Brain Tumor Treatment Facts

According to experts, there are no proven treatments to eradicate brain tumors in children. Typically, if a child’s brain tumor cannot be completely surgically removed, then chemotherapy and/or radiation may be recommended.  All three options may offer conflicting and potentially incomplete solutions and often result in added critical complications and permanent adverse side effects due to the punishing nature of the therapies.  Furthermore, a subset of children in treatment, estimated 30-40% overall, will develop progressive disease, and treatments to manage these developments are minimally effective.

While experts say that radiation and chemo are being made safer, it is unlikely to cure many more children with brain tumors. In a similar way they also predict that new chemotherapy regimes will not make “quantum leaps” in the statistics of survival.  But at this point, this is the best the medical community has to offer…

Steps to determine treatment options

First: immediately following the detection of a brain tumor (usually by MRI or CT scans), the patient will undergo a biopsy procedure, if the tumor is accessible. This phase can be performed in conjunction with a more extensive surgical resection, or independently, depending on tumor location.

Second: parents, medical experts, and the affected child develop a tumor treatment plan (again, there is NO one protocol). The Neuropathologist (a doctor who specializes in looking at brain tumor cells) will examine the tumor cells from the operation to determine the type of tumor. Together, the oncologist, radiation therapist, and neurosurgeon decide on the best options and make a recommended plan of care.

Third: a tumor treatment plan is initiated. Currently, three options for treating brain tumors are widely used: chemotherapy, radiation, and wait-and-see (and in some cases, a combination of chemo and radiation therapy). The tumor treatment therapy is determined by many factors: type of tumor, the tumor location, and your child’s age.

After each brain tumor treatment option is administered, there is usually a wait-and-see period where the physicians observe the child’s brain tumor (usually 3-6 months) through an MRI and/or CAT scan. They then make follow-up recommendations based on these findings.

Typical tests/procedures to determine treatment protocol

Tests that examine the brain and spinal cord are used to detect (find) childhood cerebellar astrocytoma. The following tests and procedures may be used:

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Biopsy: A biopsy is done by removing part of the skull and using a needle to remove a sample of the brain tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor will remove as much tumor as safely possible during the same surgery.