Supportive therapy
Supportive therapy is an important part of treatment for childhood brain cancer. It is given to treat symptoms or side effects from treatment and the brain or spinal tumour itself. These include:
- swelling of the brain (cerebral edema)
- swelling of the spinal cord (spinal edema)
- headaches or other pain
- nausea or vomiting
- fatigue
- seizures
Corticosteroids
A corticosteroid is any steroid hormone that acts as an anti-inflammatory by reducing swelling and lowering the body’s immune response (the immune system’s reaction to the presence of foreign substances). These drugs are used to treat swelling of the brain or spinal cord. They can also help to relieve headaches, nausea and vomiting.
Swelling is caused by a tumour growing and pressing on areas of the brain or spinal cord. Normal tissue may also swell as a reaction to surgery or radiation. Swelling in the brain that gets worse can result in a cancer-related emergency called increased intracranial pressure (ICP).
Most children with a brain or spinal cord tumour will be given corticosteroids to treat or prevent swelling. They are often given before and for a few days after surgery. They may also be used during radiation therapy. The most common corticosteroids used are:
- dexamethasone
- prednisone
- methylprednisolone (Medrol)
The healthcare team will determine and give the lowest effective dose for your child. The dose is gradually tapered down and discontinued after your child finishes treatment.
If swelling stops responding to corticosteroids, mannitol (Osmitrol) may be used.
Antiseizure medicines
Many children with brain tumours will have a seizure during their illness. Antiseizure medicines may be used to lower the chance of seizures. These drugs may also be called anticonvulsants.
The most common antiseizure drugs used are:
- phenytoin (Dilantin)
- carbamazepine (Tegretol)
- valproate (Depakene)
- levetiracetam (Keppra)
The healthcare team will do blood tests regularly to check the level of antiseizure drugs. To be safe and effective, the drug level must stay within a certain range.
Hormones
Sometimes a tumour or treatments can affect the pituitary gland, which is at the base of the brain. The pituitary gland controls hormone levels in the body. If the pituitary gland is damaged, your child may need to take hormones to keep them at normal levels.