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Causes, Risk Factors, and Prevention of Childhood Brain Tumor Cancer

Causes, Risk Factors, and Prevention of Childhood Brain Tumor Cancer

Why do some children develop brain tumors?

Why do some children develop brain tumorsAny time a child is diagnosed with a brain tumor or other type of cancer, the most obvious question many parents ask is “why”. What caused this child to develop a brain tumor? Unfortunately, there is no easy answer to this question. Scientists now believe that the vast majority of brain tumors in children are the result of random gene mutations but have no satisfying answer as to why a particular gene mutation occurred or why it led to the growth of a brain tumor.

Whether benign or malignant, a tumor grows when certain cells grow, divide, and replicate more quickly than normal cells and/or they do not die when they are aged or damaged. These abnormal cells then begin to build up in the brain, forming clumps or a mass, and eventually growing large enough to press on or cause damage to the healthy brain tissue.

So why do some cells grow, function, and die normally, while others grow abnormally and develop into a brain tumor? Scientists currently believe that these abnormal cells are the result of mutations (random changes) within the DNA in each cell. Mutations in oncogenes inhibit when cells grow and divide properly, while mutations in tumor suppressor genes prevent cells from slowing their rate of replication and prevent them from dying at the proper time. Because mutations are a natural part of the lifecycle of our cells—occurring frequently as our cells grow and divide over time—preventing or predicting these mutations is currently impossible.

What are the risk factors for brain tumors in children?

A “risk factor” is anything that increases a child’s risk of developing a brain tumor. As stated above, scientists believe that the vast majority of cases of childhood brain tumors are caused by random gene mutations. Gene mutations are a natural part of human biology and usually do not have a specific or identifiable cause. Therefore, there are very few known risk factors linked to the development of brain tumors in children, with two notable exceptions. Those are:

  • Radiation exposure: Exposure to large amounts of radiation has been linked to several types of cancer, including brain tumors in children. While low-level radiation exposure is an accepted aspect of today’s medical care (x-rays, for instance, for dental treatment or to diagnose a broken bone), the medical community goes to great lengths to protect children from high dosages of radiation exposure.

However, radiation therapy has proven to be an effective tool when fighting some types of cancer. While most oncologists will limit or avoid altogether the use of radiation when treating very young children, in some cases, the benefits of treating the immediate threat posed by cancer must be weighed against the potential risk of developing a brain tumor or other secondary cancer in the future.

  • Inherited genetic conditions: In a very small number of cases (less than 5%), children have an inherited genetic condition that might potentially increase the risk of developing a brain tumor. Although these conditions themselves are very, very rare, some have been linked to an elevated risk for brain tumors:
  • Neurofibromatosis type 1 (von Recklinghausen disease)
  • Neurofibromatosis type 2
  • Von Hippel-Lindau disease
  • Tuberous sclerosis
  • Gorlin syndrome (basal cell nevus syndrome)
  • Li-Fraumeni syndrome
  • Turcot syndrome
  • Hereditary retinoblastoma
  • Cowden syndrome
  • Rubinstein-Taybi syndrome

 

Can we do anything to prevent a brain tumor?

Unfortunately, all too many parents—after hearing that their child has been diagnosed with a brain tumor—feel an overwhelming sense of guilt. Many wonder whether this diagnosis is somehow their fault, or whether they might have been able to do something to prevent this diagnosis. However, any oncologist will assure these parents that there is absolutely nothing they could have done to prevent their child from developing a brain tumor. Brain tumors in children are not believed to be linked to any environmental factors or lifestyle choices (with the notable exception of radiation exposure noted above); instead, they are most likely the result of random and uncontrollable gene mutations.

About American Childhood Cancer Organization

American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer.  And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.

