Clinical Course for Medulloblastoma

After medulloblastoma is suspected on the MRI, a typical sequence of events takes place. These steps may vary depending on each individual case of medulloblastoma and what symptoms you or your child has.

External Ventricular Drain (EVD)

Hydrocephalus is a condition that occurs when too much cerebrospinal fluid builds up in the brain. It is common in patients who have medulloblastoma.

The fluid buildup from hydrocephalus causes harmful pressure in the brain. If the pressure is not relieved, the condition can be life-threatening . If the hydrocephalus is severe, your doctor may treat it by placing an external ventricular drain (EVD). This is a way to temporarily to drain the cerebrospinal fluid to reduce the pressure in the brain.

Surgery to Remove a Medulloblastoma

Surgery to remove the tumor is usually scheduled quite quickly. You may also hear this called tumor resection.

The goal is to get as much of the tumor out of the body as soon as possible to reduce the risk of the cancer causing any further damage. The hope is that surgical removal of the tumor will also help to relieve hydrocephalus if it’s present.

VP Shunt or Ventriculostomy

Many patients with medulloblastoma will continue to experience buildup of cerebrospinal fluid after surgery. When that is the case, your doctor may recommend placing a permanent ventriculoperitoneal (VP) shunt or an endoscopic third ventriculostomy (ETV). Both of these are additional ways to drain excess fluid from the brain.

Lumbar Puncture

Most patients with medulloblastoma will need a lumbar puncture to test the cerebrospinal fluid (CSF) to see if there are medulloblastoma cells in that fluid. A lumbar puncture is a procedure that involves placing a needle in the lower back (usually under anesthesia for children and teenagers) and taking a small amount of CSF. This is usually done 7-10 days or more after surgery. If there are medulloblastoma cells in the CSF, this can lead to more aggressive treatments as having cells in your CSF is considered a higher risk feature of medulloblastoma.

Radiation and Chemotherapy for Medulloblastoma

After surgery, the standard treatment for medulloblastoma is radiation and/or chemotherapy based on the age of the patient.

Radiation is usually used on both the brain and spine, to reduce the risk of the cancer spreading or recurring in those areas. Radiation treatment is typically started within four weeks after surgery.

The next course of treatment is chemotherapy. Use of chemotherapy to treat medulloblastoma depends on the type of tumor it is, how much it has spread, and other factors your health care team will discuss with you.

Clinical Trials for Medulloblastoma

There are ongoing clinical trials for medulloblastoma, which allow new drugs to be tested in this disease. While there are always risks when enrolling in clinical trials, they are the best way to get you or your child the most promising new medications and to make sure the pediatric oncology community learns all it can about what therapies work best for treating medulloblastoma.

Medulloblastoma Clinical Trials