The human brain is the “cockpit” or “command center” for the central nervous system; it is also, despite its critical role in every aspect of human life, one of the most delicate organs in the human body. Any abnormal growth or tumour in the brain, whether cancerous or non-cancerous, can cause serious damage to healthy brain tissue and impact the body’s ability to function normally rather significantly.
Treating a brain tumour/brain cancer therefore means taking the following into consideration:
- How to best remove or eliminate the tumour ;
- How to relieve symptoms caused by the tumour ;
- How to minimise damage to the healthy tissue of the brain
As with all types of childhood cancer, each child’s treatment plan will be unique, based on his or her specific type of cancer; for brain tumours, the treatment plan will depend specifically on the type of tumour, the size and location of the tumour, the grade of the tumour, and the impact of the tumour on healthy brain tissue. In general, however, treatment for brain tumours in children generally involves three types of treatment:
Whenever possible, the first line of treatment will be surgery – the goal being to remove all, or at least most of, the tumour. Radiation and/or chemotherapy may follow surgery in order to eliminate any remaining tumour cells that could not be removed during the surgery and/or to prevent the tumour from re-growing if possible.
Radiation therapy and chemotherapy play a more central role in treating brain tumours that cannot be safely removed via surgery. Due to the fact that surgery is generally the first line of treatment, this post will focus on surgical options for brain cancer in children.
Surgical Treatment for Childhood Brain Cancer
The goal of surgery as treatment for a brain tumour is, in most cases, to remove or destroy as much of the tumour as possible while minimising damage to the surrounding healthy tissues of the brain. In some cases, the surgery may also serve as an opportunity to co a biopsy; this may be required to determine the type of tumour and whether it has specific gene changes that could affect long-term prospects. The biopsy, if necessary, will help your child’s oncology team determine treatment options for after the surgery.
The most common type of surgical procedure for treatment of a brain tumour is a craniotomy. Depending on the location of the tumour, and whether brain function must be assessed during the procedure, your child may be given general anesthesia or he or she may remain awake under local anesthesia. The surgeon will remove a ‘bone flap’ from the skull just large enough to enable him or her to insert instruments and view the brain under operation, if necessary and if possible. The tumour may be cut out with a scalpel or special scissors or it may be suctioned out with a specialised device, and the removed piece of bone will then be re-attached to the skull.
Modern imaging technology is used as much as possible both before and during surgery to precisely locate and map the edges of the tumour. Imaging tests such as MRIs and CT scans are done before surgery, and ultrasounds during surgery, to maximise the surgeon’s ability to identify and remove tumourous cells while reducing the risk of removing healthy tissue.
Other specialised imaging tests, such as Functional MRIs, Intraoperative cortical stimulation, and intraoperative imaging also enable the surgeon to detect a particular function of the brain to help remove the tumour as safely and as much of it as possible.
The thought of brain surgery can be terrifying for both children and parents, but with our knowledge of the brain continuing to advance daily, as well as our ability to harness the power of advanced tools and techniques, brain surgery is actually safer and more successful than ever.
The best thing to do is to share your concerns – and your child’s concerns – with your child’s oncologist and surgical team up front so that they can make sure that both you and your child are as comfortable as possible throughout the entire treatment process.