Most children with brain and spinal cord tumors are cured. But brain and spinal cord tumors and tumor treatments may affect the child’s central nervous system (CNS) development. It is important that your child be evaluated and treated by a medical team with expertise in child development and brain tumors, such as Seattle Children’s Brain Tumor Program.
Children who have CNS tumors may need to have surgery to remove the tumors or receive radiation or chemotherapy to kill tumor cells. Many children receive more than one type of treatment.
Your child’s healthcare team will suggest a treatment plan based on your child’s tumor’s specific biology, where it is, your child’s age and other aspects of your child’s health.
Brain and Spinal Cord Tumor Treatment Options
Surgery is an essential part of diagnosis and treatment for most patients with CNS tumors. The experience of the pediatric brain surgeon (neurosurgeon) is of utmost importance. Seattle Children’s is the largest pediatric neurosurgical center in the Pacific Northwest, with unsurpassed experience in the neurosurgical care of young patients with brain or spinal cord tumors.
Our neurosurgical team uses highly technical equipment and the most current and well-researched procedures, including:
- Craniotomy: The neurosurgeon removes a part of your child’s skull (cranium), cuts the tough membrane (dura mater) that protects the brain and removes as much of the tumor as is safe. After closing the dura mater, the neurosurgeon puts back the piece of bone they removed, if possible, or uses hardware such as micro plates, screws and wires to close your child’s skull.
- Laminectomy: To remove spinal cord tumors or reach spinal nerve roots that need repair, the neurosurgeon removes parts of a few vertebrae. They usually perform this surgery using a microscope and other highly technical equipment. Sometimes the neurosurgeon uses an endoscope, a wand-like tube with a light and camera, to see and remove the tumor.
- Laser ablation surgery: For some slow-growing (low-grade) tumors deep in the brain, laser ablation surgery may be an option. This minimally invasive procedure uses light to heat and destroy unwanted cells. Seattle Children’s is the only pediatric hospital in the Pacific Northwest, and one of only a handful of centers in the country, to offer laser ablation for brain tumors. Read more.
Learn more about our Neurosurgery Program.
Radiation therapy uses high-energy beams to kill cancer cells and reduce the size of tumors. Tumors are particularly sensitive to radiation compared to healthy tissue. However, radiation has the potential to harm healthy cells and damage the development of the nervous system, particularly in very young children. It is important to have a radiation oncologist with pediatric expertise determine whether and how radiation therapy should be used.
Seattle Children’s brain tumor patients have access to the whole range of advanced radiation therapies that can help limit damage to the nervous system, including:
- Proton beam therapy: Proton beam therapy delivers positively charged atomic particles to tumors. Because of the way the radiation is deposited, it reduces the exposure of the surrounding normal tissue.
- Three-dimensional conformal radiation or intensity modulated radiation therapy (IMRT): This type of radiation uses photons. It allows doctors to use more beams and focus them in a more precise way to confine the radiation to the tumor.
- Gamma knife (stereotactic radiosurgery): Despite the “knife” in the name, there is no cutting. This type of radiation therapy focuses the X-rays extremely precisely and can be used for smaller areas to help avoid harming normal brain tissue.
Learn more about Seattle Children’s Radiation Therapy Service.
Chemotherapy means giving medicines that go throughout your child’s body, via their bloodstream, to kill tumor cells. Your child’s doctors may suggest chemotherapy as your child’s main treatment or along with surgery or radiation.
Chemotherapy is a term that is often used for any medicine used to treat a tumor.
Cytotoxic chemotherapy is a group of medications that work to treat tumors by killing rapidly dividing cells. Cytotoxic chemotherapy may have side effects on other growing cells such as hair or the lining of the mouth or the cells of the blood. Many newer medications for brain tumors work in different ways and are not considered cytotoxic.
It is very important to have an oncologist with experience in both the use of chemotherapy in young patients and supportive care to help patients receive chemotherapy safely and recover fully.
Children can get chemotherapy through a vein or, in some cases, by mouth.
Brain and Spinal Cord Tumor Survival
Doctors who treat people with cancer use 5-year survival rates as a way to measure treatment success. The 5-year survival rate means the percentage of patients with the disease who are alive 5 years after their disease was diagnosed.
Three out of 4 children diagnosed with a brain tumor today will be cured. The 5-year survival for patients diagnosed with a brain tumor at Seattle Children’s has been consistently higher than the national average for the past 20 years.
However, we do not think of our patients as statistics. The brain tumor team approaches each patient as an individual and makes recommendations for treatment to attempt to give each child, adolescent or young adult the best chance of a long and healthy life.
CNS tumor survivors may have long-term side effects from their tumor or treatment. We will continue to follow survivors until adulthood and help them find appropriate healthcare providers for any ongoing or future medical needs.
New Treatments for Brain and Spinal Cord Tumors
All major improvements in pediatric brain tumor treatment and survival have been achieved through research. It is the key to finding more effective and safer treatments in the future.
Children, adolescents and young adults treated at Seattle Children’s have the option to participate in research as part of their medical treatment. These treatment options are called clinical or therapeutic trials.
The doctors on our brain tumor team are leaders in pediatric cancer research. They lead national clinical trials of novel therapies — new drugs or other new treatment approaches that are available only to patients in studies.
Seattle Children’s has more than a dozen therapeutic trials at any time for various types of brain tumors. These are offered through cooperative groups, including the Children’s Oncology Group (COG), the Pacific Pediatric Neuro-Oncology Consortium (PNOC), the Phase 1 Consortium of COG and within our own Center for Clinical and Translational Research.
Laboratory research by Seattle Children’s scientists and doctors led to the development of the drug known as Tumor Paint BLZ-100, which lights up cancer cells so surgeons can see and remove brain tumors with greater precision. The drug is now available at Seattle Children’s in a phase 1 clinical trial for infants, children, adolescents and young adults who need brain tumor surgery. Read more.
To see if there is a clinical trial that would be appropriate for your child’s type of tumor, you or your child’s doctor can:
Our researchers are also involved in laboratory studies of brain tumor biology — how and why brain tumors form, grow and spread — and studies to develop nanoparticles that target brain cancer cells and decrease the cells’ ability to repair damage caused by radiation therapy or chemotherapy. Their work may one day lead to more effective treatment. We are part of the Children’s Brain Tumor Tissue Consortium (CBTTC), a group of hospitals that work together to study cells removed from brain tumors to improve outcomes for children.
Read more about cancer clinical trials at Seattle Children’s and Seattle Children’s Research Institute.