Medulloblastoma Treatment in Israel: Advanced Brain Tumor Care for Children and Adults

One of the most challenging brain tumors is medulloblastoma, a tumor that grows in the cerebellum, mainly in children, and is considered the second most common childhood cancer after leukemia. The Brain Tumor Center team at the Tel Aviv Medical Clinic provides these patients and their families with comprehensive, supportive, and multidisciplinary care.

​​​​​​What is medulloblastoma?

Medulloblastoma refers to a group of tumors in the nervous system. Medulloblastomas grow in the cerebellum and may also spread to the spinal cord. This malignant tumor develops from small brain cells, which are a remnant of an early stage of embryonic development. Medulloblastoma is a rare tumor in adults, but is defined as the most common brain tumor in children (especially boys). It is also the most common type of cancer in children, after leukemia (blood cancer).

What causes medulloblastoma?

It is believed that medulloblastoma originates in a progenitor cell of the cerebellum, but the original cell from which this tumor grows has not yet been identified with certainty. The tumor is thought to originate from cells of fetal tissue. called neuroectoderm. These tumors, which originate from undifferentiated embryonic cells, are classified as embryonic tumors.

Can medulloblastoma metastasize?

Medulloblastomas grow in an area of ​​the brain called the cerebellum, and they can spread through the subarachnoid space and ventricles. Unlike most primary brain tumors, which do not metastasize beyond the brain or spinal cord, medulloblastoma tumors can sometimes metastasize to other organs outside the central nervous system.

What are the symptoms of medulloblastoma in the brain?

Clinical symptoms of medulloblastoma in the brain include headaches, nausea and vomiting, ataxia (lack of coordination and clumsy movements of the limbs), and vision deterioration. Nystagmus (eye twitching), papilledema (swelling of the optic nerve head), facial paralysis (facial paralysis), torticollis (neck tilting to the side) and neck stiffness may also occur.

What signs can indicate the presence of such a brain tumor?

There are quite a few signs that can indicate the possibility of a brain tumor, but none of them are specific in themselves – meaning that each of them can also indicate another medical problem and depends greatly on the location of the tumor. Therefore, only a comprehensive neurological examination and imaging tests can diagnose whether it is a suspected medulloblastoma or another brain tumor. In the event that such a suspicion arises, the diagnosis will continue through a series of tests, which will include imaging scans and more.

Is there a difference between a normal headache and a headache resulting from a brain tumor?

First, it is important to know that normal headaches are a common phenomenon, and the vast majority of these complaints are related to causes other than a brain tumor. In most cases, a brain tumor causes not only headaches, but also vomiting and other symptoms as described above, so the appearance of headaches without other symptoms is usually not a cause for suspicion of medulloblastoma or another brain tumor. In terms of the nature of the pain, headaches originating from a tumor are worse upon waking up. Sometimes the pain appears at night with great intensity and even awakens from sleep.

How are medulloblastoma brain tumors diagnosed?

Diagnosis of medulloblastoma, like diagnosis of any brain tumor, is made using various imaging tests (CT / MRI that scan the brain). The final diagnosis is made by pathological examination of a sample from the tumor. It is of great importance to perform a molecular test for the tumor. The molecular tests divide patients into different groups with different prognoses. In medulloblastoma, there is a place to perform a lumbar puncture and send spinal fluid for examination.

Genetic diagnostics

After performing a brain tumor biopsy, we send all materials for study and genetic diagnostics to the best gene laboratories in the Israel and USA. This is a mandatory stage of modern personalized oncology.

Genetic diagnostics is necessary for 100% verification of the diagnosis, establishing the exact subtype of medulloblastoma, selecting the optimal and most effective treatment regimen, selecting and manufacturing innovative targeted drugs or other immunobiological drugs.

Thanks to molecular genetic diagnostics, we can find all known mutations in malignant cells and select the most effective treatment protocol for a specific patient, because the response to the action of certain drugs depends on the type of changes.

Thanks to such advanced diagnostic methods, we are 100% sure of the accuracy of the diagnosis and the effectiveness of the selected therapeutic regimen.

Examples of modern genetic testing panels for patients with medulloblastoma: growth factor receptor genes – PDGFRB, PDGFRA, EGFR, HER2/NEU, RET, EPH, ELK, FMS, KIT, MET, ROS, SEA, TRK, VEGFR, growth factor genes: PDGFB, EGF, TGFA, TGFB, GDNF, INT2, IIST1, NT1/WNT3, VEGF, FGFA, FGFB.

The full list of molecular genetic tests that TAMS offers to its patients can be viewed here. All genetic tests are unique tests that can be performed on the TAMC basis.

What is the treatment for medulloblastoma?

