Pediatric Neurosurgeons of New Jersey

What are brain tumors? Are they common? What do I do if my child has a brain or spine tumor?

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Brain tumors in children are relatively rare, occurring in only five of every 100,000 children. Nearly 2,300 children and adolescents in the United States are diagnosed with a brain tumor each year and are commonly treated with surgery and/or other therapies including chemotherapy and radiation. Today greater than 50 percent of children diagnosed with a brain tumor will be cured of the disease following these medical and surgical treatments.

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Tumors are masses of abnormal cells that can appear in the brain with abnormal growth. Tumors in the brain can be complicated to treat because of the delicate surrounding tissue.

 

All pediatric brain tumors require evaluation and close neurosurgical assessment. Prompt treatment of most children and adolescents with this diagnosis can help improve survival into adulthood.

 

As many children encounter physical, social, and intellectual challenges related to their treatment, we are here to help with our comprehensive center. Treatment requires ongoing care to help with your child's school and other skills that they will use throughout adulthood. Contact our team especially if

• Your child has a new diagnosis of a brain or spine tumor

• You want a second opinion through our Second Opinion Program on treatment

• Your child has been scheduled for surgery

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Team Approach

 

We believe that your child needs a comprehensive team approach to their treatment through Premier Pediatric Neurosurgery Center and our partners in the Pediatric Neuro-oncology Program at the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center. We offer an integrated pediatric oncology program specialized program in offering all the services of a leading cancer center and a pediatric hospital.

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Our pediatric neurosurgical, neurology, and neuro-oncology specialists offer:

• technological advances to diagnose tumors as early as possible

• the best treatment including neurosurgery, radiation therapy, and chemotherapy.

• access to unique Phase I clinical trials run by our own investigators and in collaboration with our Children's Oncology Group and Pediatric Oncology Experimental Therapeutics Consortium

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How can doctors diagnose a brain tumor?

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Different procedures are used to see if your child has a brain tumor and can often help to determine the type of tumor your child has and whether the tumor has spread. These tests may include:

• physical exam to test reflexes, muscle strength, eye movement, coordination, alertness, and memory

• Magnetic resonance imaging (MRI) for detailed images of the brain and spine

• Computerized Tomography scan (also called a CT or CAT scan) to view the bones and fluid filled spaces of the brain

• Biopsy or tissue sample from the tumor to provide definitive identification of the type of tumor

• Lumbar puncture (spinal tap), when necessary, to remove a small sample of spinal fluid (CSF) and determine if any tumor cells have spread from the brain. In young children, sedation makes this safer, less difficult, and less painful.

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How will my child do long-term once a brain tumor is found?

 

Today, more than half of all children diagnosed with a brain tumor will be cured of the disease. But with any cancer, prognosis and long-term survival varies greatly. Prompt medical attention and aggressive therapy are very important, as is continuous follow-up care.

 

As with other tumors in children, surgery is the first treatment and is usually followed by radiation treatment and/or chemotherapy. Unfortunately, your child’s brain is still developing and some treatments can result in short-term or long-term side effects.

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Your child’s outcome depends largely on:

• Type of tumor of we find

• Size, location, and spread of the disease

• Tumor's response to surgery and other therapies

• Your child’s age and overall health

• Your child’s response to medications, procedures and other therapies

• New developments in treatment

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Children who are treated for brain tumors require ongoing assessment and care to help them perform at school and throughout life.  Your child also may need rehabilitation for motor skill and muscle strength.

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With our partners' ongoing trials, new treatment strategies are being discovered to improve outcomes and decrease side effects. For more information on the research, see the Pediatric Brain Tumor Research and Innovation section.

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Are pediatric brain tumors treatable? What are the options?

 

Our team provides compassionate, skilled and comprehensive treatment necessary for of pediatric brain and spine tumors. We use an extensive team approach to evaluate treatment options with frequent multi-disciplinary group meetings to discuss each child’s case among experts at different institutions. A diagnosis is first made and then our neuro-oncology team will assess the location and type of tumor to begin the appropriate treatment.

 

Our group has access to the latest therapeutic options and has the most advanced technology available to treat brain and spine tumors.  Treatment options include:

 

• Surgery

• Radiation Therapy

• Chemotherapy

• Novel Therapeutic Agents with Enrollment into Clinical Trials

• Radiosurgery with Gamma Knife

• Bone Marrow Transplantation

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Treatment for brain tumors in children has progressed tremendously in the last decade. Your child’s team will determine the best treatment plan based on a number of factors,

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Surgery

 

If your child has a brain tumor, the first treatment is usually surgery to remove as much of the tumor as possible.

• Tumor specimens are examined to determine the exact type. The type of tumor will tell us what the next steps.

• It is often best to remove the entire tumor when possible. to improve the chance for survival.

  • Most high-grade tumors cannot be completely removed because of the spread of the tumor. Each case is carefully discussed as a team of doctors and then the plan is shared to discuss the options with the family

• We use the latest molecular techniques to identify abnormal genes within the tumor. This helps determine if certain medications are better for treatment.

 

Pediatric radiation therapy

 

Our doctors use precisely targeted and dosed radiation to kill cancer cells left behind after your child’s surgery. Depending on the type of tumor, some patients are treated with targeted focal radiation therapy, which isolates a small area for radiation treatment. In those tumors that may have spread, pediatric radiation therapy can sometimes be delivered to the entire brain and spine.

While radiotherapy can be quite effective in treating certain cancers, the radiation damages both cancerous and non-cancerous cells. Because of this, there can be many undesirable side effects during and after treatment. Being able to anticipate these side effects can help the care team, parents and child prepare, and in some cases prevent these symptoms from occurring.

 

What is chemotherapy for children?

 

Chemotherapy (“chemo”) is a treatment that uses drugs to target tumors and kill cancer cells by stopping their ability to grow or multiply. For some kinds of tumors, this treatment  may help shrink the tumor before surgery, making it possible to remove.

• Different medications work in different ways to fight cancer cells and shrink tumors.

• Multiple chemotherapy drugs are frequently used to target tumors in different ways.

 

Chemotherapy can be effective in treating certain cancers but  the drugs also can harm non-cancerous cells. When these cells are harmed they can produce side effects during treatment. We work with your family to anticipate these side effects and prepare your child, and, in some cases, to prevent these symptoms from occurring. Common symptoms can include: loss of hair, vomiting, and weakened immune system,

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Chemotherapy is given in different ways

• Oral: as a pill to swallow

• Intramuscularly: injection into the muscle

• Intravenously: to the blood (through an IV)

• Intrathecally: to the spinal fluid

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Targeted therapy is another way of killing tumor cells. This method uses drugs that are made to specifically inhibit a molecular pathway in the tumor's growth. These drugs often are better tolerated.

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What kind of long-term follow-up care should my child get?

 

Tumors of the brain and spine require long-term evaluations of your child to make sure the tumor is monitored or to make sure the tumor does not come back. Our team will follow your child for years to ensure that this care is provided.

 

One of our primary goals is to optimize your child's long-term function and this can be best achieved my having our specialists monitoring as needed. Many tests are available for making sure we are helping your child in every way possible.

• Intellectual function and school performance

• Hormone and growth evaluation and treatment

• Brain and spine assessment

• Cognitive and psychosocial care

• Hearing and vision tests

• Physical therapy

• Speech and occupational therapists

 

Through our clinic, you and your child and family members will be able to meet with a neurosurgeon, radiation oncologist, pediatric neuro-oncologist and neurologists at the same follow-up visit if needed.

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