The types of cancers that develop in children are different from the types that develop in adults. Although there are exceptions, childhood cancers tend to respond better to chemotherapy. Children also tolerate chemotherapy better than adults. But, because chemotherapy can have some long-term side effects, children who survive their cancer need careful attention for the rest of their lives.
Since the 1960s, most children and adolescents with cancer have been treated at specialized centers designed for them. Being treated in specialized centers offers them the advantage of a team of specialists who know the differences between adult and childhood cancers, as well as the unique needs of children with cancers. This team usually includes pediatric oncologists, pathologists, surgeons, radiation oncologists, pediatric oncology nurses, and nurse practitioners.
These centers also have psychologists, social workers, child life specialists, nutritionists, rehabilitation and physical therapists, and educators who can support and educate the entire family.
Most children with cancer in the United States are treated at a center that is a member of the Children's Oncology Group (COG). All of these centers are associated with a university or children's hospital. As we have learned more about treating childhood cancer, it has become even more important that treatment be given by experienced experts.
Do We Know What Causes Brain And Spinal Cord Tumors in Children?
The cause of most central nervous system tumors is not fully understood. But researchers are making progress toward understanding some of the chemical changes that occur in normal brain cells that may lead them to form brain tumors.
Normal human cells grow and function based mainly on the information contained in each cell's chromosomes. Chromosomes are long molecules of DNA in each cell. Brain tumors, like other tumors, are caused by abnormal changes (mutations) in a person's DNA. DNA is the chemical in each of our cells that makes up our genes -- the instructions for how our cells function. We usually resemble our parents because they are the source of our DNA. However, DNA affects more than how we look.
Some genes contain instructions for controlling when our cells grow, divide, and die. Certain genes that speed up cell division are called oncogenes. Others that slow down cell division, or cause cells to die at the right time, are called tumor suppressor genes. Cancers can be caused by DNA mutations (changes) that "turn on" oncogenes or "turn off" tumor suppressor genes. These gene changes can be inherited from a parent (as is sometimes the case with childhood cancers) or may happen during a person's lifetime as cells in the body divide to form 2 new cells.
In recent years, researchers have found the gene mutations that cause some rare inherited syndromes (like neurofibromatosis, tuberous sclerosis, Li-Fraumeni, and von Hippel-Lindau) and increase the risk of developing some central nervous system tumors. For example, the Li-Fraumeni syndrome is caused by mutation of the p53 tumor suppressor gene. Normally, this gene prevents cells with damaged DNA from growing. When mutated, it increases the risk of developing brain tumors (particularly astrocytomas), as well as some other cancers.
Most brain and spinal cord tumors in children are not the result of known inherited syndromes. A number of gene or chromosome changes have been found in some of these tumors, although it's not clear if these changes have specific causes. Still, research into these changes may lead to new treatments for central nervous system tumors in the future.
In most cases, it is not known why people without inherited syndromes develop changes in their central nervous system cells. Most risk factors for cancer somehow damage genes. For example, cigarette smoke is a risk factor for lung cancer and several other cancers because it contains chemicals that can damage genes. The brain is relatively protected from cigarette smoke and other cancer-causing chemicals that we all breathe or eat, so these factors are unlikely to play a major role in these cancers.
The vast majority of brain tumors happen for no apparent reason and are not associated with anything that the child (or parents) did or didn't do, or any known exposures in the environment.
Can Brain and Spinal Cord Tumors in Children Be Found Early?
At this time there are no blood tests or other screening exams that can be used routinely to detect brain tumors before they start to cause symptoms. These tumors usually come to light as a result of signs or symptoms the child is having. In most cases, survival of patients with brain tumors depends on the type of tumor and its location, not how early it is detected. But as with any disease, earlier detection and treatment is likely to be helpful.
How Are Brain and Spinal Cord Tumors in Children Treated?This information represents the views of the doctors and nurses serving on the American Cancer Society's Cancer Information Database Editorial Board. These views are based on their interpretation of studies published in medical journals, as well as their own professional experience.
The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.
Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.
The first part of this section describes the various types of treatments used for brain tumors in children. This is followed by a description of the most common approaches used for these tumors based on the type of tumor.
General Comments About Treatment
Children and adolescents with brain and spinal cord tumors and their families have special needs that can be best met by cancer centers for children and adolescents working closely with the child's primary care doctor. Treatment in these centers takes advantage of a team of specialists who know the differences between cancers in adults and those in children and adolescents, as well as the unique needs of younger people with cancers. This team often includes several different types of doctors, nurses, and other specialists.
Children with central nervous system tumors may be treated by surgery, radiation therapy, and/or chemotherapy. Treatment is different for different kinds of tumors. Each child's treatment must be approached individually to give the child the best chance of cure. The possible long-term side effects of treatment must also be considered.
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