Brain Tumors

Pediatric Cancers - Brain Tumors

What is a brain tumor?

A brain tumor is an abnormal growth of tissue in the brain. The tumor can either originate in the brain itself (primary brain tumor), or come from another part of the body and travel to the brain (metastastic or secondary brain tumor). Brain tumors may be classified as either benign (noncancerous) or malignant (cancerous), depending on their behavior.

A benign tumor does not contain cancer cells and usually, once removed, does not recur. Most benign brain tumors have clear borders, meaning they do not invade surrounding tissue. These tumors can, however, cause symptoms similar to cancerous tumors because of their size and location in the brain.

Malignant brain tumors contain cancer cells. Malignant brain tumors are usually fast growing and invade surrounding tissue. Malignant brain tumors very rarely spread to other areas of the body, but may recur after treatment. Sometimes, brain tumors that are not cancer are called malignant because of their size and location, and the damage they can do to vital functions of the brain.

Metastatic brain tumors are tumors that begin to grow in another part of the body, then spread to the brain through the lymph system and bloodstream. Common types of cancer that can travel to the brain include lung cancer, breast cancer, nasopharygeal cancer, melanoma (a type of skin cancer), and colon cancer. These cancers are described and treated based on the specific type of cancer. For example, breast cancer that has spread to the brain is still called breast cancer.

The American Cancer Society states that no apparent reason can be found for the development of brain tumors in children. Brain tumors cannot be directly linked to something the parents or child did or did not do.

In addition, both the American Academy of Pediatrics and the National Cancer Institute recommend that children receive cancer diagnosis and treatment at one of the more than 200 medical centers in the U.S. that specialize in pediatric cancers. The organizations cite research studies that show 20 to 40 percent higher survival rates when children receive care in such specialized centers.

Facts about brain tumors

According to the National Cancer Institute:

Illustration of lateral view of brain and divisions into cerebrum, cerebellum and brainstem
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What causes brain tumors?

The majority of brain tumors have abnormalities of genes involved in cell cycle control, causing uncontrolled cell growth. These abnormalities are caused by alterations directly in the genes, or by chromosome rearrangements which change the function of a gene.

Patients with certain genetic conditions (neurofibromatosis, von Hippel-Lindau disease, Li-Fraumeni syndrome, and retinoblastoma) also have an increased risk of developing tumors of the central nervous system. There have also been some reports of people in the same family developing brain tumors who do not have any of these genetic syndromes.

Some chemicals may change the structure of a gene that protects the body from diseases and cancer. Research has been investigating parents of children with brain tumors and their past exposure to certain chemicals, including pesticides and petroleum products.

Patients who have received radiation therapy to the head as part of prior treatment for other malignancies are also at an increased risk for new brain tumors.

What are the symptoms of a brain tumor?

The following are the most common symptoms of a brain tumor. However, each person may experience symptoms differently. Symptoms vary depending on the size and location of tumor. Many symptoms are related to an increase in pressure in or around the brain, except in very young children (whose skull bones have not yet fused together), as there is no spare space in the skull for anything except the delicate tissues of the brain and its fluid. Any tumor, extra tissue, or fluid can cause pressure on the brain and result in increased intracranial pressure (ICP), which may result from one or more of the ventricles that drain cerebral spinal fluid (CSF, the fluid that surrounds the brain and spinal cord) becoming blocked and causing the fluid to be trapped in the brain. This increased ICP may cause the following:

Symptoms of brain tumors in the cerebrum (front of brain) may include:

Symptoms of brain tumors in the brainstem (base of brain) may include:

Symptoms of brain tumors in the cerebellum (back of brain) may include:

The symptoms of a brain tumor may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is a brain tumor diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for brain tumors may include the following:

Diagnosis of a brain tumor depends mostly on the types of cells involved and the tumor location.

What are the different types of brain tumors?

Illustration of  the brain detailing common tumor sites, adult
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There are many different types of brain tumors. They are usually categorized by the type of cell where the tumor begins, or they are also categorized by the area of the brain where they occur. The most common types of brain tumors include the following:

Treatment for brain tumors

If your child has been diagnosed with a brain tumor, you may want to consider getting a second opinion before beginning treatment. In fact, some insurance companies require a second opinion for such diagnoses. According to the American Cancer Society, it is very rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort.

Specific treatment for brain tumors will be determined by your doctor based on:

Treatment may include (alone or in combination):

Newer therapies that may be used to treat brain cancer include the following:

Long-term outlook for a person with a brain tumor

Prognosis greatly depends on all of the following:

As with any cancer, prognosis and long-term survival can vary greatly from individual to individual. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for a person diagnosed with a brain tumor. Side effects of radiation and chemotherapy, as well as second malignancies, can occur in survivors of brain tumors.

Rehabilitation for lost motor skill and muscle strength may be required for an extended amount of time. Speech therapists and physical and occupational therapists may be involved in some form of rehabilitation. More research is needed to improve treatment, decrease side effects of the treatment for this disease, and develop a cure. New methods are continually being discovered to improve treatment and to decrease side effects.

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