Advancing the field of childhood brain tumor treatment
The Michigan Medicine Chad Carr Pediatric Brain Tumor Center is a national leader in basic, translational, and clinical research on pediatric brain tumors. Across all areas of research, our shared goal is improving therapies for children with brain tumors.
The University of Michigan Brain Tumor Bank includes roughly 650 neurological tumor specimens — an enormous resource which has fueled research not only here at U-M but also national multi-center collaborations. Approximately 15 percent of the specimens in the bank are from pediatric patients. With an established, robust and well-maintained tumor bank, U-M is extremely well positioned to analyze those specimens for productive research, discovery and treatment potential.
U-M’s internationally renowned Translational Neuro-Oncology Laboratory generates novel primary cell cultures from pediatric and adult glioma tissue samples to study mechanisms of glioma growth and targeted treatment response.
Our groundbreaking Pediatric Mi-Oncoseq Program is an internationally known precision oncology program focusing on the genetic analysis of pediatric cancer patients including in children with malignant brain tumors and determines whether targeted treatments may be available based upon their personalized tumor genomic sequencing profiles.
And, the multidisciplinary and multi-institutional University of Michigan CNS Precision Medicine conference is held monthly in order to optimize the diagnosis and treatment of children with brain tumors through a precision medicine approach. In this conference, members of the U-M pediatric brain tumor team and physicians from other leading national brain tumor institutions incorporate molecular results from pediatric brain tumors (Mi-Oncoseq and molecular pathology) into targeted treatments for patients.
Through these efforts, the U-M pediatric brain tumor team is changing the way pediatric neuro-oncology care is delivered, with the goal of improved treatments and long-term quality for children with brain tumors.
Pediatric brain tumor statistics
Brain tumors are the most common form of solid tumors among children under the age of 15. Although brain tumors are still rare among the general pediatric population, about 20% of all childhood cancers are brain tumors.
What are brain tumors?
Tumors are masses of abnormal cells. When a tumor develops in the brain, spinal tissue, or affecting the nervous system, tumor growth is a significant concern due to the location around delicate tissue and structures.
There are over 120 different types of brain tumors, each with its own characteristics that affect how it can be treated most effectively. C.S. Mott Children’s Hospital has expertise in treating the full range of pediatric brain tumor types, including:
- Low-grade glioma (grade I, II), including pilocytic astrocytoma and diffuse glioma
- High-grade glioma (grade III, IV), including anaplastic astrocytoma and glioblastoma (GBM)
- Optic pathway glioma
- Brainstem glioma, including diffuse intrinsic pontine glioma (DIPG)
- Atypical teratoid / rhabdoid tumor (ATRT)
- Choroid plexus tumors, choroid plexus carcinoma, choroid plexus papilloma
- Desmoplastic infantile astrocytoma
- Germ cell tumors
- Primitive neuroectodermal tumor (PNET)
Diagnosing brain tumors
Accurate diagnosis is the single most important factor in creating an effective treatment plan for a brain tumor.
Your C.S. Mott Children’s Hospital team will do a thorough examination and review of your child’s medical history as part of the diagnosis process. The physical exam may include simple office-based tests evaluating reflexes, muscle strength, alertness, eye movement and coordination.
Several additional tests may be needed to definitively diagnose your child’s condition, including:
- MRI (magnetic resonance imaging) to produce detailed images of the brain or spine
- MRS (magnetic resonance spectroscopy) to help distinguish between normal tissue and tumor tissue
- CT (computerized tomography) scan, also referred to as a CAT scan, to obtain a detailed picture of the brain and spinal structures
- Positron Emission Tomography (PET) scan and PET fusion imaging, which provide precise anatomical and functional images to help guide our treatment decisions
- Biopsy, samples removed from the tumor and examined to confirm diagnosis of a specific type of tumor
- Spinal tap, or lumbar puncture, to remove a small sample of cerebrospinal fluid to see if any tumor cells have started to spread.
- DNA analysis can provide information that not only confirms or clarifies the type and characteristics of your child’s cancer, but can reveal molecular profile information about your child that often can influence how physicians plan your child’s treatment. Innovative therapies are being developed that personalize treatment to an individual based on their genetic profile. This type of personalized treatment planning through gene sequencing is only being done at a handful of children’s hospitals across the country.
