Types of Childhood Cancer

There are many types of childhood cancer with different symptoms and treatments. Childhood cancer survival rates in the United States have increased from less than 20 percent in the 1960s to almost 80 percent today. Parents are the best advocates for their children so being informed will help guide a family to make the best decisions for the child battling cancer.

Brain & Nervous System

Brain and other nervous system cancers account for about 15% of pediatric cancers and are the second most common cancers in children. Most brain cancers of children involve the cerebellum or brain stem. In early stages they can cause headaches, nausea, vomiting, blurred or double vision, dizziness, and trouble walking or handling objects. Adults are more likely to develop cancers in different parts of the brain–usually the cerebral hemispheres. Spinal cord tumors are less common than brain tumors in both children and adults.

Brain tumors are usually found because the brain regulates vital functions such as memory, learning, hearing, sight, smell and emotion, and when these vital functions are disrupted, signs appear quickly.

Types

Tumors that start in the brain or spine are called gliomas. It is called glioma because it arises from glial cells, non-neuronal cells that provide support and protection for neurons in the brain and other parts of the nervous system. The most common site of gliomas is the brain. Gliomas are named according to the specific type of cell they share histological features with, but not necessarily originate from. The main types of gliomas are:

Ependymomas

Ependymoma is a tumor that arises from the ependyma, a tissue of the central nervous system. Ependymomas account for 10% of all brain tumors and occur in the lining of the brain or develop along the spinal cord. Usually, in pediatric cases the location is intracranial, while in adults it is spinal. The common location of intracranial ependymoma is the fourth ventricle. Rarely, ependymoma can occur in the pelvic cavity. These tumors are usually benign and grow very slowly.

Syringomyelia can be caused by an ependymoma. Ependymomas are also seen with neurofibromatosis type II. Ependymoblastoma are fast-growing, malignant tumors formed by cells that line the fluid-filled spaces in the brain and spinal cord.

Astrocytomas

Astrocytomas are a type of neoplasm of the brain. They originate in a particular kind of glial-cells, star-shaped brain cells in the cerebrum called astrocytes. This type of tumor does not usually spread outside the brain and spinal cord and it does not usually affect other organs. Astrocytomas are the most common glioma and can occur in most parts of the brain and occasionally in the spinal cord. Within the astrocytomas, there are two broad classes recognized in literature, those with:

  • Narrow zones of infiltration (mostly invasive tumors; e.g., pilocytic astrocytoma, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma), that often are clearly outlined on diagnostic images
  • Diffuse zones of infiltration (e.g., low-grade astrocytoma, anaplastic astrocytoma, glioblastoma), that share various features, including the ability to arise at any location in the CNS, but with a preference for the cerebral hemispheres; they occur usually in adults; and an intrinsic tendency to progress to more advanced grades.

People can develop astrocytomas at any age. The low-grade type is more often found in children or young adults, while the high-grade type are more prevalent in adults. Astrocytomas in the base of the brain are more common in young people and account for roughly 75% of neuroepithelial tumors

Oligodendrogliomas

A type of glioma that is believed to originate from the oligodendrocytes of the brain or from a glial precursor cell. They occur primarily in adults (9.4% of all primary brain and central nervous system tumors) but are also found in children (4% of all primary brain tumors). Oligodendrogliomas contain cells that resemble normal oligodendrocytes but are more rapidly growing than normal cells. Like other brain tumor types, oligodendrogliomas are graded on a grade I-IV scale, with IV the worst. Grade II oligodendroglioma is a slow-growing tumor. Grade III oligodendroglioma, synonymous with anaplastic oligodendroglioma, typically grows more quickly. While some oligodendrogliomas are not malignant, they all have the potential to be.

Symptoms

  • Headache
  • Vomiting
  • Seizures
  • Blurred vision and impaired speech
  • Mood changes
  • Poor coordination; difficulty with balance
  • Weakness or tingling in the arms and legs
  • Increased head circumference and bulging fontanel (“soft spot”) in infants

Typical Treatments

Standard Brain Cancer or Spinal Cord Tumor Treatment (additional new types of treatments are being tested in clinical trials and can be found on the NCI Web site):  The treatments listed below are to be used as a suggestion of what you may expect.  Please speak with your doctor about specific treatment plans he or she may have for your child.

