How specialists take you through surgery

Kids are the biggest blessing you have as parents and they falling sick, even if it’s for a minute problem, would place that extra burden on you. 

‘Brain tumours’ as the term itself suggests is alarming and a child being diagnosed with it can be devastating. Such a condition would lead to a collapse of the family. Identifying such conditions demands doing required interventions as soon as possible. And that calls for being aware of red flag signs, so that you will know how further steps must be taken.

“Brain tumors in children are masses or growths of abnormal cells that occur in a child’s brain or adjacent structures. There are many types of brain tumors recognised, some are noncancerous (benign) while the others are cancerous (malignant)” says Dr Sanjaya Fernando, Consultant Paediatric Neurologist, Colombo North Teaching Hospital, Ragama and the National Epilepsy Center Colombo.

Types of paediatric brain tumours
Pediatric brain tumours typically are primary brain tumours starting in the brain or in tissues close to it. Primary brain tumours begin when normal cells have errors (mutations) in their DNA. These mutations allow cells to grow and divide at increased rates and to continue living when healthy cells would die. The result is a mass of abnormal cells, forming a tumour. Occasionally we see secondary deposits with an original tumour at a distant locus.

Presentation varies
Signs and symptoms of a brain tumour in children vary. Some features may not be easy to detect as they simulate symptoms of other conditions; therefore they easily get ignored during the initial stages of the disease.  

Early diagnosis is crucial 
After examining the child carefully your doctor may order certain investigations, including,
Imaging tests- Imaging tests help determine the location and size of the brain tumour. Magnetic resonance imaging (MRI) is often done. 

Biopsy-Removing a sample of tissue for testing (biopsy) may be done as part of surgery to remove the tumour. 
Tests to see if cancer has spread- If it’s suspected that your child’s brain tumour has spread from another area of the body, the doctor may recommend tests and procedures to determine the original locus. 

Treatment modalities 
As new treatments and technologies are continually being developed, several options may be available at different stages in treatment.

“Treatments for brain tumours in children are typically quite different from treatment for adult brain tumours. Hence it’s very important to enlist the expertise and experience of pediatric specialists in the relevant fields” highlights Dr Fernando.

Treatment for a pediatric brain tumour depends on the type, size and location of the tumour, as well as child’s age and overall health.

Surgery
If the brain tumour is located in a place, making it accessible for an operation, neurosurgeons would work to remove as much of the brain tumour safely.

“In some cases tumours are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumours can’t be separated from surrounding tissue or they’re located near sensitive areas in the brain, making surgery life-threatening. In these situations they will debulk it as much as possible.

Surgery to remove a pediatric brain tumour carries risks, like infection and bleeding. Other risks depend on the part of child’s brain, the tumour is located” Dr Fernando underscores.

Traditional radiation therapy
Radiation therapy uses high-energy beams, like X-rays or protons, to kill tumour cells. Side effects depend on the type and dose of radiation. 

Chemotherapy
Chemotherapy uses drugs to kill tumour cells and the drugs  used depend on the type of cancer.

Rehabilitation after treatment
As brain tumours could develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation becomes an important aspect of recovery. 

• Physical therapy to regain lost motor skills or muscle strength
• Occupational therapy to get back to daily activities
• Speech therapy if there’re difficulties in speaking
• Educational therapy if your school-age child needs help to cope with changes in memory and thinking after a brain tumor
• Take Home message
• Do not ignore headaches of your child 
• Be vigilant about the associated symptoms of headache 
• Not all brain tumours are lethal 
• Even cancerous tumours have many modes of treatment 
• Post treatment rehabilitation is a must