Treatment & Prognosis
Children and adults with brain tumours should be seen at a multi-disciplinary medical centre, staffed with the following: Neurosurgeon, Neuro-Oncologist, Neuro-Radiotherapist, and a Neuro-Psychologist.
The treatment and prognosis depends on the type, grade, and location of the tumour. Type and location are explained on the previous pages (here). The grade of the tumour indicates the degree of malignancy: its tendency to spread, its growth rate, and its similarity to normal cells when viewed under a microscope.
Tumours with distinct borders are considered "grade I", are sometimes referred to as benign or mildly malignant. These tumours either do not grow or grow very slowly. Infiltrating tumours are those that tend to grow into surrounding tissue. Of the infiltrating tumours, the terms low-grade, mid-grade, and high-grade are frequently used. A "high grade" tumour is considered highly malignant. However, the exact system used to grade tumours varies with each specific family of tumours.
Brain tumours are treated with surgery, radiation, and chemotherapy. Depending on the type of tumour and the promptness of diagnosis, the 5 year survival rate is 40-80%.
The purpose of surgery is to remove as much of the tumour as possible, to establish an exact diagnosis, to determine the extent of the tumour, and sometimes to provide access for other treatments, such as implants or radiation. Some tumours are inaccessible to the neurosurgeon.
Conventional radiation therapy uses external beams of radiation aimed at the tumour, a therapy which is given over a period of several weeks. Other types of radiation are also available. Because the developing brain of a child is so very sensitive to radiation therapy, it is deliberately limited or delayed until the child has grown older and the brain has sufficiently matured.
Chemotherapy is required for the more aggressive or higher grade tumours. Many drugs will kill brain cells, but it is difficult to predict which tumours will respond to which chemotherapy agents. Therefore, treatment often consists of a combination of drugs. Certain classes of drugs will not pass the blood-brain barrier.
Quite often childhood tumours block the fluid spaces of the brain, creating pressure in the brain. In shunting, a thin Silastic tube (the shunt) is placed into the fluid spaces of the brain, passed under the skin into the child's tummy where the fluid is absorbed.
MODEL OF CARE
This website provides the 2003 Australian statistics on incidence, survival rates and mortality associated with Brain Tumours occurring in Australia.