There are different types of treatment for children with brain
stem glioma.
Children with brain stem glioma should have their treatment
planned by a team of health care providers who are experts in treating childhood brain
tumors.
Childhood brain stem gliomas may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years.
Some cancer treatments cause side effects months or years after treatment has ended.
Six types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Cerebrospinal fluid diversion
Observation
Targeted therapy
New types of treatment are being tested in clinical trials.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for children with brain
stem glioma.
Different types of treatment are available for children with brain stem glioma. Some treatments
are standard
(the currently used treatment), and some are being tested in clinical trials. A treatment
clinical trial is a research study
meant to help improve current treatments or
obtain information on new treatments for patients with cancer. When clinical trials show that
a new treatment is better than the standard
treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial
should be considered. Some clinical trials are open only to patients who have not started treatment.
Children with brain stem glioma should have their treatment
planned by a team of health care providers who are experts in treating childhood brain
tumors.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes
in treating children with cancer. The pediatric oncologist works with
other pediatrichealth care providers
who are experts in treating children
with brain tumors
and who specialize
in certain areas of medicine. These may include the following specialists
:
Childhood brain stem gliomas may cause signs or symptoms that begin before the cancer is diagnosed and continue for months or years.
Childhood brain stem gliomas may cause signs
or symptoms
that continue for months or years. Signs or symptoms caused by the tumor
may begin before diagnosis. Signs or symptoms caused by treatment may begin during or right after treatment.
Some cancer treatments cause side effects months or years after treatment has ended.
These are called late effects. Late effects may include the following:
Physical problems.
Changes in mood, feelings, thinking, learning, or memory.
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ
summary on Late Effects of Treatment for Childhood Cancer for more information).
Six types of standard treatment are used:
Surgery
Surgery
may be used to diagnose and treat childhood brain stem glioma as discussed in the General Information section of this summary.
Radiation therapy
Radiation therapy
is
a cancer treatment that uses high-energy x-rays
or
other types of radiation
to kill cancer cells
or keep them from growing. There are two types of
radiation therapy:
The way the radiation therapy is given depends on the type of the cancer being treated.
External radiation therapy is used to treat DIPG. External and/or internal radiation therapy may be used to treat focal
brain stem gliomas.
Several months after radiation therapy to the brain, imaging tests
may show changes to the brain tissue. These changes may be caused by the radiation therapy or may mean the tumor is growing. It is important to be sure the tumor is growing before any more treatment is given.
Chemotherapy
Chemotherapy
is a cancer treatment that uses drugs
to stop the growth of
cancer cells, either by killing the cells or by stopping them from
dividing. When chemotherapy is taken by mouth or injected
into a vein
or muscle, the drugs enter the bloodstream and can reach cancer
cells throughout the body (systemic chemotherapy). When chemotherapy is
placed directly in the cerebrospinal fluid, an organ, or a body cavity
such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type of the cancer being treated.
Because radiation therapy to the brain can affect growth and brain development
in young children, clinical trials are studying ways of using chemotherapy to
delay or reduce the need for radiation therapy.
Cerebrospinal fluid diversion
Cerebrospinal fluid diversion
is a method used to drainfluid
that has built up in the brain. A shunt
(long, thin tube) is placed in a ventricle
(fluid-filled space) of the brain and threaded under the skin to another part of the body, usually the abdomen. The shunt carries extra fluid away from the brain so it may be absorbed elsewhere in the body.Cerebrospinal fluid (CSF) diversion. Extra CSF is removed from a ventricle in the brain through a shunt (tube) and is emptied into the abdomen. A valve controls the flow of CSF.
Observation
Observation
is closely monitoring
a patient’s condition
without giving any treatment until signs or symptoms appear or change.
Targeted therapy
Targeted therapy
is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Some focal brain stem gliomas that cannot be removed by surgery may be treated with BRAF kinase inhibitor therapy. BRAF kinase inhibitors block the BRAF protein. BRAF proteins help control cell growth and may be mutated
(changed) in some types of brain stem glioma. Blocking mutated BRAF kinase proteins may help keep cancer cells from growing.
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI website.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial
may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring
(coming back) or reduce the side effects
of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's
listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition
has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up
tests or check-ups.
If the results of imaging tests
done after treatment show a mass
in the brain, a biopsy
may be done to find out if it is made up of dead tumor cells or if new cancer cells are growing. In children who are expected to live a long time, regular MRIs
may be done to see if the cancer has come back.
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the National Cancer Institute.
