Early Detection, Diagnosis, and Prognosis of Brain Tumors in Children

Learn about the signs and symptoms of brain and spinal cord tumors in children and teens, the tests that may be done for these types of tumors, and the outlook for those with a diagnosis.

Can brain tumors be found early?

At this time, there is no widely recommended screening test to look for brain tumors before they start to cause symptoms. Instead, most brain tumors are found because a person has signs or symptoms, such as:

• Headaches
• Nausea or vomiting
• Changes in vision
• Problems with balance and walking
• Changes in behavior
• Seizures
• Drowsiness

Younger children may have vague symptoms such as low energy, low appetite, or a loss of developmental skills like walking and talking.

Most of these symptoms are likely due to other causes, but the best way to find most brain tumors is to pay attention to possible signs and symptoms and seek medical care promptly.

For children at high risk

For some people with genetic risk factors for brain tumors, screening tests such as imaging of the brain may be recommended to catch tumors before symptoms start. For example, for people with Li-Fraumeni syndrome, a yearly brain MRI is often recommended.

Not all tumors related to these genetic syndromes need to be treated right away, but finding them early might allow doctors time to monitor them so they can be treated quickly if they begin to grow or cause problems.

How are brain tumors diagnosed?

Most brain tumors are found because signs and symptoms prompt a visit to the doctor. If the doctor suspects a tumor, you might be referred to a doctor who specializes in nervous system problems, such as a neurologist or a neurosurgeon.

Diagnosing a brain tumor often involves:

• A physical exam, including a detailed nervous system (neurologic) exam
• Imaging tests such as an MRI or CT scan
• A biopsy of the tumor

In some cases, it may not be safe or necessary to do a biopsy to determine the type of tumor. In these cases, imaging tests alone may be used to confirm the diagnosis.

Certain brain tumors are more or less common in people of certain ages. Age may help doctors narrow down what type of brain tumor your child may have if a biopsy has not yet been done or is not safe at the time the tumor is found.

What affects brain tumor prognosis in children and teens?

For most cancers, the stage – a measure of how far the cancer has spread – is one of the most important factors in choosing treatment options and determining a person’s prognosis (outlook).

But brain tumors can be serious or even life-threatening because of their location, even though they might not spread outside the brain.

Because of this, brain tumors don’t have a formal staging system like most other cancers. Instead, factors that help determine outlook include:

• The type of tumor (such as astrocytoma, ependymoma, etc.)
• The grade of the tumor (how quickly it is likely to grow, based on how the cells look under a microscope)
• The location and size of the tumor
• How much of the tumor can be removed by surgery
• Whether the tumor cells have certain gene mutations or other changes
• The person’s age
• The person’s functional level (whether the tumor is affecting normal brain function and everyday activities)
• Whether the tumor has spread through the cerebrospinal fluid (CSF), the fluid around the brain and spinal cord, to other parts of the brain or spinal cord
• Whether tumor cells have spread beyond the central nervous system

Ask your cancer care team how these and other factors might affect outlook and treatment options.