PDQ® Treatment Patients
PDQ is a computer system that provides up-to-date information on cancer and its prevention, detection, treatment, and supportive care. PDQ is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.
To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.
Cancer in children and adolescents is rare. The majority of children with cancer are treated at cancer centers with special facilities to treat childhood cancers. There are organized groups of doctors and other health care professionals who work together by doing clinical trials to improve treatments for children with cancer.
PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your child's doctor, who knows your child and has the facts about your child's disease. PDQ can also provide the names of additional health care professionals and hospitals that specialize in treating children who have cancer.
Before your child begins treatment, you may want to consider entering your child in a clinical trial. PDQ can be used to learn more about the trials. A clinical trial is a research study that attempts to improve current treatments or find new treatments for people with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers specific scientific questions in order to find new and better ways to help people with cancer. During clinical trials, information is collected about new treatments, their risks, and how well they do or do not work. When a clinical trial shows that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the "standard" treatment. Children who are treated in clinical trials have the advantage of getting the best available therapy. In the United States, about two thirds of children with cancer are treated in a clinical trial at some point in their illness.
Listings of current clinical trials are available on PDQ. In the United States, there are two major groups (called cooperative groups) that organize clinical trials for childhood cancers: the Childrens Cancer Group (CCG) and the Pediatric Oncology Group (POG). Doctors who belong to these groups or who take part in other clinical trials are listed in PDQ.
To learn more about cancer and how it is treated or to learn more about clinical trials for your child's kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer your cancer-related questions.
PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.
Childhood cerebellar astrocytoma is a type of brain tumor. A brain tumor is an abnormal growth of tissue contained within the skull, and can be benign (without cancer cells) or malignant (contains cancer cells). The brain controls vital functions such as memory and learning, the senses (hearing, sight, smell, taste, and touch), and emotion. It also controls other parts of the body, including muscles, organs, and blood vessels. Other than leukemia and lymphoma, brain tumors are the most common type of cancer that occurs in children.
This PDQ treatment information summary refers only to tumors that originate in the brain (primary brain tumors). Metastatic brain tumors, which are secondary tumors formed by cancer cells that begin in other parts of the body and spread to the brain, are not included. Brain tumors can occur in both children and adults; however, treatment may be different for adults than for children. A separate patient information summary containing information on brain cancer that occurs in adults is also available in PDQ.
Astrocytomas are tumors that develop from brain cells called astrocytes. Cerebellar astrocytomas occur in the area of the brain called the cerebellum, which is located at the back of the brain and controls balance and complex motor activities, including walking and talking. Cerebellar astrocytomas usually grow slowly and do not usually spread from the site in which they originated to other parts of the brain or body, although they can invade large areas. Some astrocytomas form cysts or are enclosed in a cyst.
If your child has symptoms that may be caused by a brain tumor, his or her doctor may order a magnetic resonance imaging (MRI) scan, a diagnostic test that uses magnetic waves to create pictures of the body.
Often, surgery is required to determine whether there is a brain tumor and what type of tumor it is. The doctor may surgically remove a small sample of the tumor tissue, which is then examined under a microscope. This is called a biopsy. Sometimes a biopsy is done by making a small hole in the skull and using a needle to extract a sample of the tumor.
Your child's treatment and chance of recovery (prognosis) depend in part on the tumor location and the extent to which the tumor has spread.
Once childhood cerebellar astrocytoma is found, more tests will be performed to learn more about the tumor. If a biopsy specimen is taken, the tumor cells will be examined carefully under a microscope to see how different they appear from normal cells. This will determine the grade of the tumor. The grade of a tumor is determined by microscopic examination of its cells to see how similar the cells are to normal cells. Cells from higher-grade, more abnormal-looking tumors usually grow faster and are more malignant than cells from lower-grade tumors. Your child's doctor needs to know the grade of tumor in order to plan treatment.
There is no staging for childhood cerebellar astrocytoma. The type of treatment given depends on the location and grade of the tumor and the patient's previous treatment.
Untreated childhood cerebellar astrocytoma means that no treatment has been given except to alleviate symptoms.
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may recur in the brain or in another part of the body.
There are treatments for all children with cerebellar astrocytomas. Three kinds of treatment are used:
Experienced doctors working together may provide the best treatment for children with cerebellar astrocytoma. Your child's treatment will often be coordinated by a pediatric oncologist, a doctor who specializes in cancer in children. The pediatric oncologist may refer your child to other specialists, such as a pediatric neurosurgeon (a specialist in childhood brain surgery), a pediatric neurologist, a psychologist, a radiation oncologist, and other doctors who specialize in the type of treatment your child requires.
Surgery is the primary treatment for childhood cerebellar astrocytoma. Complete or near complete removal of the tumor is often possible.
If the tumor cannot be completely removed, radiation therapy may be given. Radiation therapy uses high-energy radiation from x-rays and other sources to kill cancer cells and shrink tumors. Radiation therapy for childhood brain tumors usually comes from a machine outside the body (external radiation therapy).
Because radiation therapy can affect a child's growth and development, chemotherapy may be given to delay or eliminate the need for radiation therapy. Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy drugs may be taken by mouth or injected into a vein (intravenous) or a muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body.
Treatment for childhood cerebellar astrocytoma depends on the tumor location, the extent to which the tumor has spread, and the child's age and overall health.
Your child may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to have your child enter a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to test new treatments and to find better ways to treat cancer patients. Clinical trials are ongoing in most parts of the country for childhood brain tumors. For more information, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
Treatment for previously untreated childhood cerebellar astrocytoma depends on whether all of the tumor can be surgically removed. If the tumor is completely removed, there may be no further treatment. If any tumor remains after surgery, radiation therapy may be given following the surgery, or may be delayed until the tumor starts to grow again. If the child is very young and all of the tumor cannot be removed during surgery, chemotherapy may be given to delay the use of radiation therapy.
Recurrence or relapse may take place many years after initial treatment. At the time of recurrence, a complete evaluation is performed to determine the extent of the recurrence. Treatment for recurrent childhood cerebellar astrocytoma depends on whether the tumor recurs in the location in which it originated and the type of treatment that was previously given.
If your child was initially treated with surgery alone, treatment may be additional surgery to remove as much of the tumor as possible; if this is not feasible, radiation therapy may be given. If patients who were initially treated with radiation therapy cannot be treated with surgery for their recurrence, chemotherapy may be given. Clinical trials are currently evaluating the role of chemotherapy for recurrent brain tumors.
TO LEARN MORE..... CALL 1-800-4-CANCER
To learn more about childhood cerebellar astrocytoma, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is toll-free and a trained information specialist can answer your questions.
The Cancer Information Service can also send you booklets. The following booklet about brain tumors may be helpful to you:
Write to the National Cancer Institute at this address: