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Once a diagnosis has been made, doctors will then decide on a treatment plan. It may range from observation (no need for immediate therapy at all) to a combination of surgery (in which the tumor is physically removed during a surgical procedure), radiation therapy (which uses high-energy particles or waves, such as x-rays, to destroy or damage cancer cells), and aggressive chemotherapy (which uses drugs to treat the tumor). Your child's chance of recovery depends on a number of factors, including tumor type and location, and amount of tumor spread, or metastasis, but it's important to note that there are treatments available for every type of brain tumor.
Tumors that form in the tissues and cells of a child's brain are called primary brain tumors. In some cases, tumors that have originated in other parts of the body spread to the brain, but this is rare in children. The following is a list of some of the most common types of primary brain tumors found in children.
Astrocytomas (also known as gliomas)
Accounting for almost half of all childhood brain tumors, astrocytomas are tumors that arise in brain cells called astrocytes (astrocytes are star shaped cells in the central nervous system that support neurons and help remove debris). Astrocytomas can be further divided into the following types:
- Low-grade astrocytomas, which include Grade 1 (Juvenile pilocytic astrocytomas) and Grade 2 (Fibrillary astrocytomas) astrocytomas. They may be cured with surgery alone if they can be completely removed. If not, observation only may be considered. If additional treatment is required, radiation therapy is usually used for the older children and chemotherapy is used for the younger children.
- High-grade astrocytomas include Grade 3 (Anaplastic astrocytomas) and Grade 4 (Glioblastoma multiforme) astrocytomas. They are highly malignant tumors that have a much more guarded prognosis. Surgery, radiation therapy, and chemotherapy are usually recommended.
Also, diffuse pontine gliomas (a type of brain stem glioma) are highly malignant astrocytomas that occur in a very delicate part of the brain. Surgery cannot be done safely, and patients are usually treated with radiation therapy and may be candidates for new investigational treatments. Prognosis is very guarded.
Ependymomas
Ependymomas develop within the ependymal cells lining the brain's ventricles (a series of fluid filled cavities in the brain) and are treated with surgical resection and often with radiation therapy. Ependymomas, unlike astrocytomas, typically do not spread into normal, surrounding brain tissue. Children who have ependymomas that cannot be completely resected are often also treated with chemotherapy. Though there are no treatments unique to ependymomas, radiation therapy is an extremely important part of the typical treatment plan, often including the use of intensity modulated radiation therapy (IMRT) -- a targeted treatment that delivers high-doses of radiation to tumor cells while sparing surrounding healthy tissue.
