The brain and spinal cord make up the central nervous system (CNS). CNS tumors may be benign (not cancer) or malignant (cancer). But even benign CNS tumors can cause severe problems or death.
Tumors that begin in the brain are called primary brain tumors. They may spread to other areas of the brain or spinal cord, but they do not usually spread to other parts of the body.
Brain tumors may also come from tumor cells that have spread from other parts of the body. These are called metastatic or secondary brain tumors. These tumors are named for the part of the body where they began. Secondary brain tumors are rare in children.
Tumors that begin in the brain are called primary brain tumors. They may spread to other areas of the brain or spinal cord, but they do not usually spread to other parts of the body.
The central nervous system (CNS)
The brain and spinal cord make up the CNS. The CNS controls important body functions. These include thinking, learning, emotions, speech, vision, movement, pain, breathing, and heart rate.
The brain has 3 main parts: the cerebrum, cerebellum, and brain stem.
The cerebrum is the largest area of the brain. It controls thinking, learning, speaking, memory, and emotions.
The cerebellum is in the back of the brain. It controls motor function such as movement, balance, and coordination.
The brain stem is the area that connects the brain and spinal cord. It controls vital life functions such as breathing, heart rate, and blood pressure.
Messages travel back and forth from the brain to the rest of the body through the spinal cord and nerves.
Neurons communicate through nerve impulses, or electrical signals, that pass from one neuron to another.
Brain and spinal cord tumors are the 2nd most common type of cancer in children after leukemia. About 20% of childhood cancers begin in the brain or spinal cord. About 5,900 new cases of CNS tumors occur in children and teens in the United States each year. Brain and spinal cord tumors are the leading cause of pediatric cancer deaths.
Types of brain tumors
About half of all pediatric brain tumors are gliomas or astrocytomas. They form from glial cells. These cells make up the supportive tissue of the brain. Gliomas may be benign or malignant and can occur in different areas of the brain and the spinal cord.
The most common malignant brain tumor in children is medulloblastoma. This cancer forms in the cerebellum, in a region of the brain known as the posterior fossa.
Many types of tumors form in the brain and spinal cord. Symptoms can vary widely. The symptoms depend on where the tumor is located, its size, how fast it grows, and the child’s age and stage of development.
Many childhood CNS tumors grow slowly. The symptoms may be mild. They may come and go. They might not follow a typical or predictable pattern.
Loss of balance, coordination problems, or difficulty walking
Weakness in the arms or legs
Seizures
Feeling tired or changes in activity level
Unexplained weight gain or loss
Symptoms related to endocrine problems or changes in hormones such as increased thirst or early puberty
Personality changes
Changes in school performance
Problems with thinking or memory
Weakness, numbness, tingling, or changes in feeling on one side of the body (arm or leg or both)
Chronic back pain (spinal cord tumors)
Tilting the head to one side
Increased head size in infants
Symptoms of spinal cord tumors include:
Scoliosis (curving of the backbone)
Back or neck pain
Weakness in arms or legs
Difficulty walking
Problems going to the bathroom
In some cases, a child with a brain or spinal cord tumor may have problems reaching early developmental milestones for their age. Talk to your child’s care team if you have questions about your child’s development.
Diagnosis of brain and spinal tumors
Symptoms of brain and spinal cord tumors can be mild and hard to recognize at first. Early symptoms are often similar to other childhood illnesses. Depending on the type of tumor and how fast it grows, diagnosis can sometimes take a while. Diagnosis usually includes:
Physical exam and medical history to learn about symptoms, general health, past illnesses, and risk factors
Neurological exam to look at brain and nervous system function
Treatments depend on the tumor type and location, the child’s age, and how much of the tumor can be removed with surgery.
Most patients who have brain surgery take steroid medicines to reduce brain swelling. Some patients may take anti-seizure medicines.
In some cases, surgeons place a shunt in the brain to prevent fluid build-up (hydrocephalus). The shunt may be temporary or permanent.
Your child may need services to help with recovery after surgery. These may include rehabilitation and supportive care including help with vision, speech, hearing, strength, and movement. Psychology and school support services can help with emotional, social, developmental, and learning needs.
Prognosis for brain and spinal tumors
The prognosis for brain and spinal cord tumors depends on many factors. These include:
Tumor type and grade
Molecular features of the tumor
The child’s age
Whether the tumor is new or has returned
Whether the cancer has spread to other areas
If the tumor can be removed with surgery
How well the tumor responds to treatments
The average survival rate for pediatric cancers of the brain and spinal cord is about 75% in the United States. But the prognosis can vary widely based on cancer type. Talk to your child's care team about your child’s prognosis.
Support for patients with brain and spinal tumors
The impact of a brain tumor on a child’s quality of life varies widely. Some patients have few lasting effects on health and function after treatment. Other children may have long-term problems in physical, cognitive, and emotional functioning. These problems may be due to the tumor or the late effects of treatment.
Patients treated for brain tumors should be monitored for changes or problems in functioning. These may include the onset of seizures or changes in:
Strength, balance, and coordination
Thinking, learning, memory, attention, and processing information
Behavior, emotions, and social function
Speech, hearing, and vision
Hormones and endocrine function
Psychological services can help with emotional, social, developmental, and cognitive needs. Patients often need extra support for return to school. A neuropsychological assessment before and after treatment can help families identify education needs. Talk to your child’s care team about testing and academic needs.
Healthy behaviors
Simple lifestyle habits can help brain health and improve overall health.
Eat healthy
Be physically active
Get enough sleep
Manage stress
Late effects of treatment
Childhood cancer survivors should get long-term follow-up health care. Some treatments can cause late effects. These are health problems that happen months or years after treatment has ended.
It is important to have regular checkups and screenings by a primary health care provider. Your child should get a survivorship care plan after completing treatment. This plan includes guidance on health screenings, disease risk factors, and how to improve health. Survivors should share this plan with their health care providers.
Questions to ask your care team
What are our treatment options?
What are the possible side effects of each treatment?
What can be done to manage side effects?
Will my child need to be in the hospital for treatment?
Where is the treatment available? Is it close to home or will we have to travel?
What support services are available to my child? To my family?
Key points about brain and spinal tumors
Tumors of the brain and spinal cord may be benign or malignant. Even benign ones can cause severe problems or death.
Tumors that begin in the brain do not usually spread beyond the brain and spinal cord.
Symptoms can vary widely. The symptoms may be subtle, or they may come and go.
Treatment usually includes surgery. Treatment may also include chemotherapy, radiation therapy, and/or targeted therapy.
After treatment, it is important to have regular checkups and screenings by a primary health care provider.
