Though rare, brain tumors are the most common form of solid tumors among children under the age of 15 and represent about 20% of all childhood cancers. Brain tumors in children are often located in different locations and behave differently than brain tumors in adults. Consequently, management of tumors in children varies from that in adults. Children with tumors may also have a much better prognosis than adults with a similar condition.
Understanding Tumors
There are different brain tumor types and classifications based upon a tumor’s cell of origin, cell type, composition, rate of growth and other characteristics.
Most pediatric brain and spine tumors are primary tumors, meaning they originated in the brain or spine. In contrast, the most common brain tumors in adults are metastases, meaning they represent spread of a tumor located elsewhere in the body, such as the liver, breast, lung and kidney. Primary tumors are classified as “benign” or “malignant.” Both can be life-threatening.
A child’s body makes cells when they are needed for development or repair. A tumor develops when normal or abnormal cells multiply when they are not needed. The words “benign” and “malignant” are generally used to describe how normal or abnormal the cells are when viewed under a microscope. Tumors with cells that are similar in appearance to normal cells are called “benign.” Tumors with cells that appear very different than normal cells are called “malignant.” A number of factors are taken into consideration while classifying the tumor as 'benign' or 'malignant'.
Prognosis
Prognosis is a prediction about the future course of the disease and the likelihood of recovery. Prognosis is based upon many factors including the type of tumor, its location and grade, the length of time your child has exhibited symptoms, the speed of growth, and treatment options. The age of the child and the extent to which the tumor has affected the child’s ability to function are also important factors.
Brain Tumors in Children
The most common types of brain tumors in children are astrocytoma, medulloblastoma and ependymoma, however below is a full listing of pediatric tumor types.
Malignant - Medulloblastoma, PNET, ATRT, Ependymoma, Choroid plexus carcinoma, Anaplastic astrocytoma, Glioblastoma
Benign - Pilocytic astrocytoma, craniopharyngioma, choroid plexus papilloma, ganglioglioma, neurofibroma
Treatment of brain and spine tumors in children is different than treating adults. Children’s brains and bodies are still developing, so there are different considerations and standards of care. For most children, treatment starts with surgery. Histopathological examination following surgery will help to classify and grade the tumor.
Following surgery, additional treatment may be required. Possible therapies include:
- Chemotherapy
- Conventional radiation therapy
- Stereotactic radiosurgery
- Interventions to address side effects of the tumor or the treatment
- Rehabilitation to regain lost strength and skills
- Ongoing follow-up care to detect recurrence of the tumor and manage late effects of treatment
Complications following treatment
- Physical disabilities such as weakness of muscles and diminished coordination
- Learning disabilities including problems with memory, attention, comprehension and information processing
- Behavioral changes and emotional issues
- Hearing and vision problems
- Seizures and other neurological issues
- Hormonal problems including slowed growth, hypo- or hyperthyroidism, diabetes, early or late puberty, and infertility
- Damage to internal organs and/or other body systems
- The possibility of developing secondary cancers in other parts of the body or a recurrence of a tumor in the brain
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