Medulloblastoma accounts for about 20 percent of all pediatric brain tumors, and more than 70 percent of these are diagnosed in children under the age of 10. There are several subtypes of medulloblastoma, so treatment for this common childhood brain tumor includes combinations of surgery, radiation and chemotherapy designed for each patient’s unique circumstances.
About Medulloblastoma
Medulloblastomas occur in the cerebellum, at the base of the brain in areas responsible for controlling balance, posture, fine motor functions, speech and swallowing. Although some adults can develop medulloblastomas, these tumors are most often found in children. The average age at diagnosis is seven, but medulloblastomas can also affect infants and children under the age of three.
Not all medulloblastomas are alike. Neuroscientists have identified 10 subtypes, based on the kind and number of abnormal cells they contain. Since each subtype has unique characteristics, effective treatment protocols are determined by the tumor’s type and location.
Along with a patient’s medical history, a number of tests are used to diagnose and type medulloblastoma. Typical procedures include magnetic resonance imaging (MRI), a lumbar puncture to search for cancerous cells in spinal fluid and a biopsy of the tumor tissue itself.
Common Symptoms of Medulloblastoma
Early medulloblastoma symptoms can be similar to those of many illnesses, and so a diagnosis can be missed or delayed, especially in very young children. These “flu-like” symptoms include:
- Lethargy
- Loss of appetite
- Irritability
- Weight loss, especially in infants
Infants and young children may also experience a symptom called “sun setting,” an inability to raise the eyes upward.
As the tumor grows, other symptoms appear, caused by swelling and the buildup of cerebrospinal fluid around the tumor. These typically include:
- Headaches, especially in the morning or during the night
- Vomiting upon waking up
- Drowsiness throughout the day
Depending on the location of the tumor and its effects on surrounding nerves and brain structures, other symptoms can include:
- Dizziness
- Problems with balance and coordination
- Vision problems, such as double vision (diplopia) and involuntary eye jerking (nystagmus)
- Stiffness in the neck
- Tilting of the head
Treatment Options for Medulloblastoma
Medulloblastomas are generally treated by a combination of surgery, radiation and chemotherapy. Treatment plans are determined by the tumor type and size, as well as the patient’s age, health and other circumstances.
Surgery
Surgery is performed to not only to remove as much of the tumor as possible but also to relieve pressure in the brain from swelling and fluid buildup, and confirm the diagnosis with tissue samples.
Surgery most often begins with a temporary drain to control any excess buildup of spinal fluid followed by a craniotomy, the removal of a portion of the skull to expose the brain. Neurosurgeons then remove as much of the tumor as possible, while limiting damage to surrounding brain tissue. In many cases, the tumor can be completely removed.
After surgery, patients recover for several days in intensive care, with monitoring including post-operative MRI scanning. Some may experience short-term problems with speech and coordination, or swelling. Without complications, the typical hospital stay is around 5-7 days.
Radiation Therapy
For children over three, radiation therapy generally follows surgery to destroy remaining cancer cells around the tumor. Radiation therapies used after medulloblastoma surgery are determined by the tumor type and size, as well as a patient’s age and health.
Chemotherapy
A course of chemotherapy typically follows radiation therapy in order to kill any remaining tumor cells and reduce the risk of cells spreading through spinal fluids to other parts of the body.
Chemotherapy treatment involves either intravenous or oral medications designed to attack the fast-growing cells of a tumor rather than slower-growing healthy cells. Treatments are given in cycles of three to four weeks, with a rest period in between cycles.
Common but temporary side effects of chemotherapy include fatigue, nausea, loss of appetite and hair loss in the area being treated. During chemotherapy, patients might be at greater risk for infection or catching viruses such as colds and flu.
In infants and patients under the age of three, chemotherapy is typically used right after surgery rather than radiation, because radiation therapy can have severe effects on the developing brain.
Because all aspects of treating medulloblastoma impact both the brain and other systems of the body, post-treatment follow-up includes periodic MRI scans and evaluations to detect any long-term effects on growth and cognitive and motor functioning.
Treating medulloblastoma with surgery in combination with radiation and/or chemotherapy can be highly effective, with 80 percent of pediatric patients with non-metastatic medulloblastoma remaining cancer-free five years after a complete resection of the tumor..
Why Choose Neurosurgeons of New Jersey?
Neurosurgeons of New Jersey combines patient-centered care with decades of experience and research and cutting-edge technology. The center’s neurosurgeons and specialists provide state-of-the-art treatment, coupled with an understanding of the unique needs of pediatric medulloblastoma patients and their families. At Neurosurgeons of New Jersey, your neurosurgeons and their team work with you to create the treatment plan that’s right for your child.