Spinal Cord Tumors
Together, the brain and the spinal cord make up the central nervous system (CNS), which is responsible for controlling nearly all of our bodily functions. We often think of the spinal cord as the “back bone”, or the collection of vertebrae that we can feel running up the back. In fact, these vertebrae serve to protect the spinal cord, a delicate column of nerve tissues responsible for carrying critical informational signals between the brain and the body.
When classifying childhood cancers and discussing important statistics, tumors of the brain and tumors of the spinal cord are often lumped together as one broad grouping (although, of course, when diagnosing childhood cancer, each tumor is specified as a more specific “type”). And in general, treatment options for both spinal cord tumors and brain tumors are the same, usually consisting of some combination of
- Radiation therapy; and/or
However, generally speaking, spinal cord tumors are often significantly more difficult to treat with surgery; therefore, for many (but not all) patients, radiation therapy and/or chemotherapy will play a larger role in the treatment of spinal cord tumors than it does for some of the more common types of brain tumors.
Radiation Treatment for Spinal Cord Tumors
Because of their location in the spinal cord, and how they grow and interact with the delicate nerves of the spinal cord, spinal cord tumors are—in general—more difficult to treat with surgery alone. In some cases, the tumor cannot be removed entirely, although surgery may be used to remove as much of the tumor as possible. In other cases, the location of the tumor makes it impossible to access the tumor safely; in other words, surgically removing the tumor may cause too much damage to the healthy tissue of the spinal cord.
Unfortunately, radiation therapy affects healthy tissue as well as tumorous tissue, although not as quickly. Therefore, every radiation therapy treatment is designed to maximize damage to the tumor—enough to destroy as many cancerous cells as possible and (hopefully) prevent the tumor from re-growing—while minimizing potential damage to healthy tissue. However, the short- and long-term side effects of radiation therapy are potentially dangerous, and therefore the risk of radiation therapy as a treatment tool must be weighed against the benefits it offers in the fight against childhood cancer. In general, as the risk of long-term side effects is higher in younger children, radiation therapy is usually not recommended for children under 3 except as a last resort. Your child’s oncology team will help you understand the risks and benefits of radiation therapy as a potential treatment option, to ensure that you are educated in the best treatment options for your child.
Treatment Options for Some Common Types of Spinal Cord Tumors
We will present some of the most common types of spinal cord tumors and their “recommended” treatment options here; however, it is important to remember that every child and every diagnosis is unique. Your child’s oncology team will develop an appropriate treatment specifically for your child.
- Astrocytomas of the spinal cord: generally cannot be removed entirely with surgery. Surgery may be used to remove some of the tumor, followed by radiation therapy; some cases may require only radiation therapy.
- Meningiomas: usually can be treated solely with surgery.
- Ependymomas: generally can be removed through surgery, may be followed by with radiation therapy.
- Choroid plexus tumors: benign papillomas are usually treated with surgery. Choroid plexus carcinomas are malignant, and while surgery can remove the tumor entirely, most oncologists will recommend following surgery with radiation therapy and/or chemotherapy.
- Craniopharyngiomas: because these tumors usually grow very close to the pituitary gland, the optic nerves, and blood vessels critical to the brain, they are difficult to reach surgically. Surgery may be used to “debulk” the tumor (remove most of it); radiation therapy is the most common approach.
- Germ cell tumors: surgery may be used to diagnose the type of germ cell tumor (germinoma, teratomas, and yolk sac tumors are the most common types), but can rarely remove it. Radiation therapy or a combination of radiation therapy and chemotherapy is the most common treatment approach.
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.