Doctors refer to all benign and malignant neoplasms that arise in the central nervous system (CNS) as brain tumors. The CNS consists of the brain and spinal cord. Accordingly, a brain tumor can occur in the brain or in the structures of the spinal cord and the surrounding meninges.
While brain tumors are rather rare in adults, brain tumors in children rank second in the frequency statistics.
The most common brain tumors in children are astrocytomas. An astrocytoma forms from astrocytes. These are star-shaped cells that support the nerve cells in their work.
An astrocytoma can be benign or malignant. Malignant medulloblastomas occur less frequently in children. These fast-growing brain tumors develop in the cerebellum and account for around 20 percent of all brain and spinal cord tumors in children.
Slow-growing brain tumors include ependymomas. These tumors are often found in the posterior fossa of the skull.
What are the causes of brain tumors in children?
The exact causes are still unclear because most patients do not have a triggering factor. Genetic risk factors or radiation of the nervous system (in acute leukemia) are among the risk factors.
Symptoms that occur with a brain tumor
The symptoms depend on the type of tumor, its location and size. The main symptom is a headache with no apparent cause. The children also suffer from nausea and vomiting.
They appear apathetic and lose performance. A brain tumor can also make itself felt through a change in vision. For example, children may see double vision or blurred images.
Visual field restrictions and complete visual field loss are also possible symptoms of a brain tumor in children.
Other symptoms include
Coordination disorders
Headaches are the most common symptom @ Tatiana Foxy / AdobeStock
If a brain tumor is suspected in a child, magnetic resonance imaging (MRI) is the diagnostic procedure of choice. With the help of the MRI machine, the doctor can produce very precise images, even of hard-to-reach areas such as the posterior fossa. Doctors also use an MRI if the CT scan does not reveal any abnormal findings in the presence of symptoms.
MRI is the procedure of choice to detect a brain tumor in children @ pressmaster / AdobeStock
A computed tomography (CT) scan can also be used to make a diagnosis. However, it is much less specific.
Electroencephalogram (EEG)
In some cases, the doctor also uses the electroencephalogram (EEG) to make a diagnosis. With the help of the EEG, the treating physician can visualize the electrical activity of the brain. This makes it possible to roughly localize the tumour.
A cerebrospinal fluid examination (CSF examination) can provide further information. To do this, the doctor takes a sample of cerebrospinal fluid from the child's spinal canal. If the spinal cord or the spinal meninges are affected by the cancer, tumor cells will be found in the cerebrospinal fluid.
The treatment of brain tumors in children
Various treatment methods are available to treat young cancer patients: Surgery, radiotherapy and chemotherapy.
Which therapy is used depends primarily on the patient's age, state of health and the type and size of the tumor. As a rule, several treatment methods are combined.
If possible, the first step is surgical removal of the tumor. In the second step, the children receive chemotherapy and radiotherapy at the same time.
However, surgery is not always possible: for example, doctors can only operate on tumors in the brain stem in rare cases. This also applies to tumors located in the diencephalon or midbrain. Here, palliative treatment is often the only option to alleviate the symptoms of cancer patients.
As the tissue development of the central nervous system is not yet complete in children under the age of 5, doctors do not use radiotherapy to protect against late effects.
Supportive treatment methods
In many children with a brain tumor, the intracranial pressure is increased. This is also the main cause of the headaches that many patients suffer from. To prevent damage to the brain tissue caused by the high pressure, the doctor can prescribe medication such as corticosteroids. These help to reduce the pressure in the brain. After brain surgery, patients are also often given a catheter system or a shunt to reduce the pressure.
Depending on their location, brain tumors in children can cause neurological symptoms such as epileptic seizures or speech disorders. Here, the medical staff often aim to provide interdisciplinary care. For example, the children receive physiotherapy for paralysis or visit a speech therapist for speech therapy.
Pediatric oncologists and neuroradiologists - specialists for brain tumors in children
If a brain tumor is suspected, those affected should consult a specialist as soon as possible.
Paediatric oncologists specialize in the diagnosis and treatment of cancer in children. Pediatric oncology is a specialist field within medicine and pediatrics. The technical term for this medical specialty is pediatric oncology. After studying medicine, a pediatric oncologist has completed five years of training as a paediatrician. This is followed by further training in the field of oncology and hematology.
Neuroradiology also deals with the diagnosis and treatment of cancers of the central nervous system. The specialty of neuroradiology combines radiological imaging with neurology and neurosurgery. After completing his medical studies, a neuroradiologist trained as a specialist in radiology.
The prognosis for children with brain tumors
The chances of curing brain tumors in children and adolescents depend on the type of tumor, the size of the tumor and its location.
If the doctor can completely remove a benign astrocytoma, for example, then this is equivalent to a cure. The prognosis is then very good.
Malignant astrocytomas have a rather poor prognosis, even with early treatment. The 10-year survival rate for children and adolescents is around 70 percent. This means that 70 percent of patients are alive 10 years after diagnosis.
Follow-up care for children with brain tumors
Even if the brain tumor is completely removed, damage can remain.
This includes, among other things
Bladder emptying disorders
Emotional and psychological problems
Hormonal disorders
Attention, concentration and memory disorders
Behavioral problems
Sleep disorders
In the first few years after completion of tumor therapy, follow-up discussions and examinations should take place at regular intervals with the treating physicians. For example, the children receive physiotherapy, speech therapy or occupational therapy to alleviate symptoms.
Continued close monitoring is advisable in order to detect any relapses at an early stage.
Headaches are the most common symptom @ Tatiana Foxy / AdobeStock
MRI is the procedure of choice to detect a brain tumor in children @ pressmaster / AdobeStock
