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Pediatrics

Tumors of the Central & Peripheral Nervous System (Brain & Spine) – Procedures/Treatments

Terms for you to know when it comes to pediatric brain & spine tumor neurosurgery:

Biopsy

Any type of biopsy refers to the removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures.

The most common types include:

  1. incisional biopsy, in which only a sample of tissue is removed;
  2. excisional biopsy, in which an entire lump or suspicious area is removed;
  3. needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

Stereotactical Biopsy

Stereotactical Biopsy maps the brain in a 3-dimensional coordinate system. In conjunction with MRI and CT scans, the neurosurgeon is better equipped to accurately target the area of the brain in question.

Debulking

Debulking is the surgical removal of a portion of a tumor in order to decrease the tumor burden on a patient and/or to decrease the mass effect on surrounding structures. This technique is often performed in brain surgery when the entire tumor cannot be removed without serious damage to proximate structures.

Gross Total Resection (GTR)

Removal of all visible tumor, and in which subsequent scans show no apparent tumor. GTR is considered when the surgeon believes the entire tumor can be safely removed without substantial risk of unacceptable injury.

Endonasal Endoscopy

An innovative and minimally invasive surgical technique, Endonasal Endoscopy allows the neurosurgeon to remove brain tumors or lesions from the base of the skull or the top of the spine through the nose and sinuses.

Post-Surgery and Recovery

Following treatment, the tumor is sent to the pathologist. Genetic testing is often performed, as well. The ANA multidisciplinary team of medical experts including surgeons, neurologists, neuro-pathologists, neuro-oncologists, radiologists, radiation oncologists, physical therapists, nurses, psychologists and social workers meet to review your child’s condition, needs and test results. This team approach is also taken in the recommendation of the personalized treatment protocol for your child.

Tumor Board

The tumor board is a conference where a neurosurgeon, neuro-oncologist, radiation oncologist, neuroradiologist, social worker and other medical professional convene to discuss the plan and care for the individual patient.


Adjunctive Therapies

Radiation

Radiation is a localized, painless therapy to eradicate cancer cells by destroying them and/or by keeping them from reproducing. External radiation therapy is a beam directed at the cancer from outside the body. Internal radiation therapy (called brachytherapy or implant therapy), on the other hand, is from a source placed inside the body at the site of the cancer.

Radiation has come a long way, and can be delivered with more precision and effectiveness largely due to advanced imaging techniques.

At ANA, our expert neurosurgeons, in consultation with pediatric radiation oncologists, determine and recommend the best possible treatment plans—with explanations and support designed to inform and assure you.

Stereotactic Radiation (radiosurgery)

Stereotactic radiation, which uses high-powered x-rays on a small part of the body, is used for the appropriate tumor. It is a specialized type of external beam radiation therapy, delivered with accuracy and minimal exposure time, both of which are designed to provide results while limiting the effect of the therapy on healthy tissue.

Proton Beam Therapy

Proton Beam Therapy is a type of radiation delivery system that uses protons rather than x-rays. Protons (the positively charged parts of an atom) delivered at high energy destroy cancer cells. Depending on the location of the tumor, proton beam therapy, when indicated, can treat it with lower radiation doses to surrounding normal tissue. This type of radiation therapy is particularly desirable for pediatric tumors in critical structures, such as the brain and spine.

Chemotherapy

Chemotherapy (chemo) uses anti-cancer drugs that are usually given into a vein (IV) or taken by mouth. These drugs are distributed throughout the body via the bloodstream. Since chemo drugs are unable to enter the brain and reach tumor cells via this method, some of these brain/spine tumors may be treated with drugs administered directly to the cerebrospinal fluid (CSF) or to the spinal canal. In this case, a member of the ANA specialized team will insert a thin tube, called a ventricular access catheter, into the skull via a small hole. In general, chemotherapy is used for faster growing tumors. Some types of brain tumors, such as medulloblastoma, are frequently treated with chemotherapy.