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Watchful Waiting
  • Cerebrospinal fluid diversion: A method used to drain fluid that has built up around the brain and spinal cord. 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 excess fluid away from the brain so it may be absorbed elsewhere in the body.
  • High-dose chemotherapy with stem cell transplant: A way of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.

In addition, new types of treatments are often being tested in clinical trials and can be found on the National Cancer Institute Website.

 

Remember, you’re not alone.
Use our Forums to ask other parents what they’ve experienced.

Stages

Childhood Central Nervous System Embryonal Tumors

Treatment is based on the child’s risk group.

Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.

There is no standard staging system for childhood central nervous system (CNS) embryonal tumors. Instead, treatment depends on the child’s risk group:

Average risk

Childhood CNS embryonal tumors are called average risk when all of the following are true:

• The child is older than 3 years of age.

• All of the tumor was removed by surgery or there was only a very small amount remaining.

• The cancer has not spread to other parts of the body.

High risk

Childhood CNS embryonal tumors are called high risk if any of the following are true:

• The child is 3 years of age or younger.

• Some of the tumor was not removed by surgery.

• The cancer has spread to other parts of the body.

In general, cancer is more likely to recur (come back) in patients in the high-risk group.

Childhood Astrocytomas

The grade of the tumor is used in place of a staging system to plan cancer treatment.

Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.

There is no standard staging system for childhood astrocytoma. Treatment is based on the grade of the tumor and whether it is untreated or recurrent (has come back after treatment). The grade of the tumor describes how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread.

The following grades are used:

Low-grade astrocytomas:  slow-growing and rarely spread to other parts of the brain and spinal cord or other parts of the body. These include grade I (pilocytic, which form like a cyst and look almost like normal cells) and grade II (fibrillary, with cells that look long or slender like fibers) astrocytomas.

High-grade astrocytomas: fast-growing and often spread within the brain and spinal cord. These include grade III (anaplastic or malignant) and grade IV (glioblastoma, which spreads the fastest) astrocytomas.

Childhood astrocytomas may form at more than one place in the brain, but they do not usually spread to other parts of the body. Children who have neurofibromatosis type 1 are more likely to have tumors in more than one place.

Atypical teratoid/rhabdoid tumor

There is no defined staging system for childhood central nervous system atypical teratoid/rhabdoid tumor (AT/RT). Patients are classified as having newly diagnosed or recurrent disease with or without neuraxis dissemination.

GLIOMAS –

The plan for cancer treatment depends on whether the tumor is in one area of the brain or has spread throughout the brain.

Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.

There is no standard staging system for childhood brain stem glioma. Instead, the plan for cancer treatment depends on whether the tumor is diffuse (spread throughout the brain) or focal (in one area of the brain):

• Diffuse intrinsic pontine glioma is a tumor that has spread widely throughout the brain stem. A biopsy is usually not done for this type of brain stem glioma and it is not removed by surgery. A diffuse intrinsic pontine glioma is usually diagnosed using imaging studies.

• Focal or low-grade glioma is a tumor that is in one area of the brain stem. A biopsy may be done and the tumor removed during the same surgery.

Childhood Ependymoma 

The area where the tumor is found and the child’s age are used in place of a staging system to plan cancer treatment.

Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.

There is no standard staging system for childhood ependymoma. Instead, the plan for cancer treatment after surgery depends on the following:

• Whether any cancer cells remain after surgery.

• Whether the cancer has spread to other parts of the brain or spinal cord.

• The age of the child.

References:

MD Anderson Childhood Cancer Types. Houston, TX: MD Anderson. Retrieved August 15, 2011 from http://www.mdanderson.org/patient-and-cancer-information/
cancer-information/cancer-types

National Institute of Health. Types of Cancers 2011. Retrieved September 13, 2011 from http://www.cancer.gov/cancertopics/pdq/treatment

American Cancer Society. Cancer Facts and Figures 2009. Atlanta, GA: American Cancer Society. Retrieved September 1, 2011, from http://www.cancer.org/downloads/STT/CAFF2009PWSecured.pdf.

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