Brain Tumors in Children

craniopharyngioma

Each year in the United States, about 2,000 children under 16 are diagnosed with a brain tumor. Brain tumors are the most common type of cancer in children. Brain tumors can be challenging to treat. In fact, brain tumors are the second-leading cause of cancer death in children under age 15. But the outlook isn't necessarily bleak. Many types of brain tumors can be successfully treated with one or more treatment methods. In addition, new technology enables physicians to target tumors more precisely. And innovative treatments under investigation mean more hope for the future.tumors in children can be complex, so you must find a clinic that offers a combinations of the most current treatment facilities with a team of pediatric care providers who offer children their best chance for surviving brain tumors. Pediatric neuro-oncologists, endocrinologists, behavioral pediatricians, and other physicians can minimize long-term effects of the tumor.
Most brain tumors in children are primary. They start in the brain and are not the result of malignant cells spreading to the brain from another location in the body. A primary tumor in the brain rarely spreads beyond the brain and spinal cord. But any brain tumor can be life threatening if it becomes too big and presses against tissues that control vital body functions such as breathing or blood circulation.

There are many different types of brain tumors and a wide variation in how they grow and affect the brain. Treatment and chance of recovery (prognosis) depend on the type of tumor, its location within the brain, how much it has spread, and the child's age and general health.

Diagnosis

Diagnosing a brain tumor usually involves several steps. The child's physician may perform a neurological exam, which includes checking vision, hearing, balance, coordination and reflexes, among other things. Depending on the results of that exam, the physician may request one or more additional tests.

After getting the patient's medical history, physicians usually conduct a neurologic exam to help determine whether a patient has a craniopharyngioma. During this procedure a physician tests the patient's vision, hearing, balance, coordination, and reflexes. Patients may also be tested for any changes in hormone levels. Physicians may then order one or more of the following imaging studies.

• Computed tomography (CT) scan. A CT scan uses a sophisticated X-ray machine linked to a computer to produce detailed, two-dimensional images of the brain. Patients lie on a movable table that technicians guide into an enormous tube where images are taken. In some cases a special dye may be injected into the bloodstream to make tumors more visible on the images.
• Magnetic resonance imaging (MRI) scan. This technology uses magnetic fields and radio waves to generate images of the brain. MRI scans show the contour of soft tissues as well as bone. Occasionally radiologists use a special dye injected into the bloodstream to help distinguish tumors from healthy tissue.
• Angiogram. A special dye injected into the bloodstream helps locate blood vessels in and around the craniopharyngioma on an X-ray.
• Other brain scans. Other tests help doctors gauge brain activity by studying brain metabolism and chemistry and blood flow within the brain. Some tests include magnetic resonance spectroscopy (MRS), single-photon emission computerized tomography (SPECT), and positron emission tomography (PET) scanning. These scans can be combined with MRIs to help doctors understand the effects of the tumor on brain activity and function.

Sometimes a needle biopsy may be used to get a sample of the tumor tissue prior to surgery. Experienced pathologists examine the tissue in highly equipped laboratories.

Physicians recommend surgery for many craniopharyngiomas. Surgery is performed by an otorhinolaryngologist and a neurosurgeon. Surgeons will take a sample of the tumor and send it to the laboratory for examination (biopsy). A pathologist determines whether the tumor is malignant or benign. Most craniopharyngiomas are benign. Surgery may be the only treatment necessary for a benign craniopharyngioma.

For complex craniopharyngioma cases, surgeons and radiation oncologists may recommend stereotactic radiosurgery, fractionated stereotactic radiotherapy, or another surgical procedure.

During a procedure, a surgeon may determine that none or only a small part of a tumor can be safely removed. In that situation, the doctor may recommend radiation therapy following surgery. Malignant tumors may require radiation and/or chemotherapy after surgery.

Radiation Therapy

Radiation therapy uses high-energy X-rays, electron beams, or radioactive isotopes to kill cancer cells. Radiation oncologists then tailor each treatment to protect nearby normal tissue. Patients must have access to the technologies for treatment planning and delivery including intensity-modulated radiation therapy (IMRT). These advanced systems help radiation oncologists and neurosurgeons treat the cancer effectively while limiting radiation to critical normal tissues, such as the eyes, optic nerves, brain, brain stem, and spinal cord. This is important for cancers located in the head and neck.

Chemotherapy

When a biopsy reveals that a craniopharyngioma is malignant, medical oncologists use drugs to destroy cancer cells. The chemotherapy may be given by mouth or infused into the patient's veins.

Never ever let the children alone during the whole process.