Tests are used to screen for different types of cancer.Some screening tests are used because they have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.Clinical trials that study cancer screening methods are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site.There is no standard or routine
Recurrent Adult Brain Tumors
SurgeryRe-resection of recurrent brain tumors is used in some patients. However, the majority of patients do not qualify because of a deteriorating condition or technically inoperable tumors. The evidence is limited to noncontrolled studies and case series on patients who are healthy enough and have small enough tumors to technically debulk. The impact of reoperation versus patient selection on survival is not known.Localized ChemotherapyCarmustine wafers have been investigated in the setting of recurrent malignant gliomas, but the impact on survival is less clear than at the time of initial diagnosis and resection. In a multicenter randomized, placebo-controlled trial, 222 patients with recurrent malignant primary brain tumors requiring reoperation were randomly assigned to receive implanted carmustine wafers or placebo biodegradable wafers. Approximately half of the patients had received prior systemic chemotherapy. The two treatment groups were well balanced at baseline.
Summary of Evidence
Note: Separate PDQ summaries on Neuroblastoma Treatment and Levels of Evidence for Cancer Screening and Prevention Studies are also available. Intervention Screening,usually at age 6 months,for urine vanillylmandelic acid and homovanillic acid,which are metabolites of the hormones norepinephrine and dopamine. Benefits Based on solid evidence,screening for neuroblastoma does not lead to ...
Classification of Central Nervous System Tumors
The classification of childhood central nervous system (CNS) tumors is based on histology and location. Tumors are classically categorized as infratentorial, supratentorial, parasellar, or spinal. Immunohistochemical analysis, cytogenetic and molecular genetic findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification, and will likely alter classification and nomenclature in the future.Primary CNS spinal cord tumors comprise approximately 1% to 2% of all childhood CNS tumors. The classification of spinal cord tumors is based on histopathologic characteristics of the tumor and does not differ from that of primary brain tumors.[2,3,4]Infratentorial (posterior fossa) tumors include the following:Cerebellar astrocytomas (most commonly pilocytic, but also fibrillary and less frequently, high-grade).Medulloblastomas (classic, desmoplastic/nodular, extensive nodularity, anaplastic, or large cell) and variants.Ependymomas (cellular, papillary,
To Learn More About Childhood Brain Tumors
For more information about childhood brain tumors, see the followingWhat You Need to Know About™ Brain TumorsComputed Tomography (CT) Scans and CancerPediatric Brain Tumor Consortium (PBTC)For more childhood cancer information and other general cancer resources, see the following:What You Need to Know About™ CancerChildhood CancersCureSearch for Children's CancerLate Effects of Treatment for Childhood CancerAdolescents and Young Adults with CancerYoung People with Cancer: A Handbook for ParentsCare for Children and Adolescents with CancerUnderstanding Cancer Series: CancerCancer StagingCoping with Cancer: Supportive and Palliative CareQuestions to Ask Your Doctor About CancerCancer LibraryInformation for Survivors/Caregivers/Advocates
Changes to this Summary (08 / 07 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.General InformationAdded text to state that the presence of the H3F3A K27M mutation occurs exclusively in diffuse high-grade pediatric astrocytomas (cited Gielen et al. as reference 35).Treatment of Childhood Low-Grade AstrocytomasAdded Gnekow et al. as reference 28.Added text to state that a multicenter, phase III, placebo-controlled trial of 117 patients confirmed these earlier findings; 35% of the patients in the everolimus group had at least a 50% reduction in the size of the SEGA, versus no reduction in the placebo group (cited Franz et al. as reference 54 and level of evidence 1iDiv).Treatment of Recurrent Childhood Low-Grade AstrocytomasAdded text to state that surveillance imaging will frequently identify asymptomatic recurrences (cited Udaka et al. as reference 4).Added Gnekow et al.
About This PDQ Summary
About PDQPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.Purpose of This SummaryThis PDQ cancer information summary has current
Incidence and MortalityAbout 7% of all malignancies in children younger than 15 years are neuroblastomas. About one quarter of cancers in the first year of life are neuroblastomas, making this the most frequent histological type of infant cancer.[1,2] The incidence rate of the disease in children younger than 1 year is about 35 per million but declines rapidly with age to about 1 per million between ages 10 and 14 years. Males appear to be affected slightly more commonly than females, with about five cases occurring in boys to every four occurring in girls. Screening Method and SensitivityThe risk factors for and causes of neuroblastoma have not been established, and therefore it is not possible to provide information or advice for the primary prevention of this disease. It is generally thought that many neuroblastomas are present and detectable at birth, thereby allowing for detection of tumors by a single, once-in-a-lifetime screening test, such as those used for neonatal
General Information About Neuroblastoma Cancer
Neuroblastoma is a disease in which malignant (cancer) cells form in nerve tissue.Neuroblastoma often begins in the nerve tissue of the adrenal glands. There are two adrenal glands, one on top of each kidney, in the back of the upper abdomen. The adrenal glands make important hormones that help control heart rate, blood pressure, blood sugar, and the way the body reacts to stress. Neuroblastoma may also begin in the abdomen, chest, spinal cord, or in nerve tissue near the spine in the neck.Anatomy of the female urinary system showing the kidneys, adrenal glands, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of each kidney. The urine flows from the kidneys through the ureters to the bladder. The urine is stored in the bladder until it leaves the body through the urethra.Neuroblastoma most often begins during early childhood, usually in children younger than 5 years of age.See the PDQ summary on Neuroblastoma Treatment for more
Tumor growth due to maturation should be differentiated from tumor progression by performing a biopsy and reviewing histology. Patients may have persistent maturing disease with metaiodobenzylguanidine (mIBG) uptake that does not affect outcome. When neuroblastoma recurs in a child originally diagnosed with high-risk disease, the prognosis is usually poor despite additional intensive therapy.[2,3,4,5] However, it is often possible to gain many additional months of life for these patients with alternative chemotherapy regimens.[6,7] Clinical trials are appropriate for these patients and may be offered. Information about ongoing clinical trials is available from the NCI Web site.Prognostic Factors for Recurrent NeuroblastomaThe International Neuroblastoma Risk Group Project performed a decision-tree analysis of clinical and biological characteristics (defined at diagnosis) associated with survival after relapse in 2,266 patients with neuroblastoma entered on large clinical