Introduction
Brain and spinal cord cancers are when unusual cells, or tumours, grow on the brain or spinal cord. Brain and spinal cord cancers are the second most common childhood cancers.
Children are more likely to develop tumours in the lower part of the brain, which control functions like:
- sleeping
- waking up
- movement
- coordination.
In Australia, almost 100 children aged between 0–14 are diagnosed with a brain or spinal cord tumour each year.
Signs and symptoms
Signs and symptoms of brain and spinal cord tumours are usually caused by increased pressure in the head as they grow. These can include:
- headaches
- nausea and vomiting
- drowsiness
- irritability
- seizures
- periods of fainting or becoming unconsciousness
- a decline in school performance or differences in how your child usually functions.
In babies, the soft spot on the head may bulge and grow larger. This is called hydrocephalus.
Diagnosis
Brain and spinal cord cancers are diagnosed by:
- checking your child's symptoms
- lumbar puncture – a test that checks the fluid around your child's spinal cord
- CT or MRI scans of the brain and spinal cord
- a biopsy - taking a tumour sample and testing it in a lab
- tests to check the eyes and ears.
After diagnosis, your child will need some other tests to check:
- whether the cancer has spread to other body parts.
- Whether their organs are healthy enough for treatment.
Different types of brain and spine tumours include:
Medulloblastomas
Medulloblastomas are aggressive, fast-growing cancerous tumours. They usually start in the cerebellum, which is in the lower back of the brain.
Medulloblastomas are the most common type of brain cancer in children. They tend to happen more in boys and usually show up between the ages of two and six.
Ependymomas
Ependymomas are brain or spinal cord tumours that grow from ependymal cells.
Ependymal cells make up the lining of the passages that carry cerebrospinal fluid through the brain and spinal cord.
These tumours are almost always non-cancerous or benign and usually happen in older children and teenagers.
Astrocytomas
Astrocytomas are slow-growing brain or spinal cord tumours that grow from astrocyte cells. Astrocyte cells connect the nerve cells in the brain and spinal cord.
Astrocytomas have a high cure rate.
Optical nerve gliomas
Optical nerve gliomas are slow-growing tumours, usually found in children under ten. They grow on or around the optic nerve, which connects the eyes to the brain.
Optical nerve gliomas will slowly press on the optic nerve as they grow, causing a loss of eyesight.
Brain stem glioma
Brain stem gliomas are tumours that grow on or around the brain stem. The brain stem connects the larger part of the brain, called the cerebrum, to the cerebellum and the spinal cord.
Brain stem gliomas can be slow or fast-growing. Surgery is usually not possible for these types of cancers.
Oligodendrogliomas
Oligodendrogliomas are slow-growing tumours that develop from oligodendrocytes. Oligodendrocytes are cells that produce myelin. Myelin is a special coating that covers the nerves.
These tumours are commonly found in the four areas of the brain:
- frontal lobe –looks after functions like memory, emotions, social skills and movement
- parietal lobe – looks after your senses, like touch, temperature and pain
- temporal lobe – looks after emotions, memories and your ability to understand and communicate with language
- The occipital lobe looks after your ability to see, including distance, depth, and colour, as well as recognise faces and objects and form memories.
In children, these tumours can also be found in the thalamus. The thalamus sends information about movement and senses to the rest of the brain, and helps with:
- sleep
- consciousness
- learning
- memory.
Gangliogliomas
Gangliogliomas are rare, slow-growing tumours found anywhere in the brain. They are more commonly found in the temporal lobe.
These tumours grow from a mix of:
- glial cells that support the functioning of the brain
- neuronal cells that send messages throughout the body for functions like walking, eating, and breathing.
They are usually benign or non-cancerous and are more common in children and young people.
Craniopharyngioma
Craniopharyngiomas are rare tumours that grow near the pituitary gland and the hypothalamus.
The pituitary gland is a tiny gland at the base of the brain. It controls most of the body's other glands and hormones.
The hypothalamus sits above the pituitary gland and produces hormones that affect body temperature, hunger, mood, and heart rate.
These tumours are usually cystic - made up of fluid-filled hollow sacs. They are generally benign and more common in children and teenagers.
Pineal region tumours
Pineal region tumours grow in or around the pineal gland in the middle of the brain. The pineal gland makes melatonin, which is a sleep hormone.
Pineal region tumours can include:
- germ cell tumours – growing from reproductive cells
- embryonal type tumours – growing from cells leftover from when you were a fetus, during pregnancy
- teratomas – tumours that contain tissue like bone, teeth, muscle and hair
- pineocytomas – non-cancerous tumours in the pineal gland
- pineoblastomas – cancerous tumours in the pineal gland.
Treatment
Treatment for brain and spinal cord cancers can include:
- surgery to remove the tumour
- chemotherapy – when drugs are given to try to kill cancer cells
- radiotherapy – when radiation is used to kill cancer cells and shrink tumours
- a combination of all three.
Your child's doctor will try to remove the tumour without surgery when possible.
Surgery may not be possible in cases where tumours have grown in sensitive or essential parts of the brain and spinal cord.
Your child may also be treated with:
- steroids – used to reduce swelling around the tumour
- medication to prevent fits – where abnormal activity in the brain causes a seizure.
Long-term effects of treatment for brain and spinal cord cancers can include:
- physical or intellectual disability
- seizures
- growth disorders
- hearing and vision problems
- the possibility of developing a second cancer, including a second brain tumour.
Your child's doctor will discuss treatment options and side effects and answer any questions you may have.
Management
Care after treatment
Children with brain and spinal cord cancers will need ongoing care from their treatment team to check that there are no signs or symptoms that the cancer is returning.
The type of specialist your child sees will depend on the support they need.
For example:
- ophthalmologist – an eye specialist who can treat vision problems
- dietician – a health professional who can support eating and nutrition
- physio and occupational therapists – health professionals supporting movement and returning to normal activities.
Support for families
A cancer diagnosis can leave families and children feeling overwhelmed, scared, anxious, and upset. Practical and emotional support during and after treatment is essential and can come from:
- family
- friends
- healthcare professionals
- specialised support services.
Speak to your child’s treatment team for information about support services.
Resources and more information
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Cancer Institute NSW
The Institute's website provides information, support, research and data on cancer.
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Cancer Australia
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Cancer Council Helpline
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The Brainchild Foundation
The Foundation provides support and educate those who have children who are affected by the disease.
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Canteen
