imaging (MRI) scan, which uses powerful magnets and radio waves to produce detailed images of the brain and spinal cord.

Once a tumor has been identified, most children will undergo a biopsy and/or surgical removal of the tumor.

How are pediatric brain and spinal cord tumors treated?

Treatment approach depends on factors including the location of the tumor, whether the tumor is benign or malignant, and the age and overall health of the child.

Brain and spinal cord tumors tumors are often treated with a combination of surgery, radiation, chemotherapy, and targeted immunotherapy drugs, such as Bevacizumab (Avastin) or Everolimus (Afinitor), which can slow the growth of tumors.

Patients at Yale Medicine often undergo specialized treatments such as stereotactic radiosurgery, electrocorticography (brain monitoring using external electrodes), and cortical mapping where indicated.

These techniques identify areas of the brain that are critical to movement, feeling, memory, and speech so surgeons can remove as much of the tumor as possible without removing critical areas of the brain.

What are the risk factors for pediatric brain and spinal cord tumors?

Doctors don't know the cause of most childhood brain and spinal cord tumors. Radiation exposure as a result of treatments used in other medical conditions is a possible cause. In rare cases, genetic conditions can be the cause of these tumors.

What makes Yale Medicine's’s approach to treating pediatric brain and spine tumors unique?

Patients benefit from critical resources of a major children's hospital staffed with pediatric neurologists, pediatric neurosurgeons, and pediatric nurse practitioners, all specially trained to offer child-friendly and compassionate care.

Our dedicated pediatric neurosurgery program has 25 years of experience providing comprehensive services to infants, toddlers, school-age children, adolescents, and young adults.

Patients at Yale Medicine have access to proton beam radiation, which targets tumors directly while avoiding damage to the surrounding tissue. The team discusses each aspect of care with the child and his or her family and ensures that referring physicians are kept updated on each phase of treatment.

Our doctors are also involved in cutting-edge research to bring targeted therapies for specific subtypes of childhood brain and spinal cord tumors to the public. "Importantly, we apply next-generation DNA sequencing to every tumor we resect to help develop personalized treatment regimens for individual patients," says Yale Medicine pediatric neurosurgeon Kristopher Kahle, MD.