Children with brain and spinal cord cancer and their parents may have questions about their prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a child's medical history, type of cancer, stage, characteristics of the cancer, treatment, and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor's best estimate of how cancer will affect a child, and how the cancer will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and prognosis.
The following are prognostic factors for childhood brain and spinal cord cancer.
Low-grade, slow-growing tumours usually have a more favourable outcome.
Tumours in the cerebrum and cerebellum tend to have a better outcome than those in the brain stem, ventricles or midbrain. However, other factors, such as the grade, will affect the outlook of tumours in the cerebrum and cerebellum.
Small tumours that have not spread have a more favourable prognosis.
Tumours that can be completely removed by surgery (totally resectable) have a more favourable prognosis.
Children over the age of 3 years tend to have a more favourable prognosis than children under the age of 3. This may be because radiation can potentially be given to the brain in children over 3 years of age. Many types of childhood brain and spinal cord cancer are sensitive to the effects of radiation, so if the child is old enough to receive radiation, it could improve the prognosis. In addition, the types of tumours that tend to develop in children under 3 years of age may be more aggressive.
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.