• Childhood Brain Tumors

    Brain tumors are relatively rare in children, occurring in only five of every 100,000 children. While all pediatric brain tumors are life-threatening, most children and adolescents who have been diagnosed with one survive.

    Brain tumors have traditionally been given names (classified) based on the tumor’s location within the brain and according to how they look under a microscope. The different aspects of the appearance of the cells indicate what type of brain cell the tumor arose from and how “aggressive” (susceptible to spreading) the cells are likely to be.

    Brain Tumor Treatment at Dana-Farber/Boston Children's

    Children with malignant and non-malignant brain tumors are treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center  through our Brain Tumor Center. Continue reading to learn more about brain tumors or visit the Brain Tumor Center homepage to learn about our expertise and treatment options for these conditions.

    Symptoms & Diagnosis

    Each child may experience symptoms of a brain tumor differently, and symptoms vary depending on the size and location of the tumor—both in the brain and elsewhere in the central nervous system.

    Brain tumors can cause pressure on the brain, causing the following symptoms:

    • Headache
    • Vomiting (usually in the morning)
    • Nausea
    • Personality changes
    • Irritability
    • Drowsiness
    • Depression

    Symptoms of brain tumors in the cerebellum, including cerebellar pilocytic astrocytoma and medulloblastoma, include:

    • Vomiting (usually occurs in the morning, without nausea)
    • Headache
    • Uncoordinated muscle movements
    • Problems walking

    Brain tumors in the brainstem, such as diffuse pontine glioma and tectal glioma, can cause the following symptoms:

    • Vision changes, including double vision
    • Paralysis of nerves and/or muscles of the face, or half of the body
    • Respiratory changes
    • Clumsy, uncoordinated walking 

    Symptoms of brain tumors in the cerebrum, including ganglioglioma, glioblastoma multiforme and oligodendroglioma, include:

    • Seizures
    • Visual changes
    • Slurred speech
    • Paralysis or weakness on one half of the body or face
    • Personality changes or impaired judgment
    • Short-term memory loss
    • Communication problems

    Tumors in the optic pathway (eyes), such as optic pathway glioma, may cause symptoms such as:

    • Visual problems
    • Puberty or growth abnormalities
    • Excessive urination

    Symptoms of tumors in the spine (sometimes spreading from a tumor at a higher point on the spinal cord), including meningioma, may include:

    • Bowel or bladder dysfunction
    • Back pain
    • Weakness or loss of sensation in one area of the body, depending on where in the spine the tumor is located

    Diagnostic procedures for brain tumors are used to determine the exact type of tumor a child has and whether the tumor has spread. These may include:

    • Physical examination, including a neurological exam to test reflexes, muscle strength, eye and mouth movement, coordination and alertness
    • Magnetic resonance imaging (MRI) to produce detailed images of the brain and/or spine
    • Magnetic resonance spectroscopy (MRS), which is used with MRI to help identify tissue as either normal or tumor and may be able to distinguish between tumors that affect supportive cells in the brain (glial cells) or neurons (nerve cells)
    • Computerized tomography (CT or CAT) scan to capture a detailed view of the bone and fluid-filled spaces of the brain
    • Biopsy, which provides a tissue sample for definitive information about a tumor type
    • Lumbar puncture (spinal tap) to remove a small sample of cerebrospinal fluid and determine if any tumor cells have started to spread

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    Treatment for brain tumors in children has progressed tremendously in the last decade. These treatments include:

    • Neurosurgery – usually the first treatment to remove as much of the tumor as possible and to relieve pressure on the brain; in general, the more of the tumor that is removed, the greater the chance for survival
    • Radiation therapy – precisely targeted and dosed radiation to kill cancer cells left behind after surgery; in tumors that have spread, radiation therapy can be sometimes delivered to the entire brain and spine
    • Chemotherapy – drugs that interfere with cancer cells’ ability to grow or reproduce

    Progressive or Recurrent Disease

    Some brain tumors recur (come back) after a patient’s initial treatment. Recurrent brain tumors are often treated with a second surgery to remove the remaining tumor and chemotherapy and/or radiation therapy. There are a number of standard and experimental treatment options for children with progressive or recurrent brain tumors.

    Long-term Outlook

    Today, more than half of all children diagnosed with a brain tumor will be cured of the disease. Prognosis and long-term survival varies greatly, depending on the type of brain tumor a child has. Because a child’s brain is still developing, the treatments for brain tumors can result in more substantial and permanent side effects than they would for an adult. Many children who are treated for brain tumors experience significant long-term problems, such as changes in intellectual and motor function. They require ongoing assessment and specialized care to help them function at school and throughout life as well as possible.
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    A genetic test can explain why a child or young adult developed cancer or a blood disorder and can help predict whether he/she is at risk for other conditions.