Treatment of Medulloblastoma
After a tumor is found in a suspected case of medulloblastoma, the standard course of treatment involves the following steps, typically in this order:
- Surgery, to remove as much of the tumor as possible
- Radiation, in most cases
- Chemotherapy
Stem cell transplant after chemotherapy is also an option offered at some treatment facilities.
Sometimes steroids are used prior to surgery for medulloblastoma to help reduce swelling that may be present in the brain.
You will most likely work with a neuro-oncologist at this point in the care process. When considering critical treatment options, your care team should welcome and/or be able to help with getting a second opinion from another neuro-oncologist or facility if that’s a path you’d like to choose.
Medulloblastoma Treatment Plans
Treatment plans will vary based on the subtype of medulloblastoma that is diagnosed.
Surgery, radiation, and chemotherapy all come with risks. Each of these treatments can result in complications that could affect a child’s development.
Below we’ll cover an overview on the treatments used for medulloblastoma, with links to more in-depth information on each one.
Steroids
Often times, steroids are introduced at the start of treatment to reduce swelling in the brain before surgery. Most patients do not need to be on steroids long-term.
Surgery
After a tumor is found, treatment for medulloblastoma typically involves assessing surgical options. Surgery is done to remove as much of the tumor as possible in an attempt to improve prognosis and to provide a definitive diagnosis. In general, the more tumor that can be removed, the better the prognosis.
You may hear this surgery referred to as a “surgical resection.”
Radiation
In patients over ages 3-5, radiation therapy (also simply called “radiation”) is typically the next line of treatment. It is used to treat any remaining tumor that may have spread to the spine or other parts of the brain, or cancerous tissue that was unable to be removed during surgery.
Recent advances in radiation treatments, including proton radiation therapy or PRT, may provide a more focused treatment option to avoid damage to other parts of the brain.
Chemotherapy
Chemotherapy is designed to kill remaining cancerous cells left behind or those that may have spread to other areas of the spine or brain. It works by targeting cells that are actively dividing thereby stopping the cancer cells from reproducing.
The majority of children and adults with medulloblastoma receive these drugs as an injection into the vein (called intravenous, or IV, chemotherapy). Oral chemotherapy may also be an option depending on where you are being treated.
Chemotherapy may be recommended in some cases during radiation treatment.
Clinical Trials
Clinical trials are available for specific subgroups of medulloblastoma, like WNT-activated. Many researchers are working hard to develop new treatments for medulloblastoma. You can expect trials to open up in the future for other subgroups.
The Future of Medulloblastoma Research
There have been recent advancements in the understanding of medulloblastoma’s cell of origin and subtypes. “Cell of origin” refers to the specific type of cell in the brain where the cancer starts. Scientists are learning more about where these cancer cells come from and the different categories of the disease, especially groups 3 and 4.
By focusing on each subtype, scientists can study the common genetic changes that drive the cancer in those smaller, more precise categories, rather than looking at broader groups where these changes might be less common. In doing so, they aim to create better lab models. The hope is that these lab models will lead to more successful clinical trials and, ultimately, better treatments for the disease.