When Your Child Has a Brain Tumor

The brain is part of the body’s nervous system. Your child’s ability to think, learn, speak, feel emotion, and reason are all controlled by the brain. The brain also controls basic body functions such as movement, sensation, breathing, and heartbeat. A brain tumor can affect your child’s brain function and threaten his or her overall health. Tell your child’s healthcare provider about any changes in personality or behavior. For younger children, any loss of developmental milestones will need to be addressed. These include crawling, standing, and walking.

If your child has a brain tumor, your child’s healthcare provider will talk with you about the type of brain tumor and the treatment options for your child.

What is a brain tumor?

A brain tumor is a mass of abnormal cells in the brain. It can have the following features:

• A tumor can be primary. This means it started in the brain. Or, a tumor can be metastatic. This is a cancer that traveled to the brain from another part of the body. In children, primary tumors are much more common than metastatic tumors.

• A tumor can be benign or malignant. Most benign tumors are made up of slow-growing cells that rarely spread. The benign tumor cells are not cancer. They are not likely to spread to other parts of the brain or body. Most malignant tumors are made up of fast-growing cells that grow into nearby tissue. The malignant tumor cells are cancer. They are more likely to spread to other parts of the brain. Both benign and malignant tumors can be life threatening and can need a lot of treatment.

What are the risk factors for a brain tumor?

Brain tumors can occur randomly in children of all ethnicities and ages. Children with some genetic conditions are more likely to grow tumors. This includes children who have neurofibromatosis, tuberous sclerosis, or Li-Fraumeni syndrome. Radiation to the head, such as treatment for another cancer, can also cause brain tumors.

What are the symptoms of a brain tumor?

A brain tumor can affect each child differently. Common symptoms of a brain tumor include:

• Repeated headaches

• Loss of balance

• Trouble walking

• Seizures or convulsions

• Problems with vision, speech, concentration, balance, or movement

• Nausea or vomiting

• Paralysis, weakness, or numbness in one part or side of the body

• Changes in personality or behavior

• Fast increase in head size in infants

How as a brain tumor diagnosed?

Your child will likely see a pediatric neurologist or a pediatric neurosurgeon for diagnosis and treatment. These are doctors who treat problems of the brain. Your child may also see other kinds of healthcare providers.

To diagnose a tumor, a healthcare provider will ask you about your child’s health history. You will need to describe your child’s symptoms and other health problems. Your child may also have tests such as:

• Neurologic exam. This is done to check how well your child’s nervous system is working. During the exam, the healthcare provider checks your child’s muscle strength, balance, coordination, and reflexes. He or she may also check skills such as thinking and memory, vision, hearing, and talking.

• MRI scan or CT scan. One of these may be done to take detailed pictures of the brain. These help the healthcare provider find out the tumor size and location. With either test, fluid called contrast dye may be injected into a vein. This makes a tumor easier to see.

• Stereotactic biopsy. This is done to learn more about the tumor type and find out if it is benign or malignant. During this procedure, a small sample of tumor tissue is taken for lab testing. The tumor is analyzed and given a grade. The grade is based on how different the tumor cells look from normal cells. It gives clues about how fast new tumor cells are growing and spreading into nearby tissue.

• Brain surgery. This may be done to sample the tumor for a biopsy. Or it may be done to take out as much tumor as can be removed safely. The tumor is then checked by a pathologist to define the type and grade of the tumor.

• Cerebrospinal fluid exam. This is also called a lumbar puncture or spinal tap. It is done to help find out if the tumor has spread. The healthcare provider can look for tumor markers that may be in the spinal fluid.

• Positron emission tomography (PET) scan. This is a procedure that uses a radioactive sugar (glucose) solution to find cancer cells. Cancer cells use more sugar than normal cells. A scanner rotates around the body and takes images. Cells that take in more of the radioactive sugar look brighter on the scan.

How is a brain tumor treated?

Treatment for a brain tumor varies for every child. Each treatment also carries possible risks and complications. Your child’s doctor will discuss treatment options with you. Many children will get more than one type of treatment. Treatments may include:

• Surgery. This may be done to remove as much of tumor as possible.

• Chemotherapy. This may be done to treat tumor cells with medicine. Your child may be given 1 or more medicines. The medicines can be taken by mouth (orally) or into a blood vessel (IV). In some cases, they can be injected into the fluid that surrounds the brain and spinal cord. Chemotherapy is often used along with other treatments. It is given in cycles to allow the body to rest and build new healthy cells between treatments.

• Radiation therapy. This may be done to destroy tumor cells with X-ray beams. There are 2 types of radiation: focused and whole brain. With focused radiation, X-ray beams are aimed at the tumor and the area around it. With whole-brain radiation, X-ray beams are used on the entire brain. This method is more often used to treat multiple tumors. In addition to traditional radiation, stereotactic radiosurgery may also be used. It is done by sending several high doses of radiation to a specific area in the brain from different angles.

• Other medicines. These may be given to your child to help with symptoms or other problems due to the tumor or treatment. Your child may be given corticosteroids to reduce swelling in the brain. Your child may take anticonvulsants to prevent or control seizures. He or she may take antibiotics to treat infections. Other medicines may be given as needed.

What are the long-term concerns?

More brain tumors in children are now treatable. Your child’s healthcare providers will work closely with you to make sure your child gets the best care. The long-term outcome of your child’s condition depends on many factors. These include:

• Your child’s age and overall health

• The tumor type and size

• If the tumor is growing in one place or has spread

• The types of treatment, such as radiation therapy