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.
Is 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.