BY AMBER SMITH
Cancers of the brain and spinal cord have surpassed leukemia as the largest cause of cancer death in children. It’s not because there are more brain and spinal cord tumors. Rather, progress has been made in treating cancers of the bone marrow and blood cells, so more children are surviving leukemia.
The leading cause of cancer death in children is cancers of the brain and spinal cord.
Of all cancers, about 1 percent occurs in children, says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology. The average age at diagnosis is 6 or 7 years.
“Every child you save or cure of childhood cancer lives another 70-plus years,” she explains. “So when you look at years of life lost, more years of life are lost to childhood cancers, compared to adult cancers other than breast cancer.”
Comito says each day in America, 46 children are diagnosed with cancer, and seven children die from cancer. Brain and spinal cord tumors account for about one out of four childhood cancers. Each year, more than 4,000 central nervous system tumors are diagnosed in children and teens.
Some key things to know about brain and spinal cord tumors:
* Symptoms vary greatly, based on the age of the child and the size and location of the tumor. Headaches that get progressively worse and morning vomiting episodes may be clues.
Melanie Comito, MD, explains that more years of life are lost to cancers in children than to most cancers in adults.
* While adults tend to have brain tumors in the upper part of the brain, many childhood tumors appear more toward the center of the brain or in the back near the cerebellum, the part of the brain that regulates muscular activity.
* Among the more than 50 types of childhood brain tumors, half are astrocytomas. These tumors arise from star-shaped brain cells called astrocytes that make up the supportive tissue of the brain.
* Non-cancerous or benign tumors can be just as life-threatening as malignant tumors because of where they exist in the brain. “They’re often in areas where you can’t just cut them out without causing damage,” Comito explains. She adds that tumors arising in the spinal cord are typically more amenable to surgery.
* Most tumors can be diagnosed through an imaging scan, but a biopsy is usually required to tell if a tumor is slow- or fast-growing.
* Depending on a tumor’s location, treatment may include removal by surgery. Because of long-term side effects, radiation therapy is not likely to be recommended. Instead, Comito says, many childhood tumors today are treated with chemotherapy. “My treatment goal is to help the child grow up and have the best neurologic outcome that they can have.”
* The cause of most childhood brain and spinal cord tumors is unknown.
* A patient’s prognosis depends on the type of tumor, its location and grade, speed of growth and treatment options. The child’s age and the extend to which the tumor has affected his or her ability to function is also a factor.
* Lifelong follow-up care is recommended for childhood brain tumor survivors.
Follow-up care
Continuing medical care is recommended for childhood cancer survivors, who may develop complications known as late effects of treatment. These could include:
* physical disabilities such as muscle weakness or diminished coordination;
* learning disabilities including problems with memory, attention, comprehension and information processing;
* behavioral changes or emotional issues;
* hearing or vision problems;
* seizures or other neurological issues;
* hormonal problems including slowed growth, early or late puberty or infertility;
* damage to internal organs or other body systems; and
* the possibility of tumor recurrence or the development of a secondary cancer in another part of the body.
Source: American Brain Tumor Association
This article appears in the spring 2017 issue of Cancer Care magazine. Click here for a radio/podcast interview with Comito about childhood brain and spine tumors.
