Children treated on an outpatient basis for a low-grade glioma at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center are cared for at the Jimmy Fund Clinic on the third floor of the Dana Farber Cancer Institute. If your child needs to be admitted to the hospital, he will stay at Boston Children’s Hospital on the ninth floor of the Berthiaume Building.
There are a number of treatments that we may recommend for low-grade gliomas. Some of them help to treat the tumor while others are intended to address complications of the disease or side effects of the treatment. The specific course of treatment will be based on several factors, including:
- your child's age, overall health and medical history
- type, location and size of the tumor
- extent of the disease
- your child's tolerance for specific medications, procedures or therapies
- how your child's doctors expects the disease to progress
The treatments available for low-grade gliomas include:
- Surgery is usually the first step in the treatment of brain tumors. The goal is to remove as much of the tumor as possible without compromising neurological function.
- Radiation therapy uses high-energy rays (radiation) from a specialized machine to damage or kill cancer cells and shrink tumors. Due to the long-term damage that radiation can cause to the developing brain of a child, this treatment is usually only used as a last resort.
- Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Modern treatments now include biologic (also called smart drugs) that target specific abnormal pathways required by the tumor to grow and spread. A number of these types of drugs are now in clinical trials in children with low-grade gliomas
Your child may receive chemotherapy:
- orally, as a pill to swallow
- intramuscularly (IM), as an injection into the muscle or fat tissue
- intravenously (IV), directly to the bloodstream
- intrathecally, with a needle directly into the fluid surrounding the spine
These treatments may be used alone or in combination. In addition, through the low-grade glioma research program at Dana Farber/Boston Children’s, a number of less toxic biologic targeted therapies for pediatric low-grade gliomas are now available.
How are side effects of low-grade gliomas managed?
Side effects in the treatment of low-grade gliomas can arise from surgery, radiation and chemotherapy. Knowing what these side effects are can help you, your child and your care team prepare for, and, in some cases, prevent these symptoms from occurring.
- Radiation therapy often produces inflammation, which can make symptoms worse for a short time. To control this, inflammation steroids are sometimes necessary.
- Chemotherapy drugs cannot tell the difference between normal, healthy cells and cancerous cells. Some of the chemotherapy agents are associated with fatigue, diarrhea, constipation and headache. These side effects can be effectively managed under most circumstances with standard medical approaches.
Our Glioma Program also provides access to specialists who deliver complementary or alternative medicines. These treatments, which may help control pain and side effects of therapy, include the following:
- therapeutic touch
- dietary recommendations
Talk to your child’s physician about whether complementary or alternative medicine might be a viable option.
What is expected post-treatment for low-grade glioma?
The outlook for children with low-grade gliomas can vary significantly depending on:
- the location of the tumor
- whether it has spread
- whether it can be completely surgically removed
Grade I tumors are usually cured with complete surgical removal. In general, low-grade gliomas have a more positive prognosis than malignant, high-grade brain tumors. The majority of patients are long-term survivors.
What about progressive or recurrent disease?
There are numerous standard and experimental treatment options for children with progressive or recurrent low-grade gliomas.
Resources and support
There are also a number of patient and family support services at Dana-Farber/Boston Children's to help you and your family through this difficult time.
Today, the majority of children and adolescents diagnosed with pediatric brain tumors will survive into adulthood. However, many of them will face physical, psychological, social and intellectual challenges related to their treatment and will require ongoing assessment and specialized care.
To address the needs of this growing community of brain tumor survivors, Dana-Farber/Boston Children's Cancer and Blood Disorders Center established the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic.
More than 1,000 pediatric brain tumor survivors of all ages are followed by the Outcomes Clinic, a multi-disciplinary program designed to address long-term health and social issues for families and survivors of childhood brain tumors. Some of the post-treatment services provided by the Outcomes Clinic include:
- MRI scans to monitor for tumor recurrences
- intellectual function evaluation
- endocrine evaluation and treatment
- neurologic assessment
- psychosocial care
- hearing and vision monitoring
- ovarian dysfunction evaluation and treatment
- motor function evaluation and physical therapy
- complementary medicine
As a result of treatment, children may experience changes in intellectual and motor function. Among several programs addressing these needs are the School Liaison and Back to School programs, which provide individualized services to ease children's return to school and maximize their ability to learn.
In addition to providing thorough and compassionate care, our Outcomes Clinic specialists conduct innovative survivorship research and provide continuing education for staff, patients and families.
To learn more about our services or to schedule an appointment, call us at 617-632-2680.