Brain tumor – children : Treatment

Treatment

Early treatment often improves the chance of a good outcome. Treatment, however, depends on the size and type of tumor and the general health of the child.

The following are treatments for specific types of tumors:

Astrocytoma — The main treatment is surgery to remove the tumor.

Brainstem gliomas — Surgery is usually not possible because of the tumor’s location in the brain. Radiation and chemotherapy are used to shrink the tumor and prolong life.

Ependymomas — Treatment may include surgery, radiation therapy, and chemotherapy.

Medulloblastomas — Surgery alone does not cure this type of cancer. Chemotherapy and radiation are often used in combination with surgery.

The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child’s comfort.

Surgery is necessary for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of entirely removed. Debulking is a procedure to reduce the tumor’s size.

In cases where the tumor cannot be removed, surgery may help reduce pressure and relieve symptoms.

Radiation therapy and chemotherapy may be used for certain tumors.

Other medications used to treat primary brain tumors in children include:

  • Corticosteroids such as dexamethasone to reduce brain swelling
  • Diuretics such as urea or mannitol to reduce brain swelling and pressure
  • Anticonvulsants such as phenytoin or levetiracetam to reduce seizures
  • Pain medications

Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help in coping with the disorder.

Support Groups

For additional information, see cancer resources.

Prognosis (Expectations)

About 3 out of 4 children survive at least 5 years after being diagnosed with a brain tumor.

Long-term brain and nervous system problems may result from the tumor itself, or from treatment.

  • Children may have problems with attention and concentration, memory, processing information, planning, insight, initiative or desire to do things, and the ability to stay organized and on-task.
  • Children younger than age 7 (and especially those younger than age 3) appear to have the greatest risk for these problems.

Parents need to make sure that children receive needed support services at home and school.

Complications

  • Brain herniation (often fatal)
  • Loss of ability to interact or function
  • Permanent, worsening, severe brain and nervous system (neurological) problems
  • Side effects related to chemotherapy and radiation
  • Tumor returns (relapse)

Calling Your Health Care Provider

Call a health care provider if a child develops persistent headaches or other symptoms of a brain tumor.

Go to the emergency room if a child has a seizure that is unusual or suddenly develops stupor (reduced alertness), vision changes, or speech changes.


Review Date : 12/27/2009
Reviewed By : Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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