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Childhood Visual Pathway and Hypothalamic Glioma Treatment (PDQ®)
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Description
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What is childhood visual pathway glioma?
Childhood visual pathway glioma is a type of brain tumor in which cancer
(malignant) cells begin to grow in the tissues of the brain. The brain
controls memory and learning, the senses (hearing, sight, smell, taste, and
touch), and emotion. It also controls other parts of the body, including
muscles, organs, and blood vessels. Other than leukemia or lymphoma, brain
tumors are the most common type of cancer that occurs in children.
Gliomas are a type of astrocytoma, tumors that start in brain cells called
astrocytes. A visual pathway glioma occurs along the nerve that sends messages
from the eye to the brain (the optic nerve). Visual pathway gliomas are visual
pathway tumors. They may grow rapidly or slowly, depending on the grade of the
tumor.
This PDQ summary covers tumors that start in the brain (primary brain tumors).
Often cancer found in the brain has started somewhere else in the body and has
spread (metastasized) to the brain. This is called brain metastasis (refer to
the PDQ summary on Adult Brain Tumors Treatment for more information).
Like most cancer, childhood brain tumor is best treated when it is found
(diagnosed) early. If your child has symptoms, the doctor may order a computed tomographic (CT) scan, a special x-ray that uses a computer to make a picture
of your child’s brain. A magnetic resonance imaging (MRI) scan, which uses
magnetic waves to make a picture of your child’s brain, may also be done.
Often, surgery is required to see whether there is a brain tumor and to tell
what type of tumor it is. The doctor may cut out a piece of tissue from the
brain and look at it under a microscope. This is called a biopsy.
There are many types of brain tumors in children and the chance of recovery
(prognosis) depends on the type of tumor, where it is located within the brain,
and your child’s age and general health.
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Stage Explanation
Once childhood visual pathway glioma is found, more tests will be done to find
out the type of tumor. If a biopsy specimen is taken, the cancer cells will be
looked at carefully under a microscope to see how different they are from the
normal cells. This will determine the histologic grade of the tumor. Your
child’s doctor needs to know the type and grade of tumor in order to plan
treatment.
There is no staging for childhood visual pathway glioma. The treatment depends
on whether or not your child has received treatment.
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Untreated childhood visual pathway glioma
Untreated childhood visual pathway glioma means that no treatment has been
given except to treat symptoms.
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Recurrent visual pathway glioma
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the brain or in the head or spinal area.
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Treatment Option Overview
There are treatments for all children with visual pathway glioma. Three kinds
of treatment are used:
Experienced doctors working together can often give the best treatment for
children with visual pathway glioma. Your child’s treatment will often be
coordinated by a pediatric oncologist, a doctor who specializes in cancer in
children. The pediatric oncologist may refer you to other doctors, such as a
pediatric neurosurgeon (a specialist in childhood brain surgery), a pediatric
neurologist, a psychologist, a radiation oncologist, and other doctors who
specialize in the type of treatment your child requires.
Surgery is one treatment for visual pathway glioma. Depending on where the
cancer is and the type of cancer, your child’s doctor may remove as much of the
tumor as possible. If the tumor cannot be totally removed, radiation therapy
and chemotherapy may also be given. If the cancer is in a place where it
cannot be removed, surgery may be limited to a biopsy of the cancer.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink
tumors. Radiation therapy for childhood brain tumors usually comes from a
machine outside the body (external radiation therapy). Because radiation therapy can affect growth and brain development,
clinical trials are testing ways to decrease or delay radiation therapy,
especially for younger children.
These include internal radiation therapy, in which radiation
is put into the brain through thin plastic tubes, and hyperfractionated radiation therapy, in which
radiation therapy is given in several small doses per day instead of all at once. Conformal radiation therapy uses a computer to create a 3-D picture of the tumor and the radiation beams are shaped to fit the tumor; this helps to keep the radiation away from healthy tissue as much as possible.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in a vein or muscle.
Chemotherapy is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells throughout the
body. Chemotherapy is being studied to delay the use of radiation therapy in
some patients. Clinical trials are studying different chemotherapy drugs for
visual pathway gliomas.
Some cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include physical problems; changes in mood, feelings, thinking, learning or memory; and having second cancers (new types of cancer). Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.
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Treatment by type
Treatment for childhood visual pathway glioma depends on the type and stage of
the disease and your child’s age and overall health.
Your child may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or you may choose to
have your child go into a clinical trial. Not all patients are cured with
standard therapy and some standard treatments may have unwanted side effects. For these reasons, clinical trials are designed to test new
treatments and to find better ways to treat cancer patients. Clinical trials
are going on in most parts of the country for childhood visual pathway glioma.
If you want more information, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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Untreated Childhood Visual Pathway Glioma
Your child’s treatment may be one of the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood visual pathway glioma.
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Recurrent Childhood Visual Pathway Glioma
Treatment for recurrent disease depends on the type of tumor, whether the tumor
comes back in the same place or in another part of the brain, and the treatment
that was given before.
If possible, the tumor may be removed during surgery. Radiation therapy may be
given, especially if it was not given before. Chemotherapy may be used, and
clinical trials are evaluating new chemotherapy drugs. You may wish to
consider having your child treated with new methods on a clinical trial.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood visual pathway glioma.
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Changes to This Summary (12/19/2005)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Changes were made to this summary to match those made to the health professional version and links to the NCI Dictionary of Cancer Terms were added.
This information is provided from the PDQ® database in collaboration with the NCI.
