At Dana-Farber/Children's Hospital Cancer Center, we understand that a diagnosis of germinoma can cause concern for your child's future growth and development. You are probably wondering where to go from here and how to make sure your child receives the best possible care.
All of the members the Pediatric Brain Tumor Program at Dana-Farber/Children's Hospital Cancer Center are here to help. Our specialists are dedicated to anticipating any complications that your child may experience and developing the best therapeutic plans to manage them.
How are germinomas treated?
Initial treatment for germinomas depends on what is found in the actual tissue from the biopsy. Doctors first need to determine whether the tumor is a pure germinoma or a mixed germinoma. Based on that information, the therapy will differ.
A pure germ cell tumor will not need a resection (surgical removal) because it will respond well to radiation and chemotherapy. A mixed germ cell tumor may be resected completely initially but if this is too difficult, a biopsy may be performed for diagnosis, followed by chemotherapy to shrink the tumor before a resection is done to remove it.
What treatment options are available?
There are different treatment measures that may be used to treat children with germinoma tumor, including:
- Surgery: While biopsies can be done to diagnose germinomas, resection (surgical removal) is also used to take out all or parts of the tumor.
- Radiation therapy: Precisely targeted radiation can kill cancer cells that were left behind after surgery. This treatment is important in controlling the local growth of the tumor and preventing the spread of the tumor. Radiation to the whole brain and spinal cord are used to treat certain germ cell tumors that have spread throughout the brain or spine. Local tumors do not require whole brain or spinal radiation.
- Chemotherapy: a drug that interferes with the cancer cell's ability to grow or reproduce. Different of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. In patients with germinomas, chemotherapy has been recently added to the treatment regimen in order to permit the use of a lower radiation dose.
Chemotherapy can be given:
- intravenously (IV), as direct injection into the bloodstream. IV is the most common form of chemotherapy used to treat germ cell tumors.
- orally, as a pill to swallow
- Intramuscularly, as an injection into the muscle or fat tissue
- intrathecally, as a direct injection into the spinal column through a lumbar puncture
What is the long-term outlook for my child?
Germinomas carry a relatively excellent prognosis and management has therefore focused on reducing morbidity. It's very unlikely that the tumor will spread outside the central nervous system. In general, germinomas are cured in greater than 85 percent of cases with combined treated.
However, many children will face physical, psychological, social and intellectual challenges related to their treatment, which requires ongoing assessment and specialized care.
Coping and support
Children treated for a germinoma should consider visiting a survivorship clinic every year. The Dana-Farber/Children's Hospital Cancer Care established the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic, a multi-disciplinary program designed to address long-term health and social issues for families and survivors of childhood brain tumors.
In this program, children can learn:
- to manage disease complications
- to be screened for early recurrence of tumor
- to manage late effects of treatment
The School Liaison and Back to School Programs are two services that address intellectual and motor function by providing individualized services to ease children's return to school and maximize their ability to learn.
To learn more about our services or to schedule an appointment, please click here,