Childhood brain tumors frequently cause changes in hearing, memory, learning, sight, smell or emotion. Because adults or the child may notice these changes early in the development of a tumor, childhood brain tumors often are diagnosed before they have spread.

Symptoms of childhood brain tumors depend on their location in the brain. The exact symptoms change from child to child. Some signs of a possible brain tumor include:

• Frequent nausea and vomiting
• Seizures
• Headache, usually in the morning
• Later than normal growth and development milestones, such as walking or talking
• Blurred vision
• Problems speaking or swallowing
• Mood or behavior changes
• Coordination and balance problems
• Weakness or tingling in the arms or legs
• Swelling around an eye
• Weakness of facial muscles
• Problems swallowing
• Abnormal eye movement
• Abnormal tilting of head to one side
• Increase in head size (in babies)
• Pain in the back, arms or legs
• Changes in bowel or urinary habits

These symptoms do not always mean your child has a brain tumor. In fact, they usually are caused by something less serious. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.

Early and accurate diagnosis of a childhood brain tumor can increase the chances for successful treatment.

At MD Anderson’s Children’s Cancer Hospital, our specialized medical team has the depth of experience and expertise that is vital to targeting childhood brain tumors. And we have the most advanced and accurate equipment to pinpoint the exact extent and location of your child’s tumor.

Childhood brain tumor diagnostic tests

If your child has symptoms of a brain tumor, the doctor will examine your child carefully and ask you questions about your child’s and family’s medical history. The doctor also may do a neurological exam to test reflexes, muscle strength, vision and other functions of the brain and spine.

If anything appears abnormal, your doctor may refer your child to a neurologist or neurosurgeon, doctors who specialize in the nervous system.

One or more diagnostic test may be used to find out if your child has a brain tumor and if it has spread. These tests also may be used to find out if treatment is working.

Imaging tests, which may include:

• CT or CAT (computed axial tomography) scans
• MRI (magnetic resonance imaging) scans
• PET (positron emission tomography) scans
• X-rays
• Angiogram to examine blood vessels
• Bone scan

Biopsy: If imaging tests show an area that may be a brain tumor, a biopsy almost always is necessary for diagnosis. In a biopsy, the doctor removes a small amount of tissue, which is then examined with a microscope. One of the following biopsy methods will be used.

Surgery: A biopsy may be done during surgery in which all or part of the brain tumor is removed. The operation is called a craniotomy. If a tumor is difficult to reach, a CT scan may be used during surgery to locate the tumor precisely. The tissue removed is examined immediately. Sometimes surgery to remove the tumor can be done during the same procedure.

Stereotactic (needle) biopsy: If a tumor is difficult to reach, a CT scan may be used for to place a hollow needle inside the tumor and remove a small amount of tissue.

Bone marrow aspiration and biopsy

Lumbar puncture or spinal tap: A small amount of CSF (cerebrospinal fluid, which is the clear liquid in and around the brain and spine) is removed with a needle and looked at with a microscope.

Blood and urine tests

Our treatment approach

A team of some of the nation’s top experts customizes your child’s brain tumor treatment at MD Anderson’s Children’s Cancer Hospital. They work together, communicating with each other and your family, to deliver the most advanced therapies with the least impact on the body, keeping a constant eye on your child’s current and future quality of life.

These highly trained physicians specialize in childhood brain tumor treatment for both malignant (cancer) and benign (non-cancer) brain tumors. Your child’s personal medical team may include renowned neurosurgeons, radiation oncologists and neuro-oncologists. They are supported by a specially trained staff, including nurses, physician’s assistants, psychologists, social workers, rehabilitation specialists, therapists and other health professionals.

Surgical expertise

Like all surgeries, childhood brain tumor surgery is most successful when it is performed by a specialist with a great deal of experience in the particular procedure. This is especially true with brain tumors, because it is crucial to remove as much of the tumor as possible while leaving intact as much brain function as possible.

Children’s Cancer Hospital pediatric neurosurgeons are among the most skilled and recognized in the world. They perform a large number of childhood brain tumor surgeries each year, using the least-invasive and most-advanced techniques.

