Brain tumours in children or medically called pediatric brain tumours are abnormal masses or growth of cells which occur in the brain of the child or the tissues and structures near the brain. There are many types of pediatric brain tumours; some are cancerous or malignant while others are non-cancerous or benign.
The treatment and the recovery of the tumour depend on the kind of tumour, area in the brain, aggressiveness of the tumour, general health and age of the child. This is a very widely studied area; hence, multiple treatment options are available for the treatment of children with brain tumours.
The brain is composed of nerve cells and tissues and has three parts: brain stem that controls the activities of the body, cerebellum which indicates function such as walking and cerebrum that controls senses such as memory, emotions, thoughts and personality. Primary brain tumours either malignant or benign occur in the brain tissue first; however, it can spread to other parts of the tumour is cancerous. When the tumour spreads these tumours are known as secondary or metastatic brain tumours.
Some facts about brain tumours are:
- Brain tumours can occur at any age
- The exact cause of brain tumour cannot be identified
- Factors such as exposure to radiation and family history are likely to make one at more risk of developing tumour
- Signs and symptoms of a brain tumour depend on the type of tumour, location of the tumour, size of the tumour
Symptoms of Brain Tumor in Children
As mentioned, the signs and symptoms of a brain tumour in children depend on the type, size and the location of the tumour. It is also affected by the rate of growth. However, some symptoms may not be easily detected since they are similar to other conditions:
Some of the common symptoms of a brain tumour in children:
- Headaches those become more frequent and severe
- Feeling intense pressure in the head
- Vision problems
- Double vision
Some other symptoms depending on the location of the brain tumour include:
- Problem with balancing
- Weakness or sensation in arm or leg
- Weakness or drooping on one side of the face
- Changes in behaviour or personality
- Hearing issues
- Memory problems
- Trouble in walking
- Slurred speech
- A fuller spot is known as fontanel on the skull
- Abnormal eye movement
- Swallowing trouble
- Loss of appetite
- The problem in feeding in infants
Causes of Brain Tumor in Children
In most cases, the exact cause of brain tumour in children cannot be determined. Most of the brain tumours in children are primary tumours and hence, begin in the brain or the tissues near it. These types of tumours start when the normal cells have abnormal mutations in their DNA, allowing the cells to grow and divide at an increased rate and continue to live even beyond their normal life span. This causes a mass of abnormal cells, which forms a tumour. A tumour can, however, be cancerous or non-cancerous.
Risk Factors of Brain Tumor in Children
The most common risk factor that makes children more probable to develop a tumour is a family history of genetic syndromes or a family history of brain tumours. Also, children who are more exposed to ionizing radiation are at a higher risk of developing tumours.
Diagnosis of Brain Tumor in Children
Based on symptoms per case, the doctor might suggest a few diagnostic procedures to study the conditions. The diagnosis methods for brain tumour include:
- Neurological exam
- Imaging tests
- CT or PET scan
- MRI scanning
Post diagnosis, depending on the size, location and growth of the tumour – the doctor will suggest a treatment method including surgery, radiation therapy, radiosurgery, chemotherapy and targeted drug therapy. However, in most cases, surgery is the primary mode of treatment of brain tumour.
Treatment of Brain Tumor in Children
The type of treatment for a brain tumour depends on the kind of tumour, location, size, and aggressiveness of the tumour, as well as the general health and age of the child. Some of the treatment options include:
Surgery: Brain tumour surgery is primarily used in treating malign tumours and in the case of malignant tumours – are used in combination with other treatment options such as radiation and chemotherapy. The basic goals of brain tumour surgery include:
- Remove all or most of the tumour
- Relieve symptoms caused by the tumour and enhance the quality of life
- Relieve the intracranial pressure created by the tumour
- Remove a part of the tumour to slow the growth
- Drain any build-up of fluid in the brain
- Make other treatments such as chemotherapy accessible
- Help diagnose a brain tumour
The type of surgery and surgical method varies per case. However, brain tumour surgery is performed only when the tumour is located in a place which is accessible easily. The basic surgery is performed to remove as much of the tumour as possible and relieve symptoms. This type of brain tumour surgery is called Craniotomy. ‘Crani’ implying skull and ‘otomy’ meaning cutting into; therefore a craniotomy involves cutting into the skull to remove the tumour. A craniotomy is performed while keeping the patient under the influence of general anaesthesia. Then a portion of the scalp is shaved to make an incision to enter the skull and remove a piece of bone to access the area of the brain over the tumour. The surgeon opens the outermost layer of the brain tissue, locates the tumour and then removes/resects it. Once, the tumour is removed, the surgeon replaces the part of the brain or bone; this is called a flap which is secured with small metal brackets. Once, this is replaced, the surgeon stitches the scalp.
Radiation: Radiation therapy involves usage of high-powered energy cells directed to kill the cancer cells. Radiation therapy for a brain tumour can be delivered in two ways:
- External beam radiation: Involves using high-power energy beams directed at the brain tumour from outside the body to help shrink the tumour size or eliminate the cancer cells.
- Brachytherapy: In this form of radiation therapy, rice-sized radioactive seeds are placed in the brain tissue to kill the cancer cells. These radioactive seeds emit low doses of radiation over time and eventually stop emitting.
Proton Beam Therapy: This is an advanced treatment for brain tumours in children and is available only selectively. In this therapy, high doses of radiation are delivered to the targeted brain tumour, thus, minimizingthe impact to the nearby healthy tissues.This is most effective for growing children since it prevents the developing brain of the child to be negatively impacted by the radiation.
Radiosurgery: In this type, multiple beams of radiation are used to provide highly focused radiation treatment to destroy the tumour cells in the brain of the child. Each of the beam used is very powerful in its own, but the point where all the beams collide – the spot of the tumour – receives a large dose of radiation to kill the tumour cells.
Chemotherapy: This method uses drugs to eliminate the rapidly growing tissues including tumour cells. This is a very viable option for cases where the tumour has spread to remote body locations or for tumours which do not respond to hormone therapy.
Targeted drug therapy: This type of treatment involves using drug treatment to specifically focus on certain abnormalities in the tumour cells. These abnormalities are identified and the blocked causing tumour cells to die or slowdown in growth.