Treatment of childhood brain and spinal cord cancer

Treatment for childhood brain and spinal cord cancer is given by cancer specialists (oncologists). Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with children with cancer and their parents to decide on a treatment plan.

Treatment plans are designed to meet the unique needs of each child with cancer. Treatment decisions for childhood brain and spinal cord cancer are based on:

• the type of tumour
• the extent of the tumour
• the position of the tumour in the brain
• whether the tumour can be removed by surgery (resectability)

Treatment options for childhood brain and spinal cord cancer

• surgery
  • Surgeons will remove a sample of the tumour (biopsy) to find out the type of tumour.
  • Doctors will use surgery to remove as much of the tumour as possible (resection).
  • Debulking surgery removes some of the tumour to reduce its size and relieve symptoms.
  • Surgeons can place a shunt inside a ventricle to allow the flow of cerebrospinal fluid (CSF) around the brain and spinal cord.
  • An Ommaya reservoir may be placed in the brain to help deliver chemotherapy drugs directly into the CSF or tumour.
• radiation therapy
  • Radiation therapy is the primary treatment for tumours that can't be removed by surgery.
  • Radiation may be used after surgery to destroy any cells that may have been left behind.
  • It may also be used on the spinal cord to destroy any cancer cells that may have spread there from a tumour in the brain.
• chemotherapy
  • Chemotherapy can be given before surgery or radiation therapy to shrink a tumour so that it is easier to remove with surgery or target with radiation therapy (neoadjuvant therapy).
  • It can be given at the same time as radiation therapy.
  • Chemotherapy may be given after surgery or radiation therapy to destroy any cancer cells left behind (adjuvant chemotherapy).
  • It can also be used if the cancer progresses after initial treatment or recurs at a later date.
  • Chemotherapy may be used instead of radiation therapy in children younger than 3 years to avoid the potentially negative effects of radiation on the developing brain of infants and toddlers.
  • Chemotherapy is generally more effective in higher-grade tumours, but it is being used more often to treat many other types of brain tumours.
• stem cell transplant
  • Stem cell transplants are increasingly being used to treat certain brain tumours, such as high-grade gliomas and medulloblastomas.
• follow-up after treatment is finished
  • It is important for the child to have regular follow-up visits, especially in the first 5 years after treatment.

Clinical trials

Clinical trials investigate better ways to prevent, detect and treat cancer. Most children with cancer are treated in a clinical trial. For more information, go to clinical trials.

See a list of questions to ask your doctor about treatment.