We have the expertise to examine each tumor carefully to determine gene-expression profiles, which then guide us toward the most advanced, effective treatment targeted to your child’s specific cancer. This personalized medicine approach sets us above and beyond most cancer centers and allows us to attack the specific causes of each cancer.  

Our childhood brain tumor treatments

If your child is diagnosed with a brain tumor, your doctor will talk to you about the best options to treat it. This depends on several factors, including the location and type of the tumor and your child's general health.

One or more of the following therapies may be recommended to treat the cancer or help relieve symptoms.

Surgery

Surgery usually is the first treatment for brain tumors in children. If complete removal of the tumor is not possible, the surgeon will remove as much as the tumor as possible without damaging surrounding areas.

Surgery also may help:

• Reduce the size of the tumor
• Relieve symptoms, such as headaches, nausea
• Place a shunt to drain excess CSF (cerebrospinal fluid), which may cause symptoms including headaches and blurred vision

The most common surgery for brain tumors is craniotomy, in which the skull is opened. Some brain tumors can be removed with little or no damage to the brain. However, many grow in areas that make them difficult or impossible to remove without destroying important parts of the brain.

MD Anderson's Children's Cancer Hospital has the latest, leading-edge equipment, called functional MRI or fMRI, to help map the area and make surgery more accurate. Many brain tumors in children can be treated successfully with surgery alone. If additional treatment is necessary, surgery may help by reducing the size of the tumor before radiation or chemotherapy.

Brainsuite® iMRI

When a brain tumor is in a challenging location, our neurosurgeons can use this innovative open MRI system that allows them to view the tumor during surgery. This helps them remove as much of the tumor as possible without damaging other parts of the brain. MD Anderson's Brainsuite is the first in the world of its type.

Radiation therapy

Radiation therapy may be able to stop or slow the growth of childhood brain tumors that cannot be removed with surgery. It generally is not used for children younger than 3 years. Radiation therapy may be used:

• As the main treatment if surgery is not possible
• After surgery to destroy remaining tumor cells
• To help relieve symptoms

New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target brain tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

Children's Cancer Hospital uses the most advanced radiation treatment methods, including:

Gamma Knife radiosurgery delivers a pinpoint dose of radiation to the tumor from hundreds of angles. It may be used if the tumor's location makes it impossible to remove of if the child is not healthy enough for surgery.

Focused radiation therapy, which is aimed directly at the tumor and immediately surrounding area

Whole-brain radiation therapy, which may be needed if your child has two or more brain tumors

Intensity-modulated radiotherapy (IMRT), which shapes the radiation beam to the brain tumor and lessens exposure to the rest of the brain.

Proton therapy

The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world, offering passive-scattered and intensity-modulated proton therapy. It's the only proton therapy facility in the country within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.

The ability to precisely target tumors with radiation makes proton therapy ideal for treating certain types of childhood cancer. It provides accurate treatment of tumors near or within sensitive organs while limiting radiation exposure to healthy tissues, which is vital in children whose bodies are still  growing and developing. Studies show that proton therapy can also result in fewer late effects from treatment, a major concern among physicians and families when a child – especially a very young child – is undergoing radiation treatment. This includes potentially fewer issues with brain development for children who have been treated for brain tumors.

Proton therapy may be used to treat many types of tumors, including those in the brain, skull base and spine.

Chemotherapy

Children's Cancer Hospital offers the most up-to-date and advanced chemotherapy options for childhood brain tumors. Chemotherapy, often in conjunction with radiation and surgery, is frequently a treatment for tumors that are growing quickly. It sometimes may be used instead of radiation therapy in children under the age of three. Chemotherapy often is not as effective for brain cancer as some other types of cancer. This is because of the blood-brain barrier, small blood vessels in the brain and spinal cord that protect the brain from harmful substances, which may act as a shield against chemotherapy drugs.

Targeted therapies

These new drugs target the specific gene changes that cause cancer. MD Anderson is at the forefront of discovering these agents. Many of our brain tumor clinical trials determine the best drug for each patient based on analysis of the molecular profiles of patients' tumors.

Medications to decrease symptoms

Certain medications, including anti-seizure drugs, hormones and corticosteroids, may be given to help children with brain tumors feel better.