Brain tumours are the second most common type of cancer in children in developed countries and unfortunately remain a challenge to treat with higher rates of morbidity than for other childhood cancers. Brain tumours can present at any age in childhood and generally occur more in boys than girls.
The two most common types of childhood brain tumor are:
- Gliomas (astrocytomas and ependymomas) – which arise from the supportive tissue of the brain, and can be found in any part of the organ.
- Medullablastomas – which develop in the cerebellum at the back of the brain.
Signs and Symptoms
When bone marrow and other organs are affected by leukaemia blast cells then clinical signs and symptoms present themselves. The most common signs and symptoms are
- Vomiting (sometimes without nausea)
- Altered state of consciousness (somnolence, coma)
- Dilatation of the pupil on the side of the lesion (anisocoria)
- Visual disturbances
- Convulsion (fits)
- Cranial nerve disorders.
Headache and vomiting are common in children however, if the two occur together for more than weeks, the child should be taken to the specialist.
CT and MRI scans are used to identify the exact location of the possible tumour and a biopsy may be taken to confirm the type.
The mode of treatment depends on the type and site of tumor and on the age of the child. Surgery is often the first line of treatment and usually aims to remove as much of the tumour as possible with the least amount of damage to intact brain function as possible. A shunt or ventriculostomy may be performed to relieve hydrocephalus (the accumulation of cerebrospinal fluid within the skull).
Some brain tumours are more radio-sensitive than others. However, radiation can cause devastating side effects on the developing brains, therefore treatment is limited to children over the age of 5 if possible, to help reduce long-term effects
Chemotherapy is used increasingly to treat children of all ages with a CNS tumour. A variety of drugs are used and these can also be given to infants in an attempt to delay tumour growth until the child is old enough to receive radiotherapy.
Prognosis is related to the success of surgery (whether the tumour was completely removed rather than cancer cells remaining) the type of tumour, and its location. Over all 60% children with brain tumor are expected to be long term survivor. Unfortunately lot of these children can have late effects of treatment that can impair their physical, cognitive, neurological or endocrinological functions. Close follow up is therefore essential to monitor progress, provide support and for early detection of relapse or secondary malignancies.