Our multidisciplinary pediatric brain tumor team meets regularly to ensure each patient gets the benefit of a complete range of expertise across all specialties involved in treating brain tumors. Each member contributes to provide a truly collaborative approach to your child’s individual care. The result is that each child has a team of more than a dozen doctors and nurses putting their collective expertise forward to accurately diagnose the child’s individual tumor type and classification, and advise on his or her treatment plan.
Brain tumor treatment
Your child’s treatment will be fully individualized towards his specific tumor type and personal medical characteristics.
At C.S. Mott Children’s Hospital, specialists in pediatric neurosurgery, pediatric radiation therapy, pediatric oncology and pediatric neuro-oncology, pediatric endocrinology, ophthalmology, and pediatric otolaryngology work together to individualize your child’s care and apply the very latest therapies available.
Treatment generally includes some combination of:
- Neurosurgery to remove all or as much of the tumor as possible, while preserving neurological function
- Radiation therapy (high energy rays that kill or shrink cancer cells)
- Chemotherapy (cancer drugs)
- Blood and marrow transplantation
Surgical removal of the tumor is a part of most treatment plans. Our pediatric neurosurgeons use innovative intraoperative MRI technology to provide a detailed view of brain and spinal cord tumors during surgery. The high-resolution images provided by the system lead to better precision in complicated neurosurgery operations, with the goal of reducing the risk of neurological injury during the procedure, reducing the likelihood of an incomplete resection and the eventual need for reoperation.
Some children require physical rehabilitation during and/or after treatment to maintain or rebuild motor skills and muscle strength. Our renowned pediatric outpatient rehabilitation program provides comprehensive interdisciplinary therapies for patients.
In addition to the most advanced medical and surgical treatments available, your family will have access to a wide range of specialists here to support your needs along the way. Our team also includes:
- registered dietitians to provide nutritional support
- pediatric oncology-focused social workers to support your family as you move along the diagnosis, treatment and survivorship journey
- child life specialists
- a school liaison to support your child’s education during treatment
Access to clinical trials
C.S. Mott Children’s Hospital is a recognized leader in pediatric cancer treatment and research, with the largest pediatric research effort in the state of Michigan. Our neuro-oncology team is conducting basic science, translational and clinical research geared toward finding better cures for several different types of brain tumors, improving the toxicity of current treatments. We are a very active member of the Children's Oncology Group Phase I and Phase II-III consortiums, offering families access to a wide range of clinical trials designed to find new treatments for childhood cancers. We also have the most comprehensive and largest portfolio of clinical trials in the state of Michigan for relapsed cancers, many of which were developed here at U-M. Learn more about pediatric brain tumor clinical trials here.
Long term outlook for children with brain tumors
Advances in surgical techniques, as well as breakthrough progress in the medical treatment of individual types of brain tumors, have resulted in significant improvement in survival for children diagnosed with brain tumors.
Brain tumors in children appear in different locations and behave differently than brain tumors in adults. It is important to choose a treatment program with expertise specifically in the diagnosis and treatment of pediatric brain tumors.
We specialize in these types of complex tumors at C.S. Mott Children’s Hospital. Our team combines patient-centered comprehensive care with state-of-the-art technology and research to provide the best possible outcomes for pediatric brain tumor patients.
The recent increases in survival of children with brain tumors means doctors are learning a lot more about life after brain tumors.
We are committed not just to effectively treat and remove your child’s tumor, but to maximize his or her long-term outlook and give him the best possible chances of thriving throughout childhood, adolescence and into adulthood. Continued evaluation of children who have undergone treatment for a brain tumor is highly recommended to ensure early identification of any challenges or limitations your child may encounter. Our long-term survivorship clinic will continue to see your child annually to monitor his or her progress and watch closely for any opportunities to support his or her growth and development.
This may include:
- intellectual function and school performance
- neurologic assessment
- endocrine evaluation and treatment
- hearing and vision
- motor function
Identifying post-treatment effects as early as possible allows us to provide intervention and support for children while they are young, and builds a solid foundation for later learning and future development.
Take the next step
For more information or to make an appointment, call 734-936-9814.