 

For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

Childhood Brain Tumor Cancers – Detection and Diagnosis

About Childhood Brain Tumors

Childhood Brain Tumor Cancers Detection DiagnosisAfter leukemia, brain tumors (including spinal cord tumors) are the second-most common type of cancer in children, accounting for about 25% of all childhood cancer diagnoses. Brain tumors begin within the delicate and complicated tissues of the brain or the cerebrospinal fluid (as well as the spinal cord or central nervous system, as these tumors are usually classed with brain tumors in children). When dealing with brain tumors in children, oncologists rarely differentiate between benign (non-cancerous) or malignant (cancerous) tumors; all tumors in the brain can be life-threatening whether technically cancerous or not. Instead, oncologists usually focus on how fast the tumor is growing, how quickly or easily it may spread throughout the brain or spinal cord, and how easy the tumor is to remove completely.

Types of brain tumors “common” in children include:

  • Gliomas: a general term for a group of tumors that begin in the supporting cells of the brain. Gliomas account for about 50% of all brain and spinal cord tumors in children. Examples include astrocytomas, oligodendrogliomas, ependymomas, optic gliomas, and brain stem gliomas. Brain stem gliomas themselves account for about 10-20% of all brain tumors in children. Because they often grow diffusely throughout the brain stem, “diffuse midline gliomas” (such as diffuse intrinsic pontine gliomas, or DIPGs) remain very difficult to treat.
  • Embryonal tumors: accounting for about 10-20% of all brain tumors in children, embryonal tumors usually begin in the earliest forms of nerve cells and therefore are more common in younger children. The most common type is medulloblastoma, but other forms of embryonal tumors include medulloepithelioma, atypical teratoid/rhabdoid tumor, and embryonal tumor with multilayered rosettes.
  • Pineal tumors: these tumors begin in a small gland in the middle of the brain—the pineal gland—and are very difficult to treat. The most common type of pineal tumors are pineoblastomas.
  • Craniopharyngiomas: about 4% of all brain tumors in children are these slow-growing tumors which begin between the pituitary gland and the brain itself. Because they often press on the pituitary gland, the hypothalamus, and/or the optic nerves, they can be very difficult to remove without impacting the child’s vision and/or hormone balance.
  • Mixed glial and neuronal tumors: these types of tumors, including dysembryoplastic neuroepithelial tumors and gangliogliomas, are generally slow-growing and have a fairly good prognosis when treated with surgery and potentially radiation.

Childhood Brain Tumors: Detection and Diagnosis

Unfortunately, as with all childhood cancers, there is no way to “detect” a brain tumor without formal diagnostic testing. In most cases, detection and diagnosis happens only after parents, guardians, teachers, or others close to the child start observing unusual medical symptoms such as frequent headaches, nausea and vomiting, vision problems, balance problems, or seizures. Because many of these symptoms are commonplace, a pediatrician may only suspect a tumor if symptoms continue over time or worsen, or in the case of seizures appear very suddenly.

Should your child’s pediatrician suspect the presence of a brain tumor, he or she will recommend a visit to a specialist, who will conduct a series of diagnostic tests to determine if a brain tumor is present. The first diagnostic test is almost always an imaging test, usually an MRI. Using a combination of radio waves and strong magnets, an MRI can create a series of detailed images of the brain without involving radiation (which is extremely damaging to the delicate brain tissue of children, especially young children).

While an MRI or other imaging test can indicate the presence of a tumor or other abnormality, a final diagnosis usually must be made through a biopsy. A biopsy involves removing some or all of the tumorous tissue and examining it under a microscope. In some cases, a biopsy may be done simultaneously with surgery to remove the entire tumor, or it may involving only removing a piece in order to determine the appropriate course of treatment. However, in some cases, the tumor may be located in such a sensitive or difficult-to-reach area of the brain, that a physical biopsy is not possible; in these cases, diagnosis must be made on the results of imaging tests.

Once the biopsy has confirmed the presence of tumor and identified its type and grade, your child’s oncology team will work with you to determine the best course of treatment for your child.

About American Childhood Cancer Organization

American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer.  And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.

