Glioma is the most common brain tumor in children and adults. This neoplasm accounts for up to 25% of all childhood cancers. Most gliomas are benign tumors, they respond well to treatment and have a favorable prognosis. For example, with pilocytic astrocytoma (the most common type of glioma), the complete recovery rate is 90%.
Glioma can affect not only brain, but also spinal cord. The tumor develops from neuroglial cells, which perform a nutritional, supporting function for the main nerve cells – neurons. Depending on location, growth rate, and malignancy degree, glioma can pose a serious threat to health and life of child.
If your child is diagnosed with glioma, it is important to find a qualified oncologist, neurologist and neurosurgeon who has experience treating children with such brain tumors. Unfortunately, with gliomas, a not entirely correct tactic is often chosen – observation (due to the fact that most often the tumor is benign and grows slowly). In the future this can lead to difficulty in glioma surgical treatment or impossibility of its complete removal, as well as to complications associated with both the tumor itself and conservative treatment methods. Therefore, if a glioma diagnosis is made and there are no contraindications to treatment of the pathology, it is necessary to actively treat the tumor using an integrated approach.
All doctors in Pediatric Oncology Department of Tel Aviv Medical Clinic are highly qualified and have extensive practical experience in treating children with cancer of central nervous system, including gliomas. Most of them have repeatedly undergone training in the best cancer centers in USA and Europe and have professional skills in communicating with children suffered from cancer. In their practice, TAMC specialists are guided only by modern clinical recommendations and global treatment protocols.
An important treatment feature in our department is an individual approach to each child. Developing an examination and treatment regimen, doctor takes into account the smallest details from patient and his disease. Thanks to this patient-oriented approach, we achieve success even in the most difficult situations.
Also, the undoubted advantage of our Pediatric Oncology Department is multidisciplinary approach, this means a whole team of highly specialized specialists provides comprehensive care and support to one child – oncologists, neurosurgeons, neurologists, radiation therapists, chemotherapists, pediatricians, rehabilitation specialists, psychologists, physiotherapists, speech therapists, etc.
Causes of glioma in children
Unfortunately, the true cause of glioma development has not been established to date. In some cases, glioma develops as a secondary pathology due to radiation therapy for another cancer. There is also a definite connection between certain genetic diseases and syndromes and the development of gliomas of the brain or spinal cord.
Children with the following genetic diseases have an increased risk of glioma development:
- Li-Fraumeni syndrome.
- Neurofibromatosis type 1.
- Turcot syndrome.
- Tuberous sclerosis.
Glioma symptoms in children
Symptoms of brain glioma can be divided into general and focal (the latter depend on tumor location).
General symptoms:
- persistent headache;
- nausea and vomiting, especially in the morning and because of headache;
- memory impairment, various thinking disorders, inability to concentrate;
- various changes in behavior;
- convulsive syndrome;
- speech disorders (oral and written);
- visual impairment;
- disorders of movements coordination and gait.
Focal symptoms manifestations depend on which part of brain is compressed or destroyed by growing tumor, for example:
- cerebellum: imbalance, coordination, dizziness;
- temporal lobe: problems with speech, memory, coordination;
- frontal lobe: changes in patient’s mood and personality;
- parietal lobe: impaired fine motor skills, written language skills;
- occipital lobe: blurred vision, hallucinations.
Tumor growth often disrupts the normal circulation of cerebrospinal fluid. This leads to its accumulation in brain and hydrocephalus development. Excess fluid causes increased intracranial pressure. Most of glioma symptoms can be associated specifically with hydrocephalus and intracranial hypertension.
Depending on tumor structural features and its malignancy degree, several types of gliomas are distinguished. The most common of them:
- pilocytic astrocytoma,
- fibrillary astrocytoma,
- anaplastic astrocytoma,
- glioblastoma.
If there are any changes in child’s health, do not hesitate! Seek professional help, and qualified TAMC specialists will help you to understand any situation quickly and efficiently .
Modern diagnostic methods
In Pediatric Oncology Department of TAMC, only modern expert-class diagnostic equipment is used, making the diagnostic process surprisingly comfortable and accurate.
Currently, thanks to modern research methods, brain gliomas are quickly and easily diagnosed. The only question is how timely the patient consulted a doctor.
