Childhood Brain & Spinal Cord Tumors

What are Brain & Spinal Cord Tumors

Brain and spinal cord tumors are abnormal growths of tissue that originate in the cells of the brain or spinal cord. Tumors in the spinal cord are less common than brain tumors. These types of tumors rarely spread outside of the central nervous system (CNS) which is made up of the brain and spinal cord.

Brain and spinal cord tumors are differentiated by grade. Low grade tumors are slow-growing and typically have a better prognosis than high-grade tumors. Low grade tumors may not require immediate treatment unless symptoms are present. These tumors can cause symptoms similar to high grade tumors because of their size and location in the brain.

High grade tumors are usually fast-growing and invade surrounding tissue. High grade tumors may recur after treatment.

Benign tumors do not contain cancer cells and once removed, typically do not come back. These tumors can cause symptoms similar to malignant tumors because of their size and location in the brain.

Malignant tumors contain cancer cells, and are usually fast-growing and invade surrounding tissue. Malignant brain tumors rarely spread outside of the brain and spinal cord, but they may recur after treatment.

Brain Tumor Types

There are many types of brain and spinal cord tumors. Some of the more common ones include:

Embryonal tumors. Developed from embryonic cells in the nervous system during gestation, these tumors are made up of poorly differentiated neuroepithelial cells. The most common are called atypical teratoid/rhabdoid tumors. After birth, most central nervous system (CNS) embryonal tumors in children grow quickly and spread to other parts of the brain and spine. These tumors may reoccur (come back) after treatment.
Ependymoma. Tumors that form in the cells that line the ventricles (fluid-filled spaces in the brain) and the center of the spinal cord. These tumors may reoccur (come back) after treatment.
Gliomas: The most common form of brain and spinal cord tumors at all ages are gliomas, developing in parts of the brain called glial cells. These cells make up more than half of the brain and help neurons function normally. There are several types of glial cells, and glioma tumors are named for the types of glial cells from which they develop. Types of gliomas include astrocytomas, anaplastic astrocytomas and glioblastomas.
Medulloblastoma. This relatively common tumor is fast-growing and often causes rapidly progressive symptoms. Most medulloblastomas can be treated effectively, despite the tumor’s aggressive nature.
Meningeal tumors. Developed in the membranes that surround the brain and spinal cord, these tumors, called meningiomas, are more common in adults than children.
Mixed neuronal-glial tumors. Formed as a mix of glial cells and neurons, these types of brain tumors tend to be small, slow growing, and relatively rare. Examples of these types of tumors are ganglioglioma and pleomorphic xanthoastrocytoma.
Tumors arising from non-neuroepithelial tissue. These tumors develop at the base of the brain and are usually slow growing in nature. These tumors include craniopharyngiomas and pineal region tumors, like germinomas.

What are the Symptoms of Brain & Spinal Tumors?

Symptoms of brain or spinal cord tumors depend on the tumor’s size, type and location. Symptoms may be caused when a tumor presses on a nerve or damages a part of the brain or spine. They may also be caused by a tumor blocking fluid that flows through and around the brain, causing the brain to swell.

Common symptoms include:

Headaches (usually worse in the morning)
Nausea and vomiting
Balance problems
Back pain or numbness
Changes in mood, personality or ability to concentrate
Changes in speech, vision or hearing
Memory problems
Numbness or tingling in the arms or legs
Seizures or convulsions
Scoliosis

How are Brain & Spinal Cord Tumors Diagnosed?

Diagnosis starts with a complete medical history and physical exam. Your child will likely get a computer tomography (CT) and/or magnetic resonance imaging (MRI) to help with diagnosis. Other procedures and tests may be needed to diagnose a brain or spinal cord tumor, including:

Biopsy
Lumbar puncture/spinal tap

How are Brain & Spinal Cord Tumors Treated?

A customized treatment plan is put together for your child based on:

The type of brain or spinal tumor
The tumor’s location and size
Your child’s age and general health
Your child’s tolerance for treatment
You and your child’s preferences

Surgery

Surgery is often the first step of treating brain and spinal cord tumors in children. The goal of surgery may vary on a case-by-case basis. Your child may need a biopsy (removal of small sample of the tumor) or a maximal safe resection (removal of a larger sample of the tumor) to aid in diagnosis and minimize further complications for the patient.

Medical Treatments

Medical treatments for brain and spinal cord tumors include:

Chemotherapy. Drugs that attack tumor cells
Stem cell transplant. This type of transplant, also referred to as bone marrow transplant, uses an infusion of healthy bone marrow to replace damaged or diseased bone marrow
Radiation therapy. High-energy particles or waves that kill or shrink cancer cells
Steroids. To help to relieve symptoms such as brain swelling and fluid retention

Supportive Care

Supportive care or treatments for brain and spinal cord tumors include:

Rehabilitation. This helps your child recover from lost or diminished physical functions. Rehabilitation may include physical therapy, occupational therapy, or speech therapy.
Follow-up care. To regularly monitor your child for worsening symptoms, tumor recurrence, effectiveness of treatment and manage any late effects of treatment.

Prognosis

Your child’s prognosis (long-term outlook) depends on:

The type of tumor
The size and location of the tumor
Metastasis (spreading of the tumor)
The tumor's response to therapy
The age and overall health of your child
Your child's tolerance of specific medicines, procedures or therapies

Each child’s prognosis is unique to his or her individual situation. Prompt and aggressive treatment based on an accurate diagnosis gives your child the best chance to overcome their disease. Long-term, continuous follow-up care is essential for the management of a child diagnosed with a brain or spinal cord tumor.

Key Points to Remember

Brain and spinal cord tumors are the most common childhood cancer, with approximately 5,000 American children and adolescents diagnosed with primary brain tumors each year.
The cause of brain & spinal cord tumors is typically unknown and it's important to remember that there is nothing you or your child could have done to prevent one from occurring.
The symptoms and treatment plan of a brain or spinal tumor depends on several factors, including the tumor's size, type and location as well as your child's age and overall health.
Surgery is often the first line of treatment for brain or spinal cord tumors.
Riley Children’s has access to various clinical trials and advanced care techniques, which may become part of your child’s treatment plan.

Support Services & Resources

Visit the links below to learn more about brain tumor support groups and resources.

We offer a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

The American Brain Tumor Association

The goal of this national association is to aid in funding brain tumor research and providing information and education about all tumor types in all age groups.

The American Cancer Society

The American Cancer Society is a national, community-based volunteer health organization that is dedicated to eliminating cancer as a major health problem. Learn more about brain and spinal cord tumors in children on its website.

Childhood Brain & Spinal Cord Tumors Research

We understand that research done today will make patient care better tomorrow. Lessons learned in labs and clinical trials are applied to the daily and long-term treatment plans of our patients. Our program is currently a member of the following clinical trials:

Children’s Oncology Group Phase I & Pilot Consortium
Pacific Pediatric Neuro-Oncology Consortium (PNOC)
National Experimental Therapeutics (NEXT) Consortium

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.

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