Brain Tumors in Children

At Rush Children’s Hospital, we believe in caring for the whole child — and their families — while treating a brain tumor.

Expert pediatric oncologists, pediatric neurologists, pediatric neurosurgeons and other clinicians at Rush use the latest diagnostic, surgical and medical therapies. Your child’s entire care team — which also includes nurses, child life specialists, social workers, clinical psychologists  and other staff — will help you and your child stay strong and resilient throughout treatment and recovery.

Remarkable Care for Kids

• Family-centered, multidisciplinary care: Rush University Children’s Hospital emphasizes a team approach to caring for children with brain tumors — and children and their families are at the center of this team. Your child’s clinical care team will include leading clinical experts in childhood cancers, including pediatric oncologists, neurologists, neurosurgeons, radiation oncologists, palliative care specialists, child life specialists, pediatric psychologists, certified oncology nurses and others.
• Access to clinical trials: As a member of the Children’s Oncology Group (COG), Rush offers our patients opportunities to enroll in national clinical trials of promising new treatments for brain tumors in children. Pediatric oncologists at Rush collaborate with other specialists at other major medical centers across the country to determine the most effective advanced treatments and protocols for your child. 
• Kid-friendly care: We know that kids don’t stop being kids when they develop a serious illness, like a brain tumor. Child and teen life specialists at Rush will make sure that your child gets time to play, hang out, study and socialize — whether in their cheerfully-designed patient room or in our activity center and lounges filled with toys, books and games. Additionally, our social workers, cases managers and finance specialists are dedicated to supporting patients and families at every point of the brain cancer treatment.
• Focus on quality of life: Pediatric palliative care specialists offer an additional layer of care and support to your child as they undergo treatment for a brain tumor. Palliative care focuses on improving your child’s quality of life, managing pain and providing emotional support for your child and your family.

What are brain tumors in children?

Sometimes brain cells in a child grow abnormally, and a tumor forms. Depending on the size and location, a brain tumor can interfere with a child’s speech, coordination, eyesight and other vital functions.

Some hereditary diseases, such as von Hippel-Lindau disease and Li-Fraumeni syndrome, increase a child’s risk of developing a brain tumor. Currently, however, physicians and researchers do not know what causes the majority of childhood brain tumors.

Benign brain tumors vs. malignant brain tumors

• Benign brain tumors are made of normal cells that grow out of control. Benign tumors can grow in size but do not spread to other tissue.
• Cancerous (or malignant) brain tumors are made of abnormal cells.  These tumors can invade nearby tissue or spread to other organ and areas of the blood through a child’s blood stream and lymph nodes. 

Categorizing brain tumors in children

Physicians categorize both benign and malignant brain tumors in children in the following ways:

• Grade: Low-grade tumors are slower growing, and high-grade tumors grow faster and are sometimes cancerous.
• Origin: Tumors that originate in the brain are primary tumors. Tumors that begin elsewhere in the body — for example, in the bloodstream — and spread to the brain are metastatic tumors.  Most childhood brain tumors are primary tumors.  
• Invasiveness: Invasive brain tumors have spread to nearby tissue and can be challenging to remove compared to localized tumors that have not spread. 

Types of childhood brain tumors

Brain tumors are typically named for where they grow. Some arise in specific types of cells, while others only grow in certain areas of the brain or spinal cord.

• Gliomas: The term “gliomas” refers to a family of tumors that form in glial cells, which are the most abundant cells in the brain. Gliomas account for about half of all childhood brain and spinal cord tumors.
• Astrocytomas: There are various types of astrocytomas. Some are slow growing and others more rapidly growing and invasive.
• Ependymomas: These tumors arise from ependymal cells in the brain’s ventricles, which are hollow cavities filled with fluid.
• Brainstem gliomas: Two types of gliomas grow in the brainstem, which connects the brain to the spine and is located above the back of the neck:
  • Pontine gliomas: Arising in the pons section of the brainstem, these tumors tend to be aggressive.
  • Focal gliomas: These tumors tend to be slow growing.
• Oligodendroglioma: These rare tumors grow in the four lobes of the brain’s cerebrum, with most arising in the frontal lobe.
• Optic nerve gliomas: Often slow growing, these tumors form in the nerves connecting the eyes to the brain.
• Medulloblastomas: Typically cancerous and aggressive, medulloblastomas are a type of primitive neuroectodermal tumor (PNET) that grow near the bottom of the skull.  
• Neuroblastomas: These start in nerve cells called neuroblasts and develop in or near the adrenal glands, neck, chest and spinal cord.
• Germ cell tumors: While typically found in the reproductive organs, germ cells tumors sometimes develop in the brain.
• Craniopharyngiomas: These noncancerous tumors develop near the pituitary gland, which is near the bottom of the brain.
• Choroid plexus tumors: These tumors grow in the ventricles of the brain, which produce spinal fluid.
• Atypical teratoid rhabdoid tumors (ATRT): These rare tumors can develop in the back and base of the brain.