 

For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

Gold Ribbon Hero – Pedro

PedroMeet Pedro, a 5-year-old warrior turning 6 this December. Pedro is one of three children in the Curiel family and is suffering from T Cell Acute Lymphoblastic leukemia (ALL). He is receiving delayed intensification treatments in California with his mom and siblings by his side.

“The past seven months have been the most aggressive chemo then he will go to maintenance where every other week he will receive chemo and eventually getting oral chemo which is not as intense,” his mom, Vilma notes. Vilma said that he’s had muscular stiffness from the new chemo which made him unable to walk and he did not want to get out of bed.  “I think this is the most scary part of treatment. After 24 hours he started limping and getting back to his usual routine.”

pedro 2When he’s not receiving treatment, he is found drawing treasure maps around the house. Vilma said that he loves to draw these maps and hide his “treasure” and have his two brothers go find it! He started homeschooling in August, and he can now read a full sentence. He is expected to return to school after flu season.  

Pedro is currently in remission and maintenance will continue for the next three years.  

 

Golden Ribbon Hero: Beckham

Currently being treated for Stage 4 Neuroblastoma

Beckham_022Meet Beckham, one of our ambassadors for the month of September. He is a goofy 8 year old currently being treated for Stage 4 Neuroblastoma at Memorial Sloan Kettering in New York City.  Beckham was diagnosed on September 11, 2013 at the age of 3. A few weeks prior to his diagnosis, Beckham was playing with his sister and they banged their heads together. This resulted in Beckham’s black eyes.  His mom remembers looking at pictures from that time and seeing his eyes starting to darken.

“I called the doctor and they said to watch it and call if things worsened. They went down and then started to darken. I ended up taking him in to his pediatrician and they drew labs. Later that day I got a call that Beckham’s labs were abnormal and that we had an appointment with oncology up at Primary Children’s Hospital in Salt Lake City,” his mom recalls.

Beckham_014At first, doctors didn’t think Beckham had cancer, they went through many diagnoses, everything from mono to anemia. The doctors were not convinced and decided to do a bone marrow biopsy which revealed that Beckham had tumors throughout his body and bone marrow.

beckhamTreatment was aggressive and as a result Beckham started chemotherapy. The doctors performed a resection of the main tumor and radiation to his skull in Utah which resulted in soft tissue tumors and bone marrow clearing well but the tumors in his bones had hardly changed. Beckham’s mom recalls going onto a Facebook group for Neuroblastoma and was urged to take him for a second opinion at Memorial Sloan Kettering. February 2014 was the first trip to NYC where Beckham received MIBG therapy, NK cell therapy, radiation, 3f8 antibioties, cryotherapy surgery, numerous rounds of chemotherapy and surgery to remove lymph nodes in his upper right underarm and chest.

Beckham_048Beckham has had two central lines and is on his third port. “He has endured four relapses, the most recent being March of 2018 and his doctors say he is a miracle boy.”

Fortunately, his latest scans show no evidence of disease. He is currently in treatment for an alk mutation which was found in his past two surgeries.  Beckham has a lot of personality and loves to make people laugh – we are looking forward to many laughs with Beckham!

Beckham is one strong little boy and an example of true perseverance. Beckham expresses to his mom that he is never giving up and his cancer is going down!

 

*Special thanks to our Candlelighters NYC Affiliate and Barbara Zobian*

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Golden Ribbon Hero – Braeden

Brae 1Meet Braeden or “Brae” as his mom lovingly calls him. He’s a three year old,  fun-loving “ladies man” who is wise beyond his years. Brae’s mom, Kendra noticed in January of 2018 that he was whining a lot. She took him to get checked out several times and after being told he had pneumonia, the flu and even being tested for having swallowed a toy, doctors decided to do a biopsy on his back. Doctors took a sample of the mass they found in his lungs and the diagnosis was clear. “On May 5, 2018, Brae was diagnosed with AML leukemia with a genetic mutation of monosomy 7. We just found out about the monosomy 7. Basically that means that Brae has 45 chromosomes instead of 46 like everyone else.”

