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Treatment Option Overview
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There are different types of treatment for children with childhood medulloblastoma.
Different types of treatment are available for children with
childhood medulloblastoma. Some treatments
are standard (the currently used treatment), and some are being tested in clinical trials. A treatment
clinical trial is a research study meant to help improve current treatments or
obtain information on new treatments for patients with cancer. When clinical trials show that
a new treatment is better than the standard
treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial
should be considered. Clinical trials are taking place in many parts of the
country. Information about ongoing clinical trials is available from the
NCI Web site. Choosing the most appropriate cancer treatment is a
decision that ideally involves the patient, family, and health care
team.
Children with medulloblastoma should have their treatment
planned by a team of doctors with expertise in treating childhood brain
tumors.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes
in treating children with cancer. The pediatric oncologist works with other pediatric doctors who are experts in treating children
with brain tumors and who specialize
in certain areas of medicine. These may include the following specialists:
Some cancer treatments cause side effects months or years
after treatment has ended.
Some cancer treatments cause side effects that continue or appear months or years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include:
- Physical problems.
- Changes in mood, feelings, thinking, learning or memory.
- Second cancers (new types of cancer).
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information).
Four types of standard treatment are used:
Surgery
Surgery is used to diagnose and treat childhood medulloblastoma as described in the General Information section of this summary.
Radiation therapy
Radiation
therapy is a cancer treatment that uses high-energy x-rays or
other types of radiation to kill cancer cells or keep them from growing. There are two types of
radiation therapy. External radiation therapy uses a machine outside the
body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are
placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Radiation therapy to the brain can affect growth and development in young children. For this reason, ways of giving radiation therapy that limit damage to healthy brain tissue are being studied.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of
cancer cells, either by killing the cells or by stopping them from
dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer
cells throughout the body (systemic chemotherapy). When chemotherapy is
placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Because radiation therapy can affect growth and brain development
in young children, clinical trials are studying ways of using chemotherapy to
delay or reduce the need for radiation therapy.
Cerebrospinal fluid diversion
Cerebrospinal fluid diversion is 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 (hollow 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.
New types of treatment are being tested in clinical
trials. These include the following:
High-dose chemotherapy with stem cell transplant
High-dose chemotherapy with bone marrow or stem cell transplant is 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.
This summary section refers to specific treatments under study in
clinical trials, but it may not mention every new treatment being studied.
Information about ongoing clinical trials is available from the
NCI Web site.
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