Embryonal Tumors

Understanding Embryonal Tumors

Embryonal tumors are abnormal growths in the brain, made up of cells that are leftover from when a baby is developing in the womb. These cells grow uncontrollably, forming a tumor. This type of growth is a form of brain cancer, meaning it can spread and damage healthy brain tissue. It can also spread to the fluid surrounding the brain and spinal cord.

These tumors are most common in babies and young children, but they can happen at any age. Medulloblastoma is one of the most common types, starting in the lower part of the brain called the cerebellum.

Symptoms of an embryonal tumor can include:

• Headaches
• Nausea
• Vomiting
• Extreme tiredness
• Dizziness
• Double vision
• Trouble walking
• Seizures
• Other potential problems

If your child is suspected to have an embryonal tumor, it's crucial to seek care at a medical center experienced in treating pediatric brain tumors. These centers have the latest technology and expertise to ensure a correct diagnosis and effective treatment.

Diagnosing an embryonal tumor involves several steps:

• Neurological exam: Doctors assess vision, hearing, balance, muscle strength, coordination, and reflexes to pinpoint which part of the brain might be affected.
• Biopsy: A small tissue sample from the tumor is taken for examination under a microscope. This is often done during surgery, or sometimes before surgery if imaging tests show unusual features. Analyzing the tissue helps determine the specific type of tumor cells.

Treatment for embryonal tumors typically involves a combination of approaches:

• Surgery: A brain surgeon removes as much of the tumor as possible, while minimizing damage to surrounding healthy brain tissue. Often, additional treatments follow surgery to target any remaining cancer cells.
• Radiation therapy: High-energy beams (like X-rays or protons) target and destroy tumor cells. Proton beam therapy is a more precise newer technique that focuses the radiation on the tumor while limiting damage to healthy tissue. Unfortunately, this advanced therapy isn't available everywhere.
• Chemotherapy: Strong medicines are used to kill tumor cells. These medicines can be given through a vein or as pills. Chemotherapy might be used after surgery or radiation, or sometimes alongside radiation.
• Clinical trials: These studies test new treatments for embryonal tumors. These trials might offer access to the latest options, but potential side effects may not be fully understood. Talk to your child's healthcare team to see if a clinical trial is a suitable option.

It's important to discuss all treatment options with your child's healthcare team to determine the best course of action based on the specific type and location of the tumor, as well as your child's age and overall health.

Diagnosing Brain Tumors: A Guide for Patients

If your doctor suspects you might have a brain tumor, they'll likely use a series of tests to confirm the diagnosis and understand the nature of the tumor. These tests can help determine the type, location, and potential aggressiveness of the growth.

1. Neurological Exam: Your doctor will evaluate various functions of your brain. This includes checking your vision, hearing, balance, coordination, muscle strength, and reflexes. Any problems in these areas can point to a potential brain issue, but a neurological exam alone cannot diagnose a tumor. It helps your doctor pinpoint which part of the brain might be affected.

2. Head CT Scan: A CT scan uses X-rays to create detailed images of the brain and surrounding areas. It's a fast and readily available test, making it often the first imaging procedure performed when dealing with headaches or other symptoms that could have various causes. The CT scan provides preliminary information, guiding the doctor towards further tests, such as an MRI, if a brain tumor is suspected.

3. PET Scan: A PET scan (Positron Emission Tomography) uses a radioactive substance injected into your bloodstream. This substance travels to cells, and those actively dividing (like tumor cells) absorb more of it. This makes the tumor cells stand out in the images. A PET scan is particularly useful for detecting rapidly growing brain tumors, such as glioblastomas and some types of oligodendrogliomas. Slower-growing, non-cancerous (benign) tumors might not show up clearly on a PET scan. Not everyone needs a PET scan, so discuss this with your doctor.

4. Brain Biopsy: A brain biopsy involves removing a small piece of the tumor tissue for laboratory analysis. This is often done during surgery to remove the tumor. If surgery isn't possible, a needle biopsy may be performed. A stereotactic needle biopsy involves using imaging tools (like CT or MRI) to guide a thin needle into the tumor to collect a sample. The procedure is done under local anesthesia (numbing the area) or general anesthesia (putting you to sleep) to ensure comfort. A needle biopsy is sometimes preferred over surgery if the tumor is located in a sensitive area of the brain. Brain biopsies carry a small risk of complications like bleeding or brain tissue damage.

5. Lab Testing of Biopsy Sample: The collected tissue sample is sent to a laboratory for detailed examination. Lab tests reveal if the cells are cancerous or non-cancerous. They also help determine the tumor's grade, which indicates how quickly the cells are growing and multiplying. The grade is determined by how different the tumor cells look from healthy cells under a microscope, ranging from 1 (slow growth) to 4 (fast growth).