Kendra was faced with a tough decision when it came to Brae’s treatment plan; get a bone marrow transplant and face three rounds of chemo with a 30% chance of relapse, or five rounds of chemo with a 60% chance of relapse. Kendra ultimately decided against the transplant and is happy to report that after Brae’s first round of chemo, his bulky tumor is gone. Doctors have continued to treat Brae with four more chemo rounds.

Brae 2Fortunately, Braeden is facing treatment like a little soldier; the only side effect he has experienced was hair loss, which he doesn’t seem to mind. Kendra notes that everytime he goes into the hospital, the nurses fight to work with him and that he charms them. She said when Brae is at home, he loves to watch tv with his big brother and play outside. He’s particularly interested in art and loves to paint. When he goes to the hospital you can usually find him in the art room playing with the popsicle sticks and paint.

He mom happily informed us that he is currently ‘doing great’ after his fourth round of chemo. Through it all, Braeden is a positive and happy three year old.

American Childhood Cancer Organization poses the question ‘Why Not Kids?’

New initiative seeks to address the disparity between state budget allocations for adult cancer research and pediatric cancer

FOR IMMEDIATE RELEASE – September 20, 2018 – Washington, D.C.

Childhood cancer star actThe American Childhood Cancer Organization (ACCO) announced today its Why Not Kids state-level advocacy campaign, a new initiative based on successful efforts in Kentucky, that will focus on working with state governments to close the gap between budget allocations that go towards adult and childhood cancer research. ACCO will strategically implement Why Not Kids in pilot sites to advocate for policies and funding in recognition that children are not simply small adults and adult cancer treatments cannot simply be dosed down to effectively cure kids.

How urgent is this call to action? “Childhood cancer is the leading cause of death by disease in children in the United States,” said Ruth Hoffman, ACCO’s Chief Executive Officer. “The majority of children with cancer continue to be treated by drugs that were developed in the 1950s, ‘60s and ’70s. In fact, there’s been just 3 new drugs approved by the FDA in the last 20 years to specifically treat childhood cancer, compared to the more than 185 new drugs approved to treat adult cancer types over the same time period. Working towards increasing childhood cancer research through state-based budget funding can play a significant role in addressing this disparity in access to new cancer treatments.”

This disparity became very personal to ACCO Director of Government Relations and External Affairs, Jamie Ennis Bloyd, when her five-year-old son was diagnosed with aggressive stage 4 lymphoma and leukemia during the Kentucky legislative session in March of 2014. A lobbyist at the time, Jamie quickly realized the gap in state-level engagement and funding for childhood cancer. Working with state legislative commission staff, she discovered in the last 3 biennial state budgets over $15 million dollars had been allocated to adult cancer research, causing her to wonder, “if state funds have been allocated to adult cancer research – why not kids”? She soon learned no other state in the country had specifically invested in childhood cancer research either and Why Not Kids was born.

In the 2018 Kentucky legislative session Governor Matt Bevin and the Kentucky General Assembly recognized this urgent need and set a national precedent for state engagement in the fight against childhood cancer by appropriating first time funding of $5 million dollars for collaborative childhood cancer research efforts at the state’s two children’s oncology group hospitals. Already this new funding has resulted in the revelation of a cluster of a 40-county area in Kentucky in which children have an 87% higher incidence of pediatric brain tumors than what would be expected. Pediatric brain tumors are now the leading cause of death for children diagnosed with cancer in America.  

Other projects funded in Kentucky through the Why Not Kids movement include drug development for molecularly targeted therapies in Ewing’s sarcoma; trials for a new methodology for less invasive and earlier detection of relapsed Acute Lymphoblastic Leukemia; investigation into new biomarkers for earlier identification of neurocognitive impact of chemotherapy; and expansion of basic science and clinical research utilizing CAR-T immunotherapy in Acute Myeloid Leukemia, neuroblastoma and pediatric brain tumors (currently only used for B-cell malignancies).

