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Brain and Spinal Cord Tumors in Children
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- Can Brain and Spinal Cord Tumors in Children Be Found Early?
- Signs and Symptoms of Brain and Spinal Cord Tumors in Children
- Tests for Brain and Spinal Cord Tumors in Children
- Prognostic Factors for Brain and Spinal Cord Tumors in Children
- Survival Rates for Selected Childhood Brain and Spinal Cord Tumors
- Questions to Ask About Your Child’s Brain or Spinal Cord Tumor
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- Surgery for Brain and Spinal Cord Tumors in Children
- Radiation Therapy for Brain and Spinal Cord Tumors in Children
- Chemotherapy for Brain and Spinal Cord Tumors in Children
- Targeted Therapy Drugs for Brain and Spinal Cord Tumors in Children
- Drugs to Help with Symptoms in Children with Brain or Spinal Cord Tumors
- Treating Specific Types of Childhood Brain and Spinal Cord Tumors
- If Your Child Has a Brain or Spinal Cord Tumor
Prognostic Factors for Brain and Spinal Cord Tumors in Children
Why aren't brain and spinal cord tumors staged like other cancers?
For most types of cancer, the stage – a measure of how far the cancer has spread – is one of the most important factors in selecting treatment options and in determining a person's outlook (prognosis).
But tumors of the brain and spinal cord differ in some important ways from cancers in other parts of the body. One of the main reasons other types of cancer are dangerous is that they can spread throughout the body. Tumors starting in the brain or spinal cord can spread to other parts of the central nervous system, but they almost never spread to other organs. These tumors are dangerous because as they grow, they can interfere with essential functions of the brain.
Because most tumors in the brain or spinal cord do not usually spread, they do not have a formal staging system like most other types of cancer.
What factors can affect prognosis?
While these tumors aren't staged, there are other important factors that can help determine a child’s prognosis. These include:
- The type of tumor (such as astrocytoma, ependymoma, etc.)
- The grade of the tumor (how quickly the tumor is likely to grow, based on how the cells look under a microscope)
- The location and size of the tumor
- How much of the tumor can be removed by surgery (if it can be done)
- Whether the tumor cells have certain gene mutations or other changes
- The child’s age
- The child’s functional level (whether the tumor is affecting normal brain functions and everyday activities)
- Whether or not the tumor has spread through the cerebrospinal fluid (CSF, the fluid around the brain and spinal cord) to other parts of the brain or spinal cord
- Whether or not tumor cells have spread beyond the central nervous system
If your child has a brain or spinal cord tumor, talk to the treatment team to learn more about how these and other factors might affect your child’s outlook and treatment options.
Risk groups for medulloblastoma
Medulloblastomas are one of the most common types of brain tumors in children. Many clinical trials for treating medulloblastoma use a system that places children into either standard-risk or high-risk groups, based on certain factors. Children are placed in the high-risk group if any of these apply:
- The child is younger than 3
- A lot of the tumor can’t be removed during surgery
- Tumor cells are in the CSF or have spread to other parts of the brain or elsewhere
Doctors are still refining this system to make it as accurate as possible.
Along with these risk groups, medulloblastomas can also be grouped based on:
- How the tumor cells look under a microscope
- Whether the cells have certain gene changes
For example, based on gene changes, medulloblastomas can be divided into 4 types. Some of these tend to have a better outlook, so doctors may be able to use this to better tailor the treatment each child gets. (See What’s New in Research for Brain Tumors in Children?)
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Chang SM, Mehta MP, Vogelbaum MA, Taylor MD, Ahluwalia MS. Chapter 97: Neoplasms of the central nervous system. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Chintagumpala MM, Paulino A, Panigrahy A, et al. Chapter 26B: Embryonal and Pineal Region Tumors. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016.
Dorsey JF, Hollander AB, Alonso-Basanta M, et al. Chapter 66: Cancer of the central nervous system. In: Abeloff MD, Armitage JO, Niederhuber JE. Kastan MB, McKenna WG, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014.
Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization classification of tumors of the central nervous system: A summary. Acta Neuropathol. 2016;131(6):803-820.
Pomeroy SL. Clinical presentation, diagnosis, and risk stratification of medulloblastoma. UpToDate. 2018. Accessed at www.uptodate.com/contents/clinical-presentation-diagnosis-and-risk-stratification-of-medulloblastoma on April 26, 2018.
Williams D, Parsons IF, Pollack DA. Chapter 26A: Gliomas, Ependymomas, and Other Nonembryonal Tumors of the Central Nervous System. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016.
Last Revised: June 20, 2018
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