Treatment of Medulloblastoma
Treatment for Medulloblastoma takes a team of doctors and professionals. The lead doctor to oversee treatment is a pediatric oncologist, a doctor who specializes in treating children with cancer. Treating Medulloblastoma involves three approaches: surgery, radiation, and chemotherapy.
Your neurosurgeon will be able to discuss how feasible surgery is for treatment. The goal of surgery is to remove all of the visible tumor(s), however there may be cases where this is not possible depending on the where the main tumor is located. If there is any tumor left over after surgery, your doctors may need to intensify radiation or chemotherapy. Surgery to remove the tumor may cause damage to the brain which may be permanent or may be temporary. Surgery alone will not cure Medulloblastoma.
Radiation is administered by a specialist called a radiation oncologist. Radiation is a cancer treatment that uses high-energy X rays or other types of radiation to kill cancer cells. It was first noted in the 1950s that patients who received radiation to their brain and their spine had higher survival rates compared to patients who did not receive radiation.
Medulloblastoma can spread to the covering of the brain and spinal cord – that is why patients get radiation to the tumor bed (where their tumor was before surgery) as well as the rest of the brain and the entire spinal cord.
The most common type of radiation is called external-beam radiation therapy. It is radiation that comes from a machine outside the body. Your radiation therapy schedule consists of a specific number of treatments given over a set period of time (usually 5-7 weeks). A type of radiation therapy that may be used for Medulloblastoma is called proton therapy.
Proton Beam Therapy
Proton beam therapy is a specific type of radiation therapy that uses proton particles for treatment rather than the photons (x-rays) that are used for most radiotherapy. Protons have an anti-tumor effect that is very similar to conventional photon radiotherapy. In some brain tumors, protons are superior to photon radiation because they can spare nearby normal brain tissue from potentially harmful effects of radiation.
Radiation Side Effects
Radiation therapy often causes inflammation in the brain, which can temporarily make symptoms worse. Steroids are used to control inflammation when necessary.
Because the radiation of the whole brain in young children is associated with a decline in neurocognitive function, patients under the age of 3-5 years of age are treated with chemotherapy-only regimens.
Chemotherapy is the use of drugs to destroy tumor cells by keeping the tumor cells from growing, dividing, and making more cells. Chemotherapy for Medulloblastoma is usually given into a vein. The majority of patients need a central line or a port to make giving chemotherapy easier and more convenient. Chemotherapy regimens usually consists of a defined number of cycles given over a set period of time. Patients may receive one drug at a time or a combination of different drugs given at the same time.
Chemotherapy Side Effects
Side effects of chemotherapy depend on the individual patient, the type of chemotherapy as well as the dose. General side effects include fatigue, risk of infection, nausea and vomiting, hair loss, and decreased appetite. These side effects tend to go away after treatment is complete. Talking with your child’s oncologist about the chemotherapy regimen and the side effects is highly encouraged.