Brain and CNS tumours
Signs and symptoms
Persistent or recurrent vomiting, especially in the morning
New balance or coordination problems
Behaviour or personality change
Tiredness
Older children may complain of headaches of persistent or frequent recurrences
Unusual eye movements or a new squint, blurred vision or diplopia
New seizure onset (non-febrile)
Brain and central nervous system (CNS) tumours are the most common solid tumour of childhood, with around 400 new cases occurring every year in the UK.
They account for a quarter of all childhood cancers.
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Brain tumours are often picked up later than other childhood cancer due to their varied, and often initially subtle symptoms.
Within consultations, be aware of children or young people presenting with worsening headaches, morning vomiting, unsteadiness and visual symptoms.
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Astrocytoma
This is the most common brain tumour type in children, accounting for 40% (155) of cases.
Around 75% are low grade and have a 5 year survival of 95%.
Sadly high grade astrocytoma has a much poorer prognosis with under 20% of children alive at 5 years.
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Embroyonal tumours
These include medulloblastoma and PNET (primitive neuroectodermal tumours)
They are most common in the very young, accounting for 70 cases a year in the UK. Medulloblastoma has a 5 year survival of 64%, with PNET only having 36% still alive at 5 years.
Ependymoma
Ependyma makes up about 10% of childhood CNS tumours, with a 5 year survival of 71%.
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Diffuse intrinsic pontine glioma (DIPG)
This is rare but deadly.
It has very poor survival rates with almost all children dying within 9 months of diagnosis . Radiation can prolong life in some cases.
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Treatment
The main treatment for most CNS tumours is surgery (if feasible) with or without radiotherapy. Surgery is often major and life threatening, leaving children with neurological disabilities, some severe.
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Radiotherapy is avoided if possible in children under the age of 3 years due to the damage it causes to the developing brain .
Proton beam radiotherapy is used in some cases but is not yet available in the UK.
Chemotherapy is used routinely in medulloblastoma and is increasingly being used to treat other brain tumour types.
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Brain tumour survivors often suffer hormonal problems such as precocious puberty or poor growth resulting from damage to the developing brain.
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Link to the:
HeadSmart awareness card for alert symptoms in children of different ages (HeadSmart, 2011).