Brain and Spine Tumors in Children

The Central Nervous System (CNS) comprises the brain and the spinal cord, whereas the Peripheral Nervous System (PNS) comprises the nerves and ganglia (tissue mass) outside the brain and the spinal cord.

Tumors of the nervous system are the second-most common pediatric tumors (after leukemia), comprising around 26 percent of all childhood cancers. Approximately 4,600 children every year are diagnosed with brain tumors in the U.S.

Surgery is the most common treatment for these children. Although, brain tumors in children are different than those in adults, and thus are treated differently.

Although brain and spine tumors have the highest death rate of childhood cancers, advancements in surgical techniques and adjunctive therapies in the past two decades have significantly improved survival rates and outcomes for these children.

Pediatric Brain and Spine Tumors

At ANA, we have wide experience with pediatric brain tumors. They are diagnosed most often between the ages of three and eight, but can occur at any age. Almost 60% of brain and spine tumors are diagnosed before the age of 10 years. For reasons undetermined, childhood brain tumors occur in males more frequently than in females.

There has also been an unexplained increase in the incidence of brain tumors in infants over the past 20 years. There is wide speculation that this seeming increase is due to earlier diagnosis since the emergence of MRI in the past decade or so; however, this does not explain why the increase is seen primarily in males.

Once diagnosed, the treatment of brain tumors in these young pediatric patients presents many difficult challenges owing to the nature of the developing brain. Treatment and prognosis for recovery depend on several factors, including the type of tumor, its location, and the general health and age of the child.

However, today, researchers have begun to unveil the molecular and genetic causes of these tumors, which has led to promising new therapies with the potential to further improve outcomes.

In this potentially overwhelming and stressful time, the entire team at ANA is here to provide you with clear and comprehensive explanations, expert diagnosis or a second opinion, as well as treatment options.

Brain Tumor Symptoms in Children

Possible symptoms include:

• Gradual loss of sensation or movement in an arm or leg
• Unsteady or imbalanced movement, especially if present with a headache
• Vision loss in one or both eyes, especially peripheral vision loss
• Double vision, particularly if associated with a headache
• Gradual onset of difficulty of speech
• Loss of hearing, with or without dizziness
• Possible nausea or vomiting (more severe in the morning), or extreme loss of appetite
• memory loss, disorientation, confusion
• Fever
• Fatigue, listlessness or pallor
• Swelling or lumps anywhere on the body
• Insomnia or sleeping too much
• Change in disposition, e.g., whining or crying spells, unusual irritability
• Regression of toilet habits
• Easy and frequent bruising
• Nosebleeds or bleeding from any part of the body

Other symptoms associated with, although not necessarily caused by, a brain tumor include:

• Headache – While headaches are the most evident symptom of the presence of a brain tumor, many people may suffer from persistent or severe headaches but do not have a brain tumor.
• Headaches that especially raise a red flag include: a steady headache that is worse in the morning, a persistent headache combined with nausea or vomiting, or a headache that includes weakness, numbness or double vision. These types of headaches indicate the possibility of a brain tumor.

It is important that if you or someone you know suspects a brain tumor, you seek medical attention. Persistent symptoms warrant an MRI or CT scan in order to gain a diagnosis. The earlier a brain tumor is detected and treated, the better the odds of increased survival.

Spinal Tumor Symptoms in Children

The predominant symptom of both benign and malignant spinal tumors is back pain not attributed to injury or stress and located especially in the middle or lower back. The pain may increase with activity and is often worse at night. The pain may also worsen over time, as well as spread to the hips, legs, feet or arms.

Depending on the type and location of the tumor, other symptoms may occur, and can include the following:

• Loss of sensation or muscle weakness in the legs, arms or chest
• Difficulty walking, which may cause falls
• Decreased sensitivity to pain, heat, and cold
• Loss of bowel or bladder function
• Paralysis that may occur in varying degrees and in different parts of the body, depending on which nerves are compressed
• Scoliosis or other spinal deformity resulting from a large, but benign tumor.

Clinical Trials for Pediatric Tumors

ANA has access to a wide range of clinical trials, to which our experts can guide a patient whenever beneficial and relevant.

Clinical trials are rigorously controlled tests of new drugs or medical devices or procedures. In the U.S., these trials are conducted under the direction of the FDA before they are made available for general clinical use.

Besides helping to develop future treatments with your child’s participation, the benefits of clinical trials with ANA is that you gain access to treatments that are not yet widely available. Moreover, in the case of pediatric cancer, clinical trials are a key factor in improving both treatments and prognosis.

Your team at ANA will explain the meaning and goals of Phase 1, 2 and 3 clinical trials, as well as the benefits and risks of participation in any relevant trial. As always, our goal is to build your trust by way of informing and including you.

One of the organizations with which ANA works is The Children’s Oncology Group (COG). COG is a National Cancer Institute-supported clinical trials group, which is the world’s largest organization devoted exclusively to childhood and adolescent cancer research.

In the fight against childhood cancer, the COG unites more than 10,000 experts in childhood cancer at more than 200 leading children’s hospitals, universities, and cancer centers across North America, Australia, New Zealand, and Europe.

In only 50 years, the research from COG has turned children’s cancer from a virtually incurable disease to one with a combined 5-year survival rate of 80%.

Our goals are as follows:

• Cure all children and adolescents with cancer
• Reduce the short- and long-term complications of cancer treatments
• Determine the causes and find ways to prevent childhood cancer

Dr. Fried is also on the Medical Advisory Board of Virtualtrials.com. This organization is funded by The Musella Foundation For Brain Tumor Research & Information, Inc, a 501(C)3 nonprofit public charity dedicated to helping brain tumor patients through emotional and financial support, education, advocacy, and raising money for brain tumor research.

In summary, one may say that in the diagnosis and treatment of the complicated malady of brain tumors, it takes a village. That is the unique understanding and collaborative approach at Advanced Neurosurgery Associates.