At an event in Kentucky on Wednesday commemorating September as Childhood Cancer Awareness Month and speaking publicly for the first time regarding the research projects selected, Governor Matt Bevin stated, “This encourages, with just a few million dollars, the ability for collaboration in a powerful, powerful way,” Bevin said. “And I think that’s creating a tremendous level of dialogue, but also hope for the families, for the universities themselves, and for the possibility of finding cures for childhood cancer.”

ACCO’s Why Not Kids research efforts will be focused on promoting the latest in scientific advancements utilizing immunotherapy and molecularly-based treatment. ACCO will work with state pediatric oncology programs and implement these awareness and advocacy campaigns utilizing state cancer registry data, population-based incidence, and virtual tissue biorepositories to inform funding decisions. Funding for Why Not Kids pilot sites comes from Amazon and have been selected based on the June 2018 Centers for Disease Control published report of childhood cancer incidence by state with further review by experts with over 50 years of combined experience in state level cancer epidemiology and cancer registries.

About ACCO

The American Childhood Cancer Organization was founded in Washington, D.C. in 1970 by parents of children and adolescents diagnosed with cancer to advocate for their needs and support research so every child survives and leads a long and healthy life. The nation’s largest grassroots organization at the forefront of the crucial battle against childhood cancer, the ACCO is dedicated to shaping policy, supporting research, raising awareness, and providing educational resources and innovative programs to children with cancer, survivors, and their families. Since its inception, the ACCO has helped support more than half a million families affected by childhood cancer. ACCO now has 35 local ACCO affiliates known as Founding Hope chapters throughout the United States. For more information on the partnership with Amazon visit www.acco.org/amazon.

 

FOR MORE INFORMATION OR TO SET UP AN INTERVIEW: Contact Jamie Ennis Bloyd, Director of Government Relations and External Affairs, American Childhood Cancer Organization at jbloyd@acco.org 859-948-4626 or Ruth Hoffman, Chief Executive Officer, American Childhood Cancer Organization rhoffman@acco.org 202-262-9949.

 

Causes, Risk Factors, and Prevention of Childhood Brain and Spinal Cord Tumors

What causes brain and spinal cord tumors in children?

06172016 (3)Generally speaking, “cancer” is a broad name for a condition in which cells in a particular part of the body begin to malfunction. They begin to grow, divide, and replicate more quickly than normal cells, and/or they do not die as normal when they are worn out or damaged. When these abnormal, or “cancerous”, cells originate in the brain or the spinal cord, they usually form a clump or a mass known as a tumor. As the cancerous cells continue to replicate, the tumor grows until it begins to cause damage to the brain and/or the spinal cord.

Scientists are still trying to learn exactly why some cells grow, function, and die normally, while others grow abnormally and develop into a brain or spinal cord tumor. Brain and spinal cord tumors are most likely caused by mutations (random changes) in the DNA within each cell (our DNA provides instructions governing the function of each cell in our body, and ultimately how our body looks and functions as a whole). Specifically, scientists believe that mutations to two specific types of genes may be the ultimate cause of brain and spinal cord tumors in children: oncogenes control when cells grow and divide and tumor suppressor genes slow down cell division and instruct cells to die at the proper time. Whether inherited from parents or spontaneous and random, mutations to these particular genes may cause cells to malfunction and ultimately become cancerous.

Ultimately, however, scientists do not know why these mutations occur, especially in children. While lifestyle choices such as smoking can cause genetic mutations (and thus cancer) in adults, there are no known lifestyle risks associated with childhood brain and spinal cord tumors in children. Unfortunately, the genetic mutations at the root of the tumor growth are simply random changes that cannot be predicted or prevented.

Are there risk factors for brain and spinal cord tumors in children?