The examination algorithm for suspected brain tumors, including glioma, includes:
- Neurological examination. During examination, neurologist must check the child’s vision, hearing, balance, coordination, reflexes, and muscle strength. Discovered certain abnormalities, doctor will be able to guess in which part of brain the tumor is located.
- MRI (sometimes CT, MSCT) of brain with contrast. This study allows us to visualize a tumor in brain, as well as clarify tumor size, structure, localization, and condition of neighboring tissues.
- Tumor biopsy with pathohistological examination. A biopsy can be performed before surgery (stereotactic needle biopsy) or directly during surgery to glioma removal.
After biopsy, we send all materials for revision to the best pathohistological laboratories in Israel, where they are examined by a qualified specialist in brain tumors. Thanks to such thorough checks, we are absolutely sure of diagnosis correctness and further chosen treatment tactics. Also, after a biopsy, innovative molecular genetic tests can be performed to identify the characteristics of tumor cells, which subsequently makes it possible to select the most effective treatment regimen, including modern immunobiological drugs.
Prognosis for glioma in children
The prognosis for brain glioma depends entirely on how malignant the tumor is. For example, pilocytic astrocytoma has a favorable prognosis and a complete recovery rate of more than 90%. At the same time, glioblastoma (the most malignant variant of glioma) has a 5-year survival rate of only 5%.
The prognosis for brain glioma is also influenced by:
- Possibility of complete surgically tumor removal.
- Glioma gocalization.
- The pathology has arisen for the first time or specialist is dealing with a relapse.
Glioma modern treatment
Children with brain tumors should only be treated by doctors from clinics that have a specialized department of Pediatric Oncology and Neurosurgery. TAMC is just such a medical institution. We employ highly qualified specialists who are proficient in modern comprehensive treatment programs. The main aim of any therapy program is to treat the child as sparingly as possible and at the same time to minimize (if possible) the risks of side complications in future during treatment and long-term consequences after its completion.
Surgical tumor removal is the main treatment method for glioma. The main task of eurosurgeon is to remove the tumor conglomerate as completely as possible. Gliomas are often small in size and can be easily separated from healthy brain tissue, which makes complete surgical removal of pathological focus possible. In other situations, the tumor may grow into surrounding tissue or be located near vital areas of brain. Such tumors can only be partially removed. Performing brain surgeries, neurosurgeons use various auxiliary modern technologies, thanks to which they can increase the efficiency and safety of the procedure:
- Intraoperative MRI. This technology helps to neurosurgeon to clearly identify the brain anatomical structures during surgery. Thus, doctor will be able to remove the brain tumor with maximum precision without affecting vital areas of nervous tissue.
- Fluorescent dyes. Before surgery, patient is injected with a fluorescent substance. As a result, tumor tissue absorbs the substance and begins to light up, but normal brain tissue does not. Thanks to this, surgeon is able to more accurately determine tumor boundaries and remove it without damaging adjacent healthy tissue.
- Awake craniotomy. It is used in cases where the tumor is located in functionally significant areas of brain. During surgery, surgeon tests areas of brain and asks the patient to perform simple tasks: answer questions, perform simple movements of arm or leg. In this way, surgeon can identify critical areas of brain and avoid damaging them.
Stereotactic radiosurgery is especially effective for benign gliomas (for example, fibrillary astrocytoma), the size of which does not reach 3 cm. If necessary, surgery is performed using a gamma knife under MRI guidance.
Radiation therapy may be used depending on tumor type, its location and child’s age. It is often included in therapy after surgery, especially for high-grade glioma, to destroy remaining tumor cells.
The complex treatment regimen for glioma may include chemotherapy application. The essence of this treatment method is to use drugs that suppress cancer cells growth and division. Chemotherapy is often used in addition to surgery or as primary treatment when surgery is not possible. In very young children, chemotherapy may be used to delay radiation treatment until child is older.
Chemotherapy regimen depends on factors such as stage of the disease and malignancy degree of tumor, as well as molecular genetic characteristics of tumor. Different chemotherapy regimens may be used, depending on glioma type that child is diagnosed with. However, polychemotherapy alone does not lead to complete recovery unless glioma is surgically removed.
In struggle against gliomas, modern targeted therapy has recently been actively used. This treatment is based on application drugs that have the ability to influence by specific points on cancer cells. Moreover, they do not have the side effects characteristic of classical chemotherapy, since they do not affect healthy cells of the body.
