Treatment Options for Brain Tumors
Surgery
Usually, a child will need surgery to get a sample of the tumor. The neurosurgeon will determine which surgical method is most appropriate and try to remove as much of the tumor as possible. The sample of the tumor is sent out to a laboratory that looks at the cells under a microscope so that the type of tumor and genetic composition can be confirmed and used to select targeted treatments.
Tumor Location
- Depending on where the tumor is in the brain or spinal cord, complete removal of the tumor may not be possible. Certain areas of the brain are not safe to operate on because it will result in too much harm to the child. In this case, the child may need another type of treatment such as chemotherapy or radiation.
Hydrocephalus
- The brain is surrounded by fluid that is in constant motion around and inside the brain. This fluid is referred to as cerebral spinal fluid and is constantly moving. There are a few areas deep inside the brain that are filled with this fluid called ventricles. Sometimes, the tumor can get in the way of this flow and fluid will back up in the brain. Because these spaces act like reservoirs, they are most often the part of the brain where the fluid backs up and is referred to as hydrocephalus. Part of the reason for surgery is to relieve pressure from the fluid back up. In this case, the surgeon will have to insert a tube in the ventricles and attach it to a drain that allows excess fluid to be released.
Mediports
- Many of the medical treatment options can have uncomfortable side effects. Some of these side effects are directly related to the way the medicine is administered. For example, vincristine, a common chemotherapy drug, can damage the surrounding tissue if given through a small vein in the arm or leg (also called a peripheral line). To prevent this, children are often given a “mediport” (also called a central line) before starting any type of treatment. A “mediport” is a small device that is placed under the skin and channels directly into a larger vein that is better able to support the medication administration.
Chemotherapy
Chemotherapy is the administration of medicine that destroys fast growing cancer cells in the body. Although chemotherapy does not hurt, there are common side effects that offer because many healthy cells are destroyed alongside of the cancer cells. These side effects include hair loss, low appetite, weight loss, mouth sores, nausea and vomiting, diarrhea, constipation. To mitigate these side effects, chemotherapy is often administered in cycles so that the body can rest before the next cycle is given. These rest periods can range from a few days to a few weeks. The number of cycles given depends on the type of cancer being treated and how the child tolerates each cycle of chemotherapy. Each child is given an individual treatment plan that is continually monitored and adjusted throughout the course of treatment.
Anti-angiogenesis Therapy
Angiogenesis is the growth of new blood vessels. Since solid tumors need a blood supply in order to grow, anti-angiogenesis therapy acts to block the growth of new blood vessels which then limits the tumor’s blood supply and prevents growth. Similar to chemotherapy, this type of treatment is administered as a medication.
Blood and Marrow Transplantation
Nicklaus Children’s Cancer and Blood Disorders Institute offers Blood and Marrow Transplantation (BMT) when clinically indicated (also known as a stem cell transplant). Children who need high doses of chemotherapy are often offered this before starting treatment. As mentioned before, chemotherapy destroys healthy cells along with cancer cells which includes cells in the bone marrow and the blood stream. If the family decides to proceed with this procedure, the child’s own bone marrow and/or blood is removed and then stored in a freezer to then be given after high dose chemotherapy treatment is completed.
Radiation Therapy
Radiation therapy uses beams of intense energy to target the cancer cells and prevent them from replicating. This results in a decrease in the size of the tumor. The radiation itself does not hurt. Like chemotherapy, side effects from the radiation can occur and can include fatigue, nausea and vomiting, hair loss, low appetite, skin sensitivity, heightened emotions and learning difficulties. These side effects typically disappear within 6 to 12 weeks after treatment has ended.
Targeted Gene Therapy
By understanding the genetic make-up of each tumor, targeted therapies can be used to treat the tumor cells, minimizing damage to the healthy tissue. The Nicklaus Children's Hospital Cancer & Blood Disorders Institute offers proton TomoTherapy radiation treatment for cancer through a collaboration with the Miami Cancer Institute's Radiation Oncology Center. With additional support from the National Institute of Health, our team can conduct minimally invasive surgical techniques, symptom management and psychosocial support so that we can ensure the best possible outcomes and quality of life for the future.
Clinical Trials & Cancer Research
Research is being conducted across the country and at Nicklaus Children’s Hospital to find new cures, treatments and procedures for pediatric brain and spinal cord tumors. Nicklaus Children’s collaborates with national institutions to perform and investigate tumor biopsies. These provide detailed information about the tumor, to determine the best course of treatment that is often tailored to meet the needs of the child’s specific brain tumor and genetic makeup.
Learn more about cancer trials at Nicklaus Children’s Hospital.