A “risk factor” is anything that increases an individual’s chances of developing a disease like a brain or spinal cord tumor. As noted above, most cases of brain and spinal cord tumors in children appear to be caused by random genetic mutations without a known cause. There are very few known risk factors associated with this type of childhood cancer. The only two well-established risk factors are radiation exposure and certain rare inherited genetic conditions.

  • Radiation exposure: exposure to large amounts of radiation is known to cause some types of cancer, including brain and spinal cord tumors in children. Now that this danger is known, the medical community takes active steps to avoid exposing the brain and central nervous system of children to radiation unless absolutely necessary. In some cases, radiation may be required as part of treatment for another type of cancer; in these cases, the benefits of treating one type of cancer must be weighed against the potential risk of developing a brain or spinal cord tumor in the future.
  • Inherited genetic conditions: in less than 5% of cases of childhood brain and spinal cord tumors, children have an inherited genetic condition that may increase their risk of developing a tumor. These genetic syndromes themselves are exceedingly rare, and may include:
  • Neurofibromatosis type 1 (von Recklinghausen disease)
  • Neurofibromatosis type 2
  • Tuberous sclerosis
  • Von Hippel-Lindau disease
  • Li-Fraumeni syndrome
  • Gorlin syndrome (basal cell nevus syndrome)
  • Turcot syndrome
  • Cowden syndrome
  • Hereditary retinoblastoma
  • Rubinstein-Taybi syndrome

Can the development of brain and spinal cord tumors in children be prevented?

Can the development of brain and/or spinal cord tumors in children be prevented? This is a question many parents will ask themselves upon receiving the terrible diagnosis that their child has a brain or spinal cord tumor. The answer is always “no”. There is no known way to prevent or protect against brain or spinal cord tumors, and absolutely nothing that parents or guardians could have done to prevent this disease.

About American Childhood Cancer Organization

American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer.  And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.

 

For additional information about childhood cancer or on ACCO, or to order resources for you or your child, please visit our website at www.acco.org.

 

For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit:

Childhood Brain and Spinal Cord Cancer Tumors – Detection and Diagnosis

Childhood Brain and Spinal Cord Tumors: A Brief Introduction

child Brain TumorsWhen grouped together in a single classification, cancers in the brain and spinal cord are the second most common form of cancer in children after childhood leukemia, with more than 4,000 new diagnoses every year. However, it is important to recognize that this is a very broad classification: in fact, there are many different types of brain and spinal cord cancers, each of which can cause different symptoms and each of which may require a unique treatment approach. It is also important to note at the outset of any discussion about cancers of the brain and spinal cord that, unlike in other areas of the body, oncologists do not differentiate between benign (non-cancerous) and malignant (cancerous) tumors in the central nervous system. Both types of tumors can be life-threatening if not treated. For this reason, oncologists usually refer to “brain tumors” instead of “brain cancers”.

Childhood Brain and Spinal Cord Tumors: Detection Through Common Signs and Symptoms

As with all childhood cancers, there is no “early detection” screening process for tumors of the central nervous system. Diagnosis usually comes after parents begin to observe unusual medical symptoms. Most symptoms of brain and spinal cord tumors are caused by the tumor raising the pressure inside the brain (known as intracranial pressure). The increase in intracranial pressure can lead to symptoms such as:

  • Headaches
  • Nausea and vomiting
  • Crossed eyes and/or blurred vision
  • Balance problems
  • Behavioral changes
  • Seizures
  • Drowsiness, potentially leading to coma

Of course, most of these symptoms are extremely common and are only rarely caused by a tumor. However, if symptoms continue over time or worsen, or in the case of seizures begin very suddenly, your pediatrician may recommend testing to properly diagnose the cause of the medical issue as quickly as possible.