6. MRI (Magnetic Resonance Imaging): MRI uses powerful magnets to create detailed images of the brain. It's highly effective in identifying brain tumors because the images are clearer compared to other imaging tests. A contrast dye is often injected before the scan to highlight the tumor even better, improving the visibility of smaller tumors and distinguishing them from healthy brain tissue. Different types of MRIs, such as functional MRI and magnetic resonance spectroscopy, provide additional information. Functional MRI helps pinpoint areas of the brain responsible for specific functions, aiding in surgical planning. Magnetic resonance spectroscopy measures the levels of certain chemicals in the tumor cells, giving clues about the tumor type. Another type, magnetic resonance perfusion, measures blood flow within the tumor, allowing doctors to target treatment to the most active parts.

Understanding Prognosis: Doctors use all the diagnostic information (type of tumor, growth rate, location, DNA changes, complete removal possibility, and overall health) to assess the prognosis, which is the likelihood of successful treatment. Unlike some cancers, brain tumors don't have stages. Instead, factors that impact the prognosis are discussed in detail with the patient's health care team.

Important Note: This information is for educational purposes only and does not constitute medical advice. Always consult with your healthcare provider for any health concerns or before making any decisions related to your health.

Treating Brain Tumors: A Guide for Patients

A brain tumor diagnosis can be frightening. The treatment plan depends on several factors, including whether the tumor is cancerous (malignant) or non-cancerous (benign). Other important considerations are the tumor's type, size, how quickly it's growing (grade), and its location in the brain.

Treatment Options:

Treatment decisions are made by your healthcare team, considering your overall health, preferences, and the specific characteristics of your tumor. Treatment might not be immediately necessary if the tumor is small, benign, and not causing symptoms. Regular MRI scans can monitor the tumor's growth. If the tumor grows rapidly or if symptoms appear, treatment will likely be needed.

Treatment Options Include:

• Surgery: The goal of brain tumor surgery is to remove as many tumor cells as safely possible. Complete removal isn't always achievable. Some tumors are easily separated from healthy brain tissue, allowing for complete removal. However, if the tumor is near vital brain structures or cannot be easily separated, the surgeon may remove as much of the tumor as is safe. This is called a subtotal resection. Partial removal can still help reduce symptoms. Several surgical approaches exist:

  • Craniotomy: This is the most common method, involving cutting a section of the skull to access the tumor. The surgeon makes an incision in the scalp, moves aside the skin and muscles, then uses a drill to remove a section of the skull bone. Tools may be used to gently hold back healthy brain tissue to improve access. The tumor is then removed using specialized instruments, sometimes including lasers. Anesthesia is used to numb the area and put the patient into a sleep-like state. In some cases, awake brain surgery is performed to monitor brain activity as the patient responds to questions, reducing the risk of harming healthy brain tissue. The skull bone is replaced after surgery.
  • Endoscopic Surgery: This approach uses a long, thin tube with a camera (endoscope) inserted through the nose and sinuses, or a small hole in the skull, to reach the tumor. This technique is often used for pituitary tumors, which grow near the nasal cavity. It may also be used to access tumors in other parts of the brain.

• Radiation Therapy: High-energy beams (like X-rays or protons) are used to kill tumor cells. External beam radiation is the most common method, targeting the tumor area or, in some cases, the entire brain (whole-brain radiation). Proton therapy, a newer approach, aims to target the tumor more precisely, potentially reducing damage to surrounding healthy tissue. Treatment usually involves daily sessions over several weeks.

• Radiosurgery: This precise form of radiation uses multiple low-intensity beams focused on the tumor, delivering a high dose to the tumor while minimizing damage to surrounding tissue. Different types of radiosurgery machines exist, including linear accelerators (like CyberKnife or TrueBeam) and Gamma Knife. Treatment is typically completed in a single session or a few sessions.

• Chemotherapy: Strong medications are used to kill tumor cells. These medications can be taken orally or intravenously, or sometimes directly injected into the brain during surgery. Chemotherapy is often used in combination with other treatments.

• Targeted Therapy: These medications target specific molecules within the tumor cells, disrupting their growth and survival. Targeted therapies are available for some types of brain tumors. Tumor cells may be tested to determine if targeted therapy would be beneficial.

Post-Treatment Support:

After treatment, you might need support to regain lost functions, such as movement, speech, vision, or cognitive abilities. Physical therapy, occupational therapy, speech therapy, or tutoring may be beneficial.

Complementary and Alternative Therapies:

While research on complementary and alternative therapies for brain tumors is limited, and none have been proven to cure brain tumors, some may help patients cope with the stress associated with the diagnosis. Examples include art therapy, exercise, meditation, music therapy, and relaxation techniques. Always discuss these options with your healthcare team.

Taking Control of Your Care:

A brain tumor diagnosis can be overwhelming. To better manage the situation, it's important to:

• Learn about your tumor: Discuss your specific tumor type, treatment options, and prognosis with your healthcare providers. Seek information from reliable sources like the American Cancer Society and the National Cancer Institute.
• Maintain strong relationships: Support from loved ones is crucial. They can provide practical and emotional support.
• Find a support system: Talking to a friend, family member, therapist, or counselor can help you process your feelings and concerns. Support groups can also provide valuable insights and encouragement.

Remember, your healthcare team is your best resource throughout this process. Don't hesitate to ask questions and seek clarification on anything that's unclear.