Treatment and outlook

Thanks to specialists at Children's Memorial, Jonathon and Melissa have each overcome brain illness. Read more.

Specific treatment for brain tumors will be determined by your child's physician based on:

  • Your child's age, overall health, and medical history
  • Type, location, and size of the tumor
  • Extent of the disease
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Treatment may include (alone or in combination):

  • Surgery is usually the first step. The goal is to remove as much of the tumor as possible while maintaining neurological function. Biopsy surgery is also done to examine the types of tumor cells for a diagnosis, especially if the tumor is in an area with sensitive structures around it that may be injured during removal.
  • Chemotherapy is the use of drugs to treat cancerous cells. Chemotherapy has been used for many years and is one of the most common treatments for cancer. In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce.
  • Radiation therapy is a beam of energy focused directly on the tumor to kill the tumor cells directly or interfere with the tumor's ability to grow. Radiation can be given in a number of ways including external beam, stereotactic radiosurgery such as gamma knife, as well as during surgery when appropriate with the INTRABEAM.
  • Ventriculoperitoneal shunt (also called a VP shunt).
    A VP shunt may be placed in the head to drain excess fluid from inside the brain. A VP shunt helps control the pressure inside the brain.
  • Third ventriculostomy. Another method to control obstructive hydrocephalus —particularly those with posterior fossa or pineal region tumors — is a bypass in the third ventricle. The neurosurgeon creates a hole in the base of the third ventricle, which drains the CSF directly into the subarachnoid space. The advantage of this method is the avoidance of shunting, but the procedure requires neurosurgical expertise. Younger children have a higher failure rate from the hole closing up and may need the procedure repeated. If successful, the procedure eliminates the need for a shunt as well as the associated risks of shunt malfunction.

  • Lumbar puncture/ spinal tap (to test pressure in the central nervous system, to look for suspicious cells, and give medication if needed)
  • Medications:
  1. Steroids (to treat and prevent swelling especially in the brain)
  2. Anti-epileptic medication (to treat and prevent seizures associated with intracranial pressure or specifically located tumors)
  3. Antibiotics (to treat and prevent infections)
  • Bone Marrow Aspiration (to evaluate if there is further spread of tumor cells, not needed in all types of tumors)
  • Rehabilitation (to regain lost motor skills and muscle strength; speech, physical, and occupational therapists may be involved in the healthcare team)
  • Continuous follow-up care (to manage disease, detect recurrence of the tumor and to manage late effects of treatment)
  • Supportive care (for the side effects of the tumor or treatment)

Long-term outlook for a child with a brain tumor

Prognosis greatly depends on:

  • The type of tumor
  • The extent of the disease
  • Size and location of the tumor
  • Presence or absence of metastasis
  • The tumor's response to therapy and the age and overall health of your child
  • Your child's tolerance of specific medications, procedures, or therapies
  • New developments in treatment

As with any cancer, prognosis and long-term survival can vary greatly from individual to individual. Prompt medical attention and aggressive therapy are important for the best prognosis.

Continuous follow-up care is essential for a child diagnosed with a brain tumor. Side effects of radiation and chemotherapy, as well as second malignancies, can occur in survivors of brain tumors.

Rehabilitation for lost motor skill and muscle strength may be required for an extended amount of time. Speech therapists and physical and occupational therapists may be involved in some form of rehabilitation. More research is needed to improve treatment, decrease side effects of the treatment for this disease, and develop a cure.

New methods are being discovered to improve treatment and to decrease side effects.

We currently have an ongoing study in conjunction with Evanston Northwestern HealthCare and the American Brain Tumor Association (ABTA) to learn more about the health related quality of life for childhood brain tumor survivors. We invite you to learn more about participating in this questionnaire if you or your child are between the ages of 7-21 years and have been off treatment for more than one year. Please visit the link for more information.