• Brain Tumor and Brain Cancer—Child

    Definition

    A brain tumor is a disease in which cells grow uncontrollably in the brain. Cancer occurs when cells in the body divide without control or order. If cells divide uncontrollably, they form a mass of tissue. The mass is called a growth or tumor. The term cancer usually refers to malignant tumors. These can invade nearby tissue and can spread to other parts of the body. A benign tumor does not spread. But it can continue to grow and press on structures near it, causing symptoms.
    Brain cancer can fall into two categories:
    • Primary brain cancer—These begin in the brain. They can be either malignant or benign. A small benign tumor in a bad location can cause many problems.
    • Secondary or metastatic brain cancer—These tumors have spread to the brain from another site. Metastatic tumors are malignant.
    Brain Tumor
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    Causes

    The cause of most primary brain cancer is unknown. Researchers believe that the tumors may be due to defects in genes. These defects trigger cells to grow uncontrollably.
    Secondary brain cancer is caused by the cancer spreading to the brain from another site.

    Risk Factors

    These factors increase your child’s chance of developing brain tumors:
    • A genetic condition (eg, retinoblastoma )
    • Being exposed to radiation
    • Being exposed to certain chemicals
    • A condition that affects the immune system
    • Family history of certain types of cancer

    Symptoms

    Symptoms depend on how large the tumor is and where it is located. The extra tissue and fluid, which can build up around the tumor, can cause:
    • Headache— Note: Most headaches are not caused by tumors.
    • Nausea and vomiting
    • Personality changes
    • Confusion
    • Irritability
    • Drowsiness
    • Depression
    • Weakness or numbness in the arms or legs
    • Seizures
    • Vision or hearing changes, including double vision
    • Memory loss
    • Problems with speech

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Your child will have a neurologic exam. This will test muscle strength, coordination, reflexes, response to stimuli, and alertness. The doctor may also look into your child’s eyes to check for signs of brain swelling.
    Tests may include:
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
    • PET scan —a test that uses a radioactive substance to view active parts of the brain
    • Arteriography —a type of x-ray that uses contrast dye to create pictures of blood vessels in the brain
    • Biopsy —removal of a sample of brain tissue to test for cancer cells (may involve a small needle being inserted into the brain or a larger surgery)
    There are many different types of brain tumors. The doctor will classify the type. The type of brain tumor is important in determining the treatment approach.

    Treatment

    Treatment depends on the type, size, and location of the cancer. It also depends on your child’s overall health. Treatments may cause physical or mental limitations.

    Medications

    In some cases, the doctor may recommend that your child takes medicine, such as:
    • Corticosteroids—to reduce swelling in the brain
    • Anticonvulsants—to prevent seizures

    Surgery

    Examples of surgical procedures used to treat brain tumors include:
    • Craniotomy —opening the skull to remove the tumor (or as much of the tumor as possible)
    • Placement of a shunt—implanting a long thin tube in the brain to divert built-up fluid to another part of the body

    Chemotherapy and Radiation Therapy

    Chemotherapy is the use of drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. The doctor may choose to deliver the drugs into cerebrospinal fluid. This is fluid that surrounds the brain tissue.
    Radiation therapy is the use of radiation to kill cancer cells or shrink tumors. This is a common treatment for brain tumors. Radiation may be used alone or along with chemotherapy.
    Since your child is still developing and may have lost skills, the rehab therapy team will be an important part of treatment. The team may include:
    • Physical therapist to help with walking, balance, and building strength
    • Occupational therapist to help with life skills (eg, dressing, eating, using the toilet)
    • Speech therapy to help with communication and other issues (eg, swallowing difficulties)
    Your child may also work with an educational specialist to help him transition back to school and to help with learning problems.

    Prevention

    Since the exact cause is unknown, there is no way to prevent brain tumors.

    RESOURCES

    American Brain Tumor Association http://www.abta.org/

    American Cancer Society http://www.cancer.org/

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca/

    Cancer Care Ontario http://www.cancercare.on.ca/

    References

    American Association of Neurological Surgeons. Brain tumors. Neurosurgery Today.org website. Available at: http://www.neurosurgerytoday.org/what/patient%5Fe/brain2.asp . Updated March 2006. Accessed June 30, 2010.

    Children’s Hospital Boston. Brain tumors. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site659/mainpageS659P0.html . Accessed June 30, 2010.

    Children’s Hospital of Wisconsin. Brain tumors. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/router.asp?DocID=22484#22484%5F8 . Accessed June 30, 2010.

    DynaMed Editorial Team. Brain tumor. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 22, 2010. Accessed June 30, 2010.

    Editorial staff and contributors. PET scan. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 9, 2009. Accessed June 30, 2010.

    Pediatric brain and spinal cord tumor center. Comer Children’s Hospital, the University of Chicago website. Available at: http://www.uchicagokidshospital.org/specialties/cancer/brain-spinal/index.html . Accessed July 10, 2010.

    Wood D. Brain tumor and brain cancer. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 30, 2009. Accessed June 30, 2010.

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