Brain and Spinal Cord Tumors

General Information | Treatment Options | Resources

 

Treatment
  • Overview
  • Standard Treatment
  • Clinical Trials
  • Treatment By Type

There are different types of treatment for children with brain and spinal cord tumors.

Different types of treatment are available for children with brain and spinal cord tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Clinical trials are taking place in many parts of the country. Some clinical trials are open only to patients who have not started treatment.

Children with brain or spinal cord tumors should have their treatment planned by a team of health care providers who are experts in treating childhood brain and spinal cord tumors.

Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children with brain tumors and who specialize in certain areas of medicine. These may include the following specialists:

  • Neurosurgeon.
  • Neurologist.
  • Neuro-oncologist.
  • Neuropathologist.
  • Neuroradiologist.
  • Radiation oncologist.
  • Endocrinologist.
  • Psychologist.
  • Ophthalmologist.
  • Rehabilitation specialist.
  • Social worker.
  • Nurse specialist.

Childhood brain and spinal cord tumors may cause symptoms that begin before diagnosis and continue for months or years.

Childhood brain and spinal cord tumors may cause symptoms that continue for months or years. Symptoms caused by the tumor may begin before diagnosis. Symptoms caused by treatment may begin during or right after treatment.

Some cancer treatments cause side effects months or years after treatment has ended.

These are called late effects. Late effects of cancer treatment may include the following:

  • Physical problems.
  • Changes in mood, feelings, thinking, learning, or memory.
  • Second cancers (new types of cancer).

Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information).

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

Three types of standard treatment are used:

Surgery

Surgery may be used to diagnose and treat childhood brain and spinal cord tumors as discussed in the General Information section of this summary.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Radiation therapy to the brain can affect growth and development in young children. For this reason, clinical trials are studying ways of using chemotherapy to delay, reduce, or end the need for radiation therapy. Also, ways of giving radiation therapy that lessen damage to healthy brain tissue are being used. Stereotactic radiosurgery is a type of radiation therapy that uses a rigid head frame attached to the skull to aim high-dose radiation beams directly at the tumors, which causes less damage to nearby healthy tissue. It is also called stereotaxic radiosurgery and radiation surgery. This procedure does not involve surgery.

The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Anticancer drugs given by mouth or vein to treat brain and spinal cord tumors cannot cross the blood-brain barrier and enter the fluid that surrounds the brain and spinal cord. Instead, an anticancer drug is injected into the fluid-filled space to kill cancer cells there. This is called intrathecal chemotherapy.

New types of treatment are being tested in clinical trials.

This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.

High-dose chemotherapy with stem cell transplant

High-dose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Childhood Astrocytoma

Childhood astrocytomas include both low-grade and high-grade astrocytomas. See the PDQ summaries on Childhood Cerebral Astrocytoma/Malignant Glioma Treatment, Childhood Cerebellar Astrocytoma Treatment, and Childhood Visual Pathway and Hypothalamic Glioma Treatment.

Childhood Brain Stem Glioma

See the PDQ summary on Childhood Brain Stem Glioma Treatment for information.

Childhood Central Nervous System Embryonal Tumors

Childhood central nervous system (CNS) embryonal tumors include ependymoblastoma, medulloblastoma, medulloepithelioma, pineal parenchymal tumors, pineoblastoma, and supratentorial primitive neuroectodermal tumors.(See the PDQ summary on Childhood Central Nervous System Embryonal Tumors Treatment for more information.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood embryonal tumor.

Childhood Central Nervous System Germ Cell Tumors

Treatment of childhood CNS germ cell tumors may include:

  • Radiation therapy, usually to the whole brain and spine.
  • Chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood central nervous system germ cell tumor.

Childhood Craniopharyngioma

Treatment of childhood craniopharyngioma may include the following:

  • Surgery and/or radiation therapy, which may include internal or external radiation therapy or stereotactic radiosurgery.
  • Regional chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood craniopharyngioma.

Childhood Ependymoma

See the PDQ summary on Childhood Ependymoma Treatment for information.

Childhood Medulloblastoma

See the PDQ summary on Childhood Central Nervous System Embryonal Tumors Treatment for information.

Childhood Spinal Cord Tumors

Treatment of childhood spinal cord tumors may include the following:

  • Surgery with or without radiation therapy.
  • Chemotherapy. (In very young children, chemotherapy is used only for low-grade tumors.)

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood spinal cord neoplasm.

Childhood Supratentorial Primitive Neuroectodermal Tumors and Pineoblastoma

See the PDQ treatment summary on Childhood Central Nervous System Embryonal Tumors Treatment for information.

Childhood Visual Pathway and Hypothalamic Glioma

See the PDQ summary on Childhood Visual Pathway and Hypothalamic Glioma Treatment for information.

Cancer information from the NCI PDQ service