...EVERY SINGLE HEALTH PROBLEM THAT CAN POSSIBLY HAPPEN TO YOU AFTER YOU’VE HAD BRAIN CANCER AS CHILD.
Well, that’s not very specific, is it? Problem is, there is a lot that can go wrong when you are a child with a brain tumor, but there is also a lot that can continue to go wrong as an adult from that same tumor. Considering that the brain is the most common place for solid tumors in children, the later effects of these tumors should be of concern to more than just parents with young children.
According to the Brain Tumor section of the Children’s Hospital Boston website (which, nationally ranked #3 in Top Ranked Pediatric Hospitals for Cancer by U.S. News for 2010-11, should know what it’s talking about), there are many types of brain tumors. They list:
- choroid plexus tumor
- craniopharyngioma
- dysembryoplastic neuroepithelial tumor
- ependymoma
- germ cell tumors (brain)
- high-grade gliomas—see site for all of the types
- low-grade gliomas—see site for all of the types
- medulloblastoma
- meningioma
- primitive neuroectodermal tumors (PNET)
- rhabdoid tumor
Many different tumors. Many possible effects. These are influenced by not only type, but also by size, location, stage of growth, their (and the child’s) kind and response to treatment, and whether the tumor is benign or malignant. One of the most important factors is age of the child, though. Certainly, this relates to how well one can endure the rigorous treatment process; more interesting for our contemplation, however, is how these tumors might actually affect brain development on a biological level. It is easy to understand the danger of having a tumor in an area that is a major control center of the whole body, especially when it’s still growing as it is in a young child. You can blast that tumor with radiation, poison it with chemotherapy, or excise it perfectly, but the story doesn’t end there; you have to ask, what happens to the rest of the brain? Further, what happens to the functions of the brain if it is damaged by a tumor and/or the treatment for it?
As you would imagine, the brain does not seem to enjoy being tampered with while growing. So even if a child survives, here are the some of the problems—temporary or permanent—they might experience as mentioned in the Follow-Up Treatment and Rehabilitation suggestions listed by the Children’s Brain Tumor Foundation:
· impairments in the use of arms or legs, in coordination and gait, or in swallowing
· communication difficulties: language, speech, or understanding
· alteration of hormonal function; for example, “The pituitary, thyroid, and hypothalamus are glands in the brain that secrete hormones that control metabolism, growth, and sexual development. Sometimes treatment for a brain tumor can alter their function and lead to medical problems, such as diabetes insipidus, early or delayed puberty, and growth problems.”
· short-term or long-term problems with learning and behavior
They elaborate on the educational and medical outcomes that are often not witnessed until years after surgery or therapy. These include learning disabilities, problems with “intellectual ability, academic achievement, memory, and attention,” seizures, lack of muscle coordination, neurosensory problems, and problems related to endocrine system damage like growth hormone deficiencies, early-onset puberty, obesity, hypothyroidism, among others. For some patients, there is the risk of heart, lung, kidney, or skeletal complications, as well as new tumor development.
Well, there are a lot more problems than we bargained for when we embarked on this research project, so it looks like we are going to have to do more research before we come up with any one good question to guide us even further. Here are some that have got us started though:
· Are neurological problems attributed more so to the impact of the physical tumor itself in the brain or the effects of radiation and/or chemotherapy? To what extent?
· How can surgery (i.e. removal of the tumor) be compared to other types of brain surgeries? (Think: surgical procedures done to treat epilepsy, Parkinson’s, etc.—even the outdated lobotomy). Are there similar neurological effects that can be witnessed?
· How do the presence of benign versus malignant tumors alter treatment since, either way, the tumor can affect brain function? What effects can a benign tumor cause if left untreated and would it be more beneficial/safer to leave a benign tumor intact or to remove it?
· How can we use this data to draw correlations between long term health defects and kinds of treatment to better determine steps to treat childhood cancer? How should the child and parent be better informed of this data before making a decision and how to prepare for risks after treatment?
There’s lots more to think about; if you have got any other ideas related to the problems caused by childhood brain tumors, please share them! Here are just a few articles to check out if you are interested (and not all are on just brain cancer!):
Neurocognitive Status in Long-Term Survivors of Childhood CNS Malignancies: A Report From the Childhood Cancer Survivor Study (This is the press release, which is a little shorter: Brain Tumors in Childhood Leave a Lasting Mark on Cognition, Life Status)
