If your child has been diagnosed with a brain or spinal cord tumor, you probably want to find the surest -- but safest -- way to treat it. Usually, that means surgery to remove the tumor. That’s often followed by other treatments, like radiation therapy or chemotherapy.
A neurosurgeon and other members of your child’s health care team should explain the nature of the tumor and the various treatment options. A number of things will determine what kind of treatment your doctor recommends.
Is Surgery Always Necessary?
No. A benign tumor is a concern, but it might not need to be removed right away. If your child’s tumor is slow growing or doesn’t appear to be changing, her doctor may decide to take a wait-and-see approach. He can monitor the tumor with the help of an MRI. This painless test uses a magnetic field and radio waves to produce images of the body’s interior.
Other Nonsurgical Treatments
In many cases, monitoring isn’t enough. The tumor may be cancerous and growing. If surgery isn’t an option, you still have others, such as:
Radiation therapy. This uses high-energy particles or waves to destroy cancer cells. It can also damage healthy cells around a tumor, and have serious effects on brain development. Radiation usually isn’t done on children under 3 years old.
Newer techniques are making radiation therapy more precise.
Both radiation therapy and chemo may cause nausea and fatigue. Spinal radiation therapy tends to cause more nausea than radiation of the brain. But radiation of the brain can cause children to lose some brain function.
Other possible side effects of chemo include:
- Sores in the mouth
- Loss of appetite and weight loss
- Hair loss
- Easy bruising and bleeding
- Increased risk of infections due to a weakened immune system
Craniotomy. This is the most common surgery to remove a brain tumor. The surgeon starts by cutting through the scalp. He removes a piece of skull to expose the brain. The goal is to remove the entire tumor or as much as possible (this depends on where the tumor is located). The surgeon places the piece of skull back into position and sews the scalp back together. If a new tumor appears or if your child continues to have symptoms, she may need a second surgery.
Neurendoscopy. A surgeon makes a small hole in the skull or goes through the nose or mouth, depending on the location of the tumor. He uses small tools to remove the tumor. One of these has a tiny camera that sends images back to a monitor next to the operating table. The surgeon uses these images to find and remove the tumor.
Spinal surgery. This can take many forms, depending on whether the tumor is in the lower back (lumbar) or the upper back (thoracic). Sometimes spinal surgery is done from the child’s front. Other times, it’s done from the back or even a combination of both. This approach may be necessary when the tumor is in a place that’s hard to reach safely and completely from one side.
Sometimes, doctors recommend radiation therapy or chemotherapy in addition to surgery to help make sure all the cancer cells are dead.
Brain and spinal surgeries are complicated and risky procedures. But new technologies and surgeon training are improving every year, giving children with tumors better odds than ever before.