Patients with brain tumors such as medulloblastoma should be treated only by Pediatric brain tumor specialists from clinics with a specialized oncology and neurosurgery department. Tel Aviv Medical Clinic is exactly such a medical center. We employ highly qualified specialists who are proficient in modern comprehensive treatment programs. The goal of any therapy program is to cure a person in the most gentle mode and at the same time reduce the risks of possible side effects during treatment and long-term consequences after its completion.

All our patients can become participants in clinical trials of new drugs, therapy protocols, innovative treatment methods. Tel Aviv Medical Clinic specialists actively participate in such experiments, in addition, they are constantly improving and finalizing standard protocols for the treatment of various oncological diseases. If the patient meets the necessary parameters (we will be able to give an answer after studying all your medical documents), he can become a participant in such a clinical trial and try closed protocols (developed within the clinic) as an alternative treatment. Often, this is the only chance for a patient to overcome a serious disease, especially in situations where standard treatment regimens have proven ineffective. Treatment for medulloblastoma includes surgery to remove the tumor, radiation therapy to the brain and spine, chemotherapy, and sometimes experimental treatment methods in clinical trials.

Neurosurgical intervention is the main type of treatment for medulloblastoma. Its goal is the most complete removal of the tumor conglomerate, and if the latter is impossible, resection of the accessible part of the tumor.

Modern neurosurgery in Israel has achieved incredible development, so patients with CNS tumors have access to innovative and effective surgical interventions on the brain, including:

• stereotactic radiosurgery, for example, using a gamma knife, cyber knife, x-knife and nano knife, when the operation is performed precisely without a single incision with a scalpel;
• cryosurgery is a neurosurgical intervention in which probes cooled with liquid nitrogen are used, leading directly to the tumor in order to destroy it, while completely preserving healthy surrounding tissue.

Neurosurgical intervention can also be performed by craniotomy, which is the removal of a certain part of the skull bones so that the surgeon can access the part of the brain that interests him and perform all the necessary manipulations. Modern neuroimaging equipment, such as intraoperative MRI, allows surgeons to create a real-time, precise brain map for each patient. This ensures the filigree removal of the tumor conglomerate and the preservation of functionally important areas of the brain.

Sometimes neurosurgical interventions are performed in awake mode, when the patient is not put under general anesthesia and remains fully conscious. This approach allows monitoring important functions of the brain during the operation and avoiding their disruption.

The next stage after surgical treatment is radiation therapy. The intensity of radiation and its type depend on the stage of the disease.

Proton radiation therapy is shown to be particularly effective. This type of radiation allows achieving the maximum dose of radiation in the tumor area, while the surrounding healthy tissues receive a minimum amount of ionizing radiation. TAMS has the most modern proton beam therapy units, which are not only effective, but also safe for practical use.

Chemotherapy is also included in the treatment complex for medulloblastoma. Chemotherapy doctors of our department will calculate the optimal number of sessions and dosage of drugs, depending on age, risk level of pathology and its stage.

Patients with recurrent medulloblastoma or initially resistant tumor to standard treatment protocols after surgery and radiation therapy may be offered treatment within the framework of clinical trials. The latter include the use of innovative immunotherapy drugs, including targeted therapy. Among targeted drugs, signal transduction inhibitors (Vismodegib) are used today for the treatment of medulloblastoma; they block molecular signals inside malignant cells, which leads to their irreversible death.

Autologous hematopoietic stem cell transplantation is also used in the treatment of patients with recurrent medulloblastoma. The procedure is performed after high-dose chemotherapy and allows damaged bone marrow cells to be replaced with healthy ones (these are the child’s own cells, prepared before the start of chemotherapy).

What is the life expectancy after the discovery of medulloblastoma in children ?

Chances of recovery for patients with Medulloblastoma depend on the biological characteristics of the tumor and the level of its spread in the nervous system. Without treatment, life expectancy is short – only a few months from the time of diagnosis. Surgery to remove the tumor, combined with radiation therapy and chemotherapy, significantly prolongs survival.

What is the main difference in the development of brain tumors between adults and children?

In adults, most brain tumors are secondary – that is, the result of metastases sent from a tumor that grew in another organ in the body. In children, the vast majority of brain tumors are primary, that is, originating in the brain itself, such as medulloblastoma.

Why is it worth receiving treatment at the Tel Aviv Medical Clinic ?

The Brain Tumor Center at the Tel Aviv Medical Clinic, the leading and largest privat center in Israel for cancer treatment, is concentrated with top-notch specialists in Israel and with an international reputation, along with advanced technologies and equipment from the forefront of world medicine. This is a winning combination of vast experience and knowledge, innovative approaches and groundbreaking research, which reaches the patient’s bedside and brings the best clinical excellence in the treatment of brain tumors, including the most complex ones.

At the Tel Aviv Medical Clinic, patients receive comprehensive medical and emotional support. Our patient-centered approach ensures personalized treatment plans, empathy, and dedicated service for both patients and their families during this challenging time.

If you or a loved one has been diagnosed with medulloblastoma, contact our specialists today for a consultation.