Brain & Spinal Tumours

  • A brain or spinal cord tumour is a disease formed by abnormal cells in the tissues of the brain or spinal cord.
  • The brain controls many crucial body functions.
  • The spinal cord connects the brain with nerves in most parts of the body.
  • Brain and spinal tumours are a common type of childhood cancer.
  • The origin of most childhood brain and spinal cord tumours is unknown.
  • Tests that examine the brain and spinal cord are used to identify childhood brain and spinal tumours.
  • Some childhood brain and spinal tumours are diagnosed through imaging tests.
  • Certain factors affect prognosis, i.e. the chance of recovery.

(Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®)–Patient Version, 2020).

Statistics

  • Brain and spinal cord tumours are the second most common cancers in children (after leukaemia). They account for about 1 out of 4 childhood cancers.
  • More than 4,000 brain and spinal cord tumours are diagnosed each year in children and teenagers.
  • The incidence rate (number of tumours per 100,000 children) has not changed much in recent years.
  • Malignant (rapid growing) brain and spinal cord tumours are slightly more common in boys, while non-malignant tumours are slightly more common in girls.
  • About 3 out of 4 children with brain tumours (all types combined) survive at least 5 years after being diagnosed.
  • But the outlook can vary a great deal based on the type of tumour, its location, and other factors.

(American Cancer Society, 2020)

Signs & Symptoms

The signs and symptoms of childhood brain and spinal cord tumours differ from child to child.

Signs and symptoms are dependent on the following:

  • Location of the tumour formation in the brain or spinal cord.
  • Size of the tumour.
  • The growth speed of the tumour.
  • The child’s age and development.

Consult with your child’s doctor if your child experiences any of the following:

Spinal Cord Tumour Signs and Symptoms:

  • Back pain or pain that stretches from the back to the arms or legs.
  • A variation in bowel habits or difficulty urinating.
  • Weakness in the legs.
  • Difficulty walking.

Brain Tumour Signs and Symptoms:

  • Morning headache or headache that goes away after vomiting.
  • Recurrent nausea and vomiting.
  • Vision, hearing, and speech impairments.
  • Loss of balance and difficulty walking.
  • Unusual lethargy or changing activity level.
  • Unfamiliar changes in personality or behaviour.
  • Seizures.
  • Increase in the head size (particularly in infants).

Diagnosis

  • If doctors have reason to believe there might be a brain tumour, a biopsy may be performed to remove a tissue sample.
  • For tumours in the brain, the biopsy is performed by removing a piece of the skull and removing a tissue sample using a needle.
  • A pathologist inspects the tissue under a microscope to identify cancer cells. If cancer cells are present, the doctor may remove as much tumour as safely possible during the same surgery.
  • The pathologist inspects the cancer cells to identify the type and grade of brain tumour. The grade of the tumour depends on how abnormal the cancer cells look under a microscope and how quickly the tumour is expected to grow and spread.

The following test may be conducted on the removed tissue sample:

Immunohistochemistry:

A laboratory examination that uses antibodies to check for certain antigens in a patient’s tissue sample. The antibodies are typically connected to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen then becomes visible under a microscope. This type of test is used to help diagnose cancer and to help identify one type of cancer from another type of cancer.

(Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®)–Patient Version, 2020)

Risk Factors

“A risk factor is anything that affects a person’s chance of getting a disease such as a brain or spinal cord tumour. Different types of cancer have different risk factors.” – (American Cancer Society, 2018).

Lifestyle-related risk factors, including diet, body weight, physical activity, and tobacco use play a substantial role in many adult cancers. But these factors usually take numerous years to influence cancer risk and are thus not thought to play much of a role in childhood cancers, including brain tumours.

Very few risk factors have been found for brain and spinal cord tumours. It is not clear what causes most of these tumours.

  • Radiation exposure
    • The only well-established environmental risk factor for brain tumours is radiation exposure to the head, which most regularly comes from the treatment of other conditions.
  • Inherited and genetic conditions
    • Infrequently, children have inherited abnormal genes from a parent that leads to an increased risk for certain types of brain tumours. In some instances, these abnormal genes are not inherited but arise as a result of deviations (mutations) in the gene before birth.

(American Cancer Society, 2018).

Treatment

  • There are different types of treatment for children with brain and spinal cord tumours.
  • Children with brain or spinal cord tumours should have their treatment planned by a team of health care providers who are experts in treating childhood brain and spinal cord tumours.
  • Three types of standard treatment:
    • Surgery
    • Radiation therapy
    • Chemotherapy
  • New types of treatment are being tested in clinical trials.
    • High-dose chemotherapy with stem cell transplant
  • Treatment for childhood brain and spinal cord tumours may cause side effects.
  • Follow-up tests may be needed.

(Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®)–Patient Version, 2020)

References

  1. American Cancer Society. (2018, June). Risk Factors for Brain and Spinal Cord Tumors in Children.
    Retrieved from American Cancer Society: https://www.cancer.org/cancer/brain-spinal-cord-tumors-children/causes-risks-prevention/risk-factors.html
  2. Childhood Brain and Spinal Cord Tumors Treatment Overview (PDQ®)–Patient Version. (2020, May).
    Retrieved from Nationls Cancer Institute: https://www.cancer.gov/types/brain/patient/child-brain-treatment-pdq