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Childhood Brain Tumors: Staging and Prognosis Factors

Childhood Brain Tumors: Staging and Prognosis Factors

Childhood Brain Tumor Cancer – Stages and Prognosis

When discussing childhood cancer, we often hear about the “stage” of the cancer. What does that mean, and is it relevant when discussing brain tumors in children? When oncologists first diagnose a case of cancer, part of the diagnosis usually involves an assessment of how and where the cancer has spread from the original point of growth. This assessment is known as “staging”. For many types of pediatric cancer, the “stage” of the cancer is an important factor in developing an appropriate treatment plan and determining the patient’s prognosis, or outlook.

Brain Tumors childIs staging relevant for childhood brain tumors? In fact, this is one of the major differences between brain tumors and other types of cancers in children. Regardless of whether they are malignant (cancerous) or benign (non-cancerous), brain tumors in children rarely spread to other organs beyond the central nervous system (which includes the brain and the spinal cord). Therefore, oncologists do not utilize a formal staging system when diagnosing and treating brain cancers.

Yet although brain tumors do not generally present a threat to other organs of the body, both malignant and benign tumors can be extremely dangerous—and often life-threatening—as they interfere with the brain’s ability to function normally. As a brain tumor grows, it will press on, impede, or otherwise impair the healthy brain tissue nearby, depending on its precise location. Therefore, the location, size, and rate of growth are used to determining both treatment options and long-term prognosis, instead of more traditional “staging” used when diagnosing other types of cancers.

Prognosis Factors for Childhood Brain Tumors

Instead of staging, oncologists dealing with a diagnosis of a brain tumor will look at “prognosis factors” to help determine treatment options and to help assess each child’s potential for long-term survivorship. Some key prognosis factors include:

  • The type of tumor: a brain tumor’s “type” is based on the type of cells from which the tumor began to grow. Some of the most common types of brain tumors in children include: gliomas (almost 50% of all brain tumors in children) such as glioblastomas, oligodendrogliomas, ependymomas, and brain stem gliomas; astrocytomas, and embryonal tumors (10-20% of all brain tumors in children) such as medulloblastomas.
  • The tumor’s “grade”: A tumor is “graded” based on how quickly it is growing. Most oncologists use a four-level system of grading when dealing with brain tumors in children. Low grade tumors (grade I or grade II) usually grow relatively slowly and are less likely to invade or infiltrate adjacent healthy brain tissue. High grade tumors (grade III or grade IV) grow relatively quickly and are considered invasive. High grade tumors usually require a more aggressive treatment approach.
  • The tumor’s location and size: The location and size of the tumor will greatly impact the symptoms the tumor causes, due to the specific functionality of the healthy brain tissue impacted by the growth of the tumor. Location and size will also determine treatment options; whether the tumor can be surgically removed, and how much of the tumor can be surgically removed, will greatly impact both treatment options and long-term prognosis.

Other prognosis factors for childhood brain tumors include:

  • Whether the tumorous cells have specific gene mutations
  • Whether the tumor has spread to other parts of the brain or spinal cord via the cerebrospinal fluid
  • Whether tumorous cells have spread beyond the central nervous system
  • The child’s age and functional abilities as impacted by the tumor

Just as every child is unique, so each cancer diagnosis is unique as well. If your child has been diagnosed with a brain tumor (whether benign or malignant), your child’s oncology team will ensure that you understand all of these prognosis factors as they relate to your child and his or her type of cancer. While the general guidelines contained here and in other similar literature are important, they are just that: only general guidelines. Only your child’s oncology team can determine your child’s key prognosis factors and their implications for long-term survivorship.

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 more information about the American Childhood Cancer Organization and how we can help, call 855.858.2226 or visit:

Gold Ribbon Hero: Colton R.

unnamed-6Meet Colton, a Super Mario collector and identical twin brother to Jaiden. He loved watching Spongebob and wanted to be a chef when he grew up. Colton was diagnosed with diffuse intrinsic pontine glioma (DIPG) in 2016 and fought a hard battle before losing his life after 16 months.unnamed-3

On the morning of October 10, 2016, Colton’s mom noticed that Colton’s walk was abnormal. Thinking it was just a sleepy walk, Shannon sent him to school. When the nurse called Shannon, she knew that something was wrong. The nurse suspected a stroke because Colton was exhibiting left sided weakness and urged her to take Colton to the emergency room. The doctor appeared very concerned and instructed Shannon to take him to the nearest children’s hospital two hours away. Following an MRI, the oncologist and neurologist confirmed the diagnosis of DIPG. The family was told there was no cure for DIPG and at best, they had 9-12 months left with Colton.  “We were devastated, not only did our child have a brain tumor, but one that had less than a 1% survival rate,” Shannon remembers.

unnamed-1According to Shannon, “radiation would only buy us time and there were trials we could participate in, but none were proven to save our child at this point.” During his treatment, Colton had multiple labs done, hospital stays, pneumonia, seizures and eventually lost his ability to walk, talk and swallow. He endured 30 rounds of radiation with a smile on his face. He also participated in a clinical trial for a year at Cincinnati Children’s Hospital.