Symptoms of brain tumors in children

Depending on the type and size of the tumor and the part of the brain affected, your child may experience some of the following symptoms:

• Expanding head size in infants
• Frequent headaches
• Recurring vomiting
• Slurred speech
• Seizures
• Coordination or balance difficulties

Many of these symptoms can appear with other more common childhood health problems, which makes diagnosing a brain tumor difficult.  Your child’s pediatrician can help you determine whether you should consult with a pediatric neurologist or pediatric oncologist at Rush University Children’s Hospital.

Care for brain tumors in children at Rush

Diagnosis

Diagnostic tests: Imaging tests, such as an MRI or CT scan, may be used to identify or confirm a brain tumor. Your child needs to be still during these tests, which can be challenging depending on your child’s age and personality. Your child’s clinician may recommend sedating them for the test.

Diagnostic surgery and biopsy: Depending on your child’s condition, your child’s care team may recommend surgery to remove all or part of the tumor to help determine your child’s diagnosis. 

After the surgery, neuro-pathologists at Rush will study the tissue under a microscope to identify the type and grade of tumor, as well as genetic or molecular markers. This expert diagnostic testing allows your child’s care team to tailor and personalize treatment that will be most effective for the specific type of tumor.

Treatment

Your child’s care team will work closely with you, your child and each other to determine the best treatment plan for your child.

Cancer surgery: Your child may need surgery to diagnose or treat a brain tumor.

• Minimally invasive surgery: When possible, pediatric neurosurgeons at Rush use endoscopic approaches to remove tumors that can be reached through the nose. Endoscopic approaches reduce recovery time after surgery. 
• Open surgery: If your child needs traditional open surgery, pediatric neurosurgeons use the smallest openings possible. They’re able to do this by using computer-guided, 3D maps of your child’s brain to help them identify and separate the tumor from healthy tissue. 

Chemotherapy and other drug therapies: Your child may need chemotherapy after surgery to kill any remaining cancer cells and prevent them from spreading. Your child’s care team may also recommend these promising drug therapies:

• Targeted therapy: When molecular mutations are identified in tumors, your child’s pediatric oncologist may recommend drugs that specifically attack those mutations. These therapies tend to cause few side effects because the drugs do not affect noncancerous cells.
• Immunotherapy: These drugs help your child’s immune system attack brain cancer cells.

Radiation therapy: Your child may need radiation therapy to treat the brain tumor. To limit the side effects of radiation in children, radiation oncologists at Rush determine how to use the lowest possible amount of radiation to target cancer cells, while leaving children’s  healthy tissue unharmed. One of these innovative approaches may be used:

• Proton radiation therapy: Sometimes protons are good at killing targeted cancer cells without harming surrounding cells and tissue. Special machines, called synchrotrons and cyclotrons, are needed to provide this type of radiation therapy. 
• Stereotactic radiosurgery: This nonsurgical radiation therapy may be used for small, well-defined tumors. A single high dose of radiation is delivered to the tumor, using the TrueBeam STx system, which minimizes damage to healthy surrounding tissue and reduces the amount of radiation therapy needed. 
• Image-guided radiation therapy (IGRT): Radiation oncologists at Rush may use an image-guided system (TomoTherapy Hi-Art or Varian Trilogy) to precisely pinpoint a tumor. IGRT can adjust for changes in a young child’s position as well as tumor changes throughout treatment.

Rehabilitation: Sometimes brain tumors or treatments can cause developmental delays, problems with growth and development, and other issues, including speech and vision problems. Pediatric development specialists, pediatric psychologists, and pediatric rehabilitative medicine specialists — which include physical, occupational and speech therapists — work with children of all ages to identify and address these issues.    

Alternative and complementary therapies: Your child can receive counseling, massage therapy, acupuncture, nutritional counseling and other supportive therapies from Rush’s Cancer Integrative Medicine Program.

Palliative care: Pediatric palliative care specialists offer an additional layer of care and support to your child as they undergo treatment for a brain tumor. Palliative care focuses on improving your child’s quality of life, managing pain and providing emotional support for your child and your family.

Long-term monitoring and support

Your child’s care team will follow your child through adulthood to quickly identify and address any cancer recurrence.

With coordinated medical, behavioral and rehabilitation care, Rush provides a comprehensive continuum of care for other health and development problems that are sometimes associated with brain tumors, including seizures and learning disabilities. 

Rush also provides comprehensive, multidisciplinary care for adults with brain tumors.