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Brain tumors are clumps of cells in the brain that are dividing incorrectly (too much or too fast).
There are many different kinds of cells that can behave this way. Some are aggressive and spread through the brain and spine. When the cells spread, we call them malignant or metastatic.
In other types of brain tumors, the cells just stay in one place, but are a problem because they are growing in the skull, an area where space is limited.
Unlike adult cancers, doctors think that brain tumors in young people are not caused by any environmental factors, but rather by a "two hit" theory. This theory implies that first the brain cells divide incorrectly, and second the body's usual process for finding and stopping this bad division doesn't work.
Brain tumors seem to occur more often in children under 3 years old and in teenagers.
There are a few genetic syndromes that make brain tumors more likely, such as neurofibromatosis and Li-Fraumeni syndrome. However, in most kids the cause of brain tumors is unknown.
Because vomiting and headaches are symptoms of common viruses, the other symptoms such as neurological changes, falling, weakness in one arm or leg, weakness in one side of the face and changes in vision or speech are important to identify that something is wrong with the brain.
Some children also experience sudden trouble in school or personality changes.
Medical history and physical exam
The most important test is a neurologic medical history and physical exam. During this exam, the doctor will ask questions about your child's behavior and discuss any physical changes.
MRI of the brain and spine
Next, doctors at Children's Hospital Colorado will do an MRI, which is an imaging test that shows the inside of the brain and spine. This test does not use any radiation, so it is very safe. During the MRI, a dye is used (injected from a needle) to help doctors see details of the tumor. Most kids under 6 years old will need medication to help them sleep and remain still during the MRI. Older kids can be awake and even watch a movie during the test.
After the test, it is the goal of our program to give you MRI results immediately, so you don't have to wait until your next appointment for a diagnosis.
Sometimes doctors need to do a spinal tap, also called a lumbar puncture, which is a "poke" in the lower back to drain out a teaspoon of cerebrospinal fluid (the liquid that surrounds the brain and spinal cord). Your child's doctor will look at this fluid under the microscope to see if there are any tumor cells in it.
At Children's Colorado, we always try to do this test while your child is sleeping with the help of medication, so that the spinal tap doesn't cause pain or anxiety.
Finally, doctors at Children's Colorado often need to do surgery to figure out what kind of cells are growing inside the tumor. Our expert neurosurgeons and pathologists remove the tumor and then study it with special tests to determine exactly what kind it is.
Children's Hospital Colorado is the only hospital in the surrounding eight states that can accurately diagnose brain tumors using the advanced technique of live tumor testing. Specialized gene testing helps guide new treatments that specifically target the genes of that tumor.
In addition, our technicians and nurses are skilled at helping your child feel comfortable during this sometimes scary procedure. The test requires children to lie still, and our child-friendly staff knows how to help kids relax.
We know that this is a scary time for children and their families, which is why we do everything possible to make the experience less stressful. From the minute you walk in the door, we'll meet with you and explain what a brain tumor is, discuss what to expect in our clinic, and set up support services for your family.
We'll also work closely with the MRI staff to meet our patients' needs and help calm your child's nerves before testing. We've found that child life therapy and creative art therapy helps reduce stress and prepare kids for tests and surgery.
Treatment will depend on the kind of tumor and how aggressively it behaves. Some brain tumors only need to be followed by routine MRIs. Other brain tumors that are growing in a sensitive part of the brain or spine will need to be removed during surgery. Other types of tumors will need radiation, chemotherapy or genetic or immunotherapy.
Because brain tumors in young adults are usually caused from faulty cells that form during childhood, our pediatric experts also specialize in treating and curing tumors in young adults into their 20s.
Our Neuro-Oncology Program is the only clinic in the surrounding eight states where your child can get state-of-the-art treatment for a pediatric brain tumor. Our doctors and nurse practitioners are known internationally for their expertise in diagnosing, treating and caring for kids and young adults with brain tumors.
Finally, we have the only dedicated pediatric radiation oncologist in the region, which means his sole focus is radiation therapy for kids with cancer. Our radiation therapy is planned and administered for the sensitive nature of a child's growing brain. Because your child's brain is still developing, it is important that the radiation doctor knows exactly what, where and how much radiation to deliver to the tumor.
In addition, doctors and nurses who specialize in anesthesia will take care of your child during radiation. You can feel comfortable knowing that our pediatric staff will sedate your child to help him or her sleep and lie still so the radiation goes to exactly to the right spot.
Hospice and Palliative Care, Pediatrics