Description

Medulloblastoma (muh-dul-o-blas-TOE-muh) is a cancer-brain tumor that starts in the lower part of the brain. This part of the brain is called the cerebellum. It is involved in muscle coordination, balance and movement.

Medulloblastoma begins as a growth of the cells, which is called a tumor. The cells grow quickly and can spread to other parts of the brain. Medulloblastoma cells tend to spread through the liquid that surrounds and protects the brain and the spinal cord. This is called the cerebrospinal fluid. Medulloblastomas usually does not spread to other parts of the body.

Medulloblastoma can occur at any age, but occurs most often in young children. Although medulloblastoma is rare, is the most common form of cancer-brain tumor in children. Medulloblastoma occurs more often in families that have a history of conditions that increase the risk of cancer. These syndromes include the syndrome Gorlin or Turcot syndrome.

Symptoms

Medulloblastoma symptoms occur when the cancer grows or causes pressure to build up in the brain. The signs and symptoms of medulloblastoma may include:

  • The dizziness.
  • Double vision.
  • Headaches.
  • Nausea.
  • Poor coordination.
  • Fatigue.
  • Staggering walk.
  • Vomiting.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Causes

It is not clear what causes medulloblastoma. This type of cancer begins as a growth of the cells in the brain.

Medulloblastoma occurs when cells of the brain develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes tell cancer cells to grow and multiply quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells form a mass called a tumor that can grow to exert pressure on nearby structures. The cancerous cells can invade and destroy healthy body tissue. You can also spread to other areas.

Risk factors

Factors that may increase the risk of medulloblastoma include:

  • The young age. Medulloblastoma can occur at any age. This most common type of cancer in children.
  • Hereditary syndromes. Medulloblastoma occurs more often in families that have a history of conditions that increase the risk of cancer. These conditions include anemia, Fanconi syndrome, Gorlin syndrome, Li-Fraumeni syndrome, Rubinstein-taybi syndrome, and Turcot syndrome.

Diagnosis

The diagnostic process usually begins with a summary of your medical history and a review of the signs and symptoms. Tests and procedures used to diagnose medulloblastoma include:

  • Neurological examination. During this examination, vision, hearing, balance, coordination, and reflexes are tested. This can help to show what part of the brain could be affected by the tumor.
  • Imaging tests. Imaging tests, capture images of the brain. The pictures can show the size and location of the tumor. These tests can show pressure or blockage of the cerebrospinal fluid. Ct scans and Mris are used for the imaging, but further tests may be necessary in certain situations.
  • Tissue sample of the test. A biopsy is a procedure to remove a sample of the tumor to the test. Biopsies for medulloblastoma are rare, but they can be used in certain situations. In a biopsy, a part of the skull is removed. You use a needle to take a sample of the tumor. The sample is analyzed in a laboratory to see if it is of a medulloblastoma.
  • The removal of cerebrospinal fluid for testing. A lumbar puncture, also called a spinal tap, involves inserting a needle between two bones in the lower part of the spine. The needle is extracted from the cerebrospinal fluid from around the spinal cord. The fluid is tested in a laboratory to detect tumor cells. This test is performed only after handling the pressure in the brain or in the removal of the tumor.

Treatment

Treatment for medulloblastoma usually includes surgery followed by radiation therapy or chemotherapy, or both. Your health care team takes into account many factors when creating a treatment plan. These factors can include the location of the tumor, how fast it is growing, if it has spread to other parts of the brain and of the results of the tests on the tumor cells. Your health care team also takes into account your age and your overall health.

The treatment options include:

  • Surgery to relieve fluid accumulation in the brain. A medulloblastoma can block the flow of cerebrospinal fluid. This can cause an accumulation of fluid that puts pressure on the brain. To reduce the pressure, a surgeon can create a pathway for fluid to flow out of the brain. Sometimes, this procedure may be combined with surgery to remove the tumor.
  • The surgery to remove the medulloblastoma. The goal of surgery is to remove all of the medulloblastoma. But sometimes it is not possible to completely remove the tumor, as it is close to important structures deep within the brain. The majority of people with medulloblastoma need more treatments after surgery to destroy any cancer cells that are left.
  • The radiation therapy. Radiation therapy uses high-energy rays to kill cancer cells. The energy can come from X-rays, protons, and other sources. During radiation therapy, a machine directs the rays of energy to specific points in the body. Radiation therapy is often used after surgery.
  • Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Typically, children and adults with medulloblastoma receiving these drugs as an injection into the veins. Chemotherapy may be used after surgery or radiation therapy. Sometimes this is done at the same time as radiation therapy.
  • Clinical trials. Clinical trials enrolling participants eligible for the study of new treatments for the study of new ways of using existing treatments, such as different combinations or the time of radiation therapy and chemotherapy. These studies provide an opportunity to try the latest treatment options, although the risk of their side effects may not be known. Talk with your health care professional for advice.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Because appointments can be brief, it is a good idea to be prepared. Here's some information to help you prepare.

What you can do

  • Be conscious of any thing you need to do ahead of time. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
  • Write important personal information, including major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking and the dose.
  • Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For medulloblastoma, some basic questions to ask include:

  • I have a medulloblastoma?
  • More evidence is needed?
  • Can my medulloblastoma be deleted?
  • Why do I need additional treatments if the surgery removes all medulloblastoma?
  • What are the treatment options?
  • What is the stage of my medulloblastoma?
  • Has my medulloblastoma spread to other parts of my body?
  • How much does it cost each treatment to increase my chances of a cure or to prolong my life?
  • What are the possible side effects of each treatment?
  • How will each treatment affect my daily life?
  • There is a treatment option which you think is the best?
  • What would you recommend to a friend or family member in my situation?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?
  • Is that I have to keep coming back?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Medulloblastoma