Because the central nervous system controls the function of the entire body, the location of the tumor within the brain or spinal column may cause different types of symptoms:

  • Tumors in the cerebrum (large, outer part of the brain) can cause symptoms relating to the specific function controlled by the area of the cerebrum affected by the growth of the tumor, such as:
    • Tumors in the area of the cerebrum responsible for movement can lead to weakness or numbness in a specific part of the body, usually only on one side
    • Tumors in the area of the cerebrum responsible for language can cause speech or comprehension problems
    • Tumors at the front of the cerebrum can lead to issues with thinking, personality, and language skills
    • Tumors at the back of the cerebrum or near cranial nerves can cause issues with vision
  • Tumors in the cerebellum can cause symptoms relating to walking or other normal body functions
  • Tumors in the basal ganglia can cause unusual or abnormal body positions or movements
  • Tumors in cranial nerves (not those in the cerebrum) may cause loss of hearing, balance issues, weakness of facial muscles, or potentially trouble with swallowing
  • Tumors in the spinal cord may cause numbness, weakness, lack of coordination, and even bladder and/or bowel concerns

Childhood Brain and Spinal Cord Tumors: Diagnosis

In most cases, the first step in diagnosing a brain or spinal column is an imaging test, most likely an MRI (magnetic resonance imaging). An MRI is able to create detailed images of the brain using a combination of radio waves and strong magnets; moreover, it does not involve the use of radiation, which can be extremely damaging to the brain tissue of young children. While not painful or physically invasive, an MRI can be a difficult test for some children. It can take a long time and often requires the patient to stay still in a confining tube for an extended period. Some children may require sedation or medication to help them relax in order to make this test less stressful.

Should the MRI or other imaging scan reveal a tumor, the next step is, when possible, to conduct a biopsy, in which some or all of the tumorous tissue is removed from the body and examined under a microscope. A biopsy may be done simultaneously with surgery to remove the entire tumor, or it may be done as a stand-alone procedure in order to determine next steps in treatment. In some cases, usually due to the location of the tumor in a sensitive or dangerous area of the brain or spinal cord, a physical biopsy may not be possible and diagnosis must be made on the basis of imaging alone.

Specific types of biopsies include:

  • Stereotactic needle biopsy: Guided by MRI or CT scans, the surgeon drills a very small hole into the skull precisely over the location of the tumor. A very small, hollow needle then withdraws a small part of the tumor. This approach is usually used to biopsy tumors in areas where surgery may be difficult or dangerous, but a sample of tissue is still required for precise diagnosis.
  • Craniotomy: If the surgical team believes that they can safely remove all or most of the tumor, a biopsy will be performed as the tumor is removed. Small samples of the tumor are examined immediately during the surgery to determine whether further surgery is required.
  • Lumbar puncture (spinal tap): This test is used to determine whether there are cancerous cells in the cerebrospinal fluid, or the fluid that surrounds the brain and spinal cord. The test involves removing some of the fluid through a small needle inserted between the bones of the spine.
  • Bone marrow aspiration and biopsy: This test may need to be done if it is believed the tumor has spread beyond the nervous system. During the aspiration, a small amount of liquid bone marrow is removed from a large bone, usually the hip bone, using a small, hollow needle. A biopsy involves removing a small piece of bone along with some of the marrow.

About American Childhood Cancer Organization

American Childhood Cancer Organization (ACCO) is a non-profit charity dedicated to helping kids with cancer and their families navigate the difficult journey from cancer diagnosis through survivorship. Internationally, ACCO is the sole U.S. member of Childhood Cancer International (CCI), the largest patient-support organization for childhood cancer in the world. Here in the United States, ACCO promotes the critical importance of ensuring continued funding into new and better treatment protocols for childhood cancer.  And most importantly, ACCO is focused on the children: developing and providing educational tools for children fighting cancer and their families, empowering them in their understanding of childhood cancer and the medical decisions they must make during this difficult journey. All of ACCO’s resources are available free of charge for families coping with childhood cancer.

For additional information about childhood cancer or on the ACCO, or to order resources for you or your child, please visit our website at www.acco.org , call 855.858.2226 or visit: