Medulloblastoma

Treating Pediatric Brain Cancer

The Department of Neurosurgery at Rutgers Health at RWJBarnabas Health treats pediatric brain cancer through a team approach utilizing the expertise of board-certified pediatric oncologists, neurologists, neurosurgeons, pediatricians, and other pediatric health care providers. With the collaboration of a multidisciplinary team, we strive for optimal treatment outcomes for our patients. Our team handles even the most complex cases of pediatric brain tumors by utilizing state-of-the-art tools for diagnosis and treatment. Many of our patients are referred to our hospital by other physicians, owing to a reputation of excellence and compassionate care for our young patients.

Interested in learning more about how we can help provide a second opinion or tailor a treatment plan for your child? Contact The Department of Neurosurgery at Rutgers Health at RWJBarnabas Health to take a tour of our facilities.

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What Is a Medulloblastoma?

Medulloblastoma is the most common malignant (cancerous) brain tumor in children, most commonly found in children between the ages of 3 and 8. These tumors are fast-growing and aggressive, located in the lower back part of the brain at the base of the skull, just above the brainstem. This area of the brain is called the cerebellum, which controls complex motor functions, movement, balance, and coordination. Medulloblastoma is a primary brain tumor, meaning it originates in the brain rather than traveling from some other area of the body. These tumors are all classified as grade 4, meaning they are aggressive and spread quickly.

This cancer occurs in infants and children, and rarely in adults. According to data from the National Cancer Institute, an estimated 357 people are diagnosed every year, and an estimated 3,840 people live with this tumor. Treatment for child patients is different than for adults, because their brains are still developing.

Medulloblastoma Symptoms

Symptoms vary from one patient to the next based on the location and size of the tumor, and whether it has spread to other areas. Usually, symptoms result from increased intracranial pressure as the tumor grows.

Some of the symptoms of a medulloblastoma include:

  • Abrupt onset of headaches, most prevalent in the morning
  • Nausea and vomiting
  • Fatigue, excessive sleepiness
  • Lack of coordination
  • Difficulty walking
  • Trouble balancing
  • Abnormal eye movements
  • Vision changes, such as blurry vision caused by swelling of the optic disk at the back of the eye

If the medulloblastoma tumor spread to the spinal cord, the patient may experience additional symptoms, including back pain, further difficulty walking, and inability to control bladder and/or bowels.

Medulloblastoma Diagnosis

The process of diagnosis starts with taking the patient’s medical history and discussing their signs and symptoms, sometimes with the parent if the child is very young.

  • Neurological exam: Your child’s doctor will check for abnormalities in hearing, vision, balance, coordination, and reflexes, which can help determine which part of the brain a tumor might be located.
  • Imaging tests: These tests can identify pressure or blockage of the cerebrospinal fluid (CSF), which can be an indication of medulloblastoma. Computerized tomography (CT) scans or magnetic resonance imaging (MRI) scans must be done to diagnose a brain tumor to find the tumor’s location and determine size.
  • Biopsy: This is needed to analyze suspicious brain tissues in a lab to determine cell type.
  • Lumbar puncture: Also called a spinal tap, this procedure involves collecting CSF from around the spinal cord, to test it for tumor cells or other abnormalities. This test is done after surgery to remove the tumor or relieve pressure on the brain.

Medulloblastoma Treatment

If your child has been diagnosed with a medulloblastoma, timely treatment is important. Your child’s treatment will be tailored to his or her age, overall health, and the team will come up with a strategy based on the size and location of the tumor. A neuro-oncologist with experience in pediatric medulloblastoma treatment will be on your child’s treatment team to strive for the best outcome.

  • Surgery to relieve fluid buildup in the brain: The first-line treatment for a medulloblastoma is surgery, whenever possible. The goal is to obtain tissue to take a biopsy to determine the tumor type and grade.
  • Surgery to remove the medulloblastoma: A neurosurgeon carefully removes the tumor without harming the nearby tissue. If the medulloblastoma is too close to critical structures deep within the brain, additional treatments will target any remaining cancer cells.
  • Radiation therapy: Surgery is usually followed by radiation to the brain or spine, as the disease has a tendency to spread to the spine. A radiation oncologist uses radiation therapy on the brain and spinal cord using high-energy x-rays or proton beams to kill cancer cells.
  • Chemotherapy: This standard cancer treatment is also recommended for many patients, depending on the subtype of medulloblastoma and how much the tumor has spread. The goal is to use the drugs to kill cancer cells through an intravenous injection. High-dose chemotherapy may be a recommended treatment after stem cell rescue (a stem cell transplant colleting the patient’s own stem cells). Sometimes chemotherapy is administered at the same time as radiation therapy.
  • Clinical trials: New research in the field of pediatric cancer is constantly improving treatment outcomes. Eligible participants may be able to enroll in these research studies to try the latest treatment options, although side effects may not yet be known. To learn if this is the right option for your child, ask your child’s treatment team.

Medulloblastoma Prognosis

According to the National Cancer Institute, the 5-year survival rate for medulloblastoma is over 72% if the disease has not spread. However, survival rates vary depending on the location and size of the tumor. If the disease has spread to the spinal cord, the rate of survival is about 60%. Children younger than 3 years old often have the lowest survival rates, because their tumors are more aggressive.

Contact Us

We encourage you to contact us either directly or get a referral through your child’s pediatrician or primary care provider. Treatment can be coordinated through your child’s primary health care providers.

Request an appointment online now or call 833-656-3876.