What is Brain Stem Gliomas?
The brain stem is the central hub of the brain and central nervous system connecting the brain and the spinal cord. It includes the midbrain, pons and medulla. Brain stem gliomas account for approximately 10% of pediatric brain tumors.
Types of Brain Stem Gliomas
- Focal Brainstem Gliomas
(30% of brainstem gliomas) involve more commonly the upper midbrain and lower medulla and carry the best prognosis.
- Diffuse Brainstem Gliomas
(70%) are most commonly found in the pons and upper midbrain, are infiltrative and carry the worst prognosis.
- Double vision or an inability to close the eyelids
- Drooping of the face
- Difficulty chewing and swallowing food
- Weakness in the arms and legs, clumsiness or wobbliness, and difficulty walking
- Difficulty talking
- Radiation Therapy
Radiation therapy uses x-rays or other high-energy particles to kill cancer cells. Radiation therapy is the most common treatment for brain stem glioma.Fatigue, drowsiness, nausea, vomiting, and headache are common side effects of radiation therapy. Because radiation therapy can sometimes interfere with the normal growth and development of the child’s brain, the doctor may choose to treat the cancer in another way. To avoid or reduce the need for radiation treatment in young children, the doctor may use chemotherapy to shrink the tumor.
Chemotherapy uses drugs to kill cancer cells. Because it kills cancer cells throughout the body, it is called a systemic treatment. Chemotherapy alone is not an effective treatment for brain stem glioma; however, in some cases, a doctor may use chemotherapy during or after radiation treatments.Because chemotherapy attacks rapidly dividing cells, including those in normal tissues such as the hair, lining of the mouth, intestines, and bone marrow, children receiving chemotherapy may lose their hair, develop mouth sores, or have nausea and vomiting. Chemotherapy may lower the body’s resistance to infection, lead to increased bruising and bleeding, and cause fatigue. These side effects can be controlled during treatment and usually go away after chemotherapy is completed. The severity of the side effects depends on the type and amount of the drug being given and the length of time the child receives the drug.
Surgery is used to treat brain stem glioma only when the tumor’s appearance on an MRI scan is focal, thus suggesting it may be possible to remove the cancer without damaging the brain, such as when a tumor grows out from the brain stem. For most children with diffuse types of brain stem gliomas, surgery is not necessary or possible because of the location of the tumor and the risk involved.