Shannon said that, “Colton was so incredibly brave through all he endured. He kept a smile on his face and never let his diagnosis get him down even when he lost his ability to walk and talk he kept a smile on his face. As a family we have created the Team Colton DIPG Foundation to assist other families battling DIPG. We continue to spread awareness for Childhood cancer and pray for the day when no family is ever told there’s no more we can do.”unnamed-5

The Ritchie family has established Team Colton DIPG Foundation that offers grants to families of children battling DIPG.  You can learn more about them here: https://www.facebook.com/groups/270014580059933/?ref=share

To learn more about DIPG: https://www.acco.org/brain-cancers/

To purchase the DIPG book: https://store.acco.org/collections/acco-books-and-information-resources/products/understanding-the-journey-a-parents-guide-to-dipg

Donate to help kids fight cancer: https://www.acco.org/donate/

 

Potential Treatment Options for Childhood Brain Tumors

Childhood Brain Cancer Treatment

 

Potential Treatment Options for Childhood Brain TumorsThe brain is the “command center” for our entire central nervous system, yet despite its critical role in every aspect of human life, it is one of the most delicate organs in the entire body. Any abnormal growth, or tumor, in the brain—whether technically malignant (cancerous) or benign (non-cancerous)—can cause serious damage to the healthy brain tissue and significantly impact the body’s ability to function normally. Therefore, treating a brain tumor requires taking into consideration

  • how to best remove/eliminate the tumor;
  • how to relieve symptoms caused by the tumor; and
  • how to minimize damage to the healthy tissue of the brain.

As with all types of childhood cancer, every child will have a unique treatment plan based on his or her specific type of cancer; for brain tumors, the treatment plan will depend specifically on the type of tumor, the size and location of the tumor, the grade of the tumor, and the impact of the tumor on healthy brain tissue. In general, however, treatment for brain tumors in children generally involves three types of treatment:

  • Surgery
  • Radiation Therapy
  • Chemotherapy

Whenever possible, treatment will usually begin with surgery, with the goal of removing all or at least most of the tumor. Radiation therapy and/or chemotherapy may follow surgery in order to (1) eliminate any remaining tumor cells that could not be removed during the surgery and/or (2) prevent the tumor from re-growing if possible. Radiation therapy and chemotherapy will play a more central role in treating brain tumors that cannot be safely removed through surgery; however, because surgery is usually the first line of treatment, this blog will focus on surgical options for brain tumors in children.

Surgical Treatment for Brain Tumors in Children

The goal of surgery as treatment for a brain tumor is, in most cases, to remove or destroy as much of the tumor as possible while minimizing damage to the surrounding healthy tissues of the brain. In some cases, the surgery may serve as a simultaneous opportunity to conduct a biopsy, which involves collecting a sample of the tumor to be examined under a microscope; this may be required to determine the type of tumor and whether the tumor has specific gene mutations (changes) that could impact long-term prognosis. The biopsy, if necessary, will help your child’s oncology team determine post-surgical treatment options.

The most common type of surgical procedure for treatment of a brain tumor is a craniotomy. Depending on the location of the tumor, and whether brain function must be assessed during the procedure, the child may be under general anesthesia or may remain awake under local anesthesia. The surgeon will remove a piece of skull (the boney area of the head that protects the brain) large enough to enable him or her to insert instruments and view the brain under operation, if necessary and if possible. The tumor may be cut out with a scalpel or special scissors or it may be suctioned out with a specialized device, and then the removed piece of bone reattached to the skull.

Today’s surgeons utilize modern imaging technology as much as possible both before and during surgery to precisely locate and map the edges of the tumor. Imaging tests such as MRIs and CT scans before surgery, and ultrasounds during surgery, maximize the surgeon’s ability to identify and remove tumorous cells while reducing the risk of removing healthy tissue. Some specialized imaging tests, such as Functional MRIs, Intraoperative cortical stimulation, and intraoperative imaging also enable the surgeon to detect a particular function of the brain to help remove the tumor as safely and as extensively as possible.

The idea of brain surgery can be scary, for children and parents alike. Luckily, our knowledge of the brain continues to advance each and every day, as does our ability to harness the power of advanced tools and techniques, making brain surgery safer and more successful than ever. We encourage you to share your concerns—and your child’s concerns—with your child’s oncologist and surgical team right up front, so they can ensure that you and your child are as comfortable as possible throughout the entire treatment process.

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 more information about the American Childhood Cancer Organization and how we can help, call 855.858.2226 or visit: