BASIC FACTS
ABOUT NON-MALIGNANT
BRAIN TUMORS
“Where hope
springs eternal”
Pediatric Brain Tumor Foundation®
A Resource for Families
Pediatric Brain Tumor Foundation®
i
Acknowledgements
The Pediatric Brain Tumor Foundation® wishes to
thank Bridget McCarthy, Ph.D., of the Department of
Epidemiology, University of Illinois at Chicago, and
Carol Kruchko, President, Central Brain Tumor Registry
of the United States, for assistance in preparing this
booklet. We also thank Roger McLendon, M.D., Chief,
Neuropathology and Surgical Pathology at Duke
University Medical Center and Michael Prados, M.D.,
Director of Transitional Research in Neuro-Oncology
and Principal Investigator Brain Tumor Research Center,
University of California, San Francisco, for scientific
review of this publication.
Sources
Statistical and descriptive data in this publication were
obtained from the Central Brain Tumor Registry of the
United States (CBTRUS, cbtrus.org) and the World
Health Organization (WHO) Classification of Tumours of
the Central Nervous System.
DISCLAIMER
The Pediatric Brain Tumor Foundation® does not
render medical advice or professional medical services.
Information in this publication is NOT intended
to be a substitute for medical care or advice
and should not be used for the diagnosis or
treatment of a brain tumor or any other health
problem. If you have or even suspect you have a
problem concerning your health or that of someone
else, you should consult with your health care provider.
Educational materials provided by the Pediatric Brain
Tumor Foundation® are based on current information
at the time of publication. Medical research concerning
disease and treatments in an ongoing process, however,
and you should review all subjects with your doctors
and medical institutions to obtain the most up-to-date
information available.
COPYRIGHT
© 2010 by the Pediatric Brain Tumor Foundation®.
First printing 2010.
The contents of this publication have been prepared
for the exclusive use of the Pediatric Brain Tumor
Foundation®. They may not be reproduced in part or in
their entirety without the written permission of the PBTF.
Pediatric Brain Tumor Foundation®
ii
Our Mission
•Find the cause of and cure for
childhood brain tumors through the
support of medical research;
•Increase public awareness about the
severity and prevalence of childhood
brain tumors;
•Aid in early detection and treatment of
childhood brain tumors;
•Support a national database on all
primary brain tumors; and
•Provide hope and emotional support
for the thousands of children
and families affected by this lifethreatening disease.
ABOUT THE PEDIATRIC BRAIN TUMOR
FOUNDATION®
The Pediatric Brain Tumor Foundation® (PBTF) was
established in 1991 to find the cause of and cure for
childhood brain tumors. Our primary source of support
is the national Ride for Kids® program, which began
in 1984 and has helped make us the world’s largest
non-governmental source of funding for childhood brain
tumor research. We also offer support programs for
families with a child who has been diagnosed with a
brain tumor. Our resources include free literature about
brain tumors and scholarships for survivors of pediatric
brain tumors. A list of our resources can be found on the
back cover of this publication.
Pediatric Brain Tumor Foundation®
1
INTRODUCTION
Few challenges can compare to dealing with the news
that a member of your family has a brain tumor. When
the patient is a child, the emotional burden can seem
beyond your ability to bear. The experience of thousands
of other families, however, proves that it is not.
The first step on the path to coming to terms with
a pediatric brain tumor, and to restoring control over
your family’s life, is to understand as best you can
what the child faces. Exactly what kind of tumor is it?
Where is the tumor? What are the consequences for
the rest of the body? What can be done? What are the
prospects for the future? There are hundreds of different
tumors known to medical science. Most pose grave
risks if left alone, but some can be treated with a high
degree of success. Each tumor of the brain presents
unique problems of diagnosis and treatment, but the
starting point for a parent is always the same: gaining
knowledge.
This booklet is one in a series produced to help
you learn more about the specific tumor that is at the
root of your child’s illness. It contains the most recent
information drawn from leading scientists and physicians
around the world. It is not a substitute for personal
consultations with a medical doctor specializing in
pediatric brain tumors. The knowledge you gain can help
you ask questions, confidently voice your concerns and
actively participate as a member of your child’s medical
care team.
It is important to keep in mind that pediatric
brain tumors require specialized treatments best
delivered at comprehensive medical centers equipped
with departments devoted to cancer and staffed by
a multidisciplinary team of specialists. Such a team
will include physicians, nurses, social workers, child
psychologists, child life specialists and rehabilitation
professionals. The care they provide should include
education and support services for your family.
Medical research has produced incredible advances
in recent years, dramatically improving survival rates,
life expectancy and treatment options while reducing
harmful side effects of what can be difficult courses of
treatment. But there is still much we do not know about
the causes of childhood brain tumors or the cures.
Funding more research, increasing public awareness and
aiding in the early detection and treatment of pediatric
brain tumors is the mission of the PBTF. Families like
yours are at the heart of that mission. If you need
further information or other publications, our staff would
be happy to take your call.
Contact us at 800-253-6530 or
[email protected]. Our website is pbtfus.org.
2
Pediatric Brain Tumor Foundation®
A FEW BASIC FACTS
What causes brain tumors?
The short answer is: We don’t know. Researchers
believe that inherited and genetic factors may be
involved. Environment may also play a part. While
science has yielded valuable information, it has yet to
produce concrete answers about the causes of most
brain tumors. Please go to pbtfus.org to listen to our
conference, “Risk Factors and Pediatric Brain Tumors” for
more information.
In addition, some tumors in the brain can be
caused by a cancer that first took hold elsewhere in the
body, but they are not the focus of this booklet. Instead,
we are dealing with primary tumors that originate in the
brain.
What is the difference between benign/
non-malignant and malignant brain tumors?
The way medical professionals use language can
be confusing to laypeople, and “benign” is a perfect
example. Popular usage of the word implies that a
tumor is mild or non-threatening, even though there
is no such thing as a non-threatening brain tumor. It
is more helpful to use the term “non-malignant” to
distinguish such growths from malignant tumors.
Malignant tumors are composed of cancerous
growths, groups of cells that divide and multiply out of
control. Malignant brain tumors can shed cancerous cells
to other sites in the brain or spinal cord. However, they
rarely spread to other parts of the body. They are always
life-threatening and the hardest tumors to treat.
Non-malignant tumors, by contrast, are not
cancerous and they rarely invade the tissues around
them. However, any tumor in the brain or spinal cord,
which together form the central nervous system (CNS),
can grow in size and pose a serious threat. Treatment is
essential. The CNS controls behavior, personality, senses,
movement, coordination and automatic functions like
breathing. Anything that could crowd out vital regions or
disrupt the normal functioning of the CNS could cause
serious problems, even death.
Children are at extra risk from non-malignant tumors
because the brain, along with the rest of the body, is still
developing. What happens in the early years can have
enormous consequences for the rest of the child’s life.
In addition, some non-malignant tumors of the brain
can turn malignant if they are not removed in time. It is
critical to consult with a pediatric neurosurgeon as soon
as possible.
The good news is that treating non-malignant brain
tumors is much easier, for both the patient and the
Pediatric Brain Tumor Foundation®
3
treatment team Non-malignant tumors rarely grow
back after being removed, or resected. Removal, which
usually requires brain surgery, is often aided by welldefined borders between the non-malignant tumor
growth and surrounding healthy tissue. The location of
the tumor in the brain will determine whether a surgeon
can remove the tumor in part or completely.
Once the tumor has been removed, most patients
will not require the same degree of intensive follow-up
treatments that come with malignant tumors. In many
cases, the long-term effects are generally mild. Survival
rates are typically high for non-malignant tumors,
reaching 90 percent or more, depending on the type of
tumor.
If your doctors diagnose your child with a nonmalignant tumor, you may be told it is a Grade I tumor.
The grading system is widely used to describe tumors
according to the threat they pose. Grade II tumors are
also considered non-malignant, but with a significant
chance of becoming malignant. Sometimes grading a
tumor can be difficult, and experts may make different
diagnoses. It is often a good idea to get more than one
medical opinion, especially if a tumor has been given an
“intermediate” grade.
Grade III and IV tumors are malignant and present
the most serious risks to health. The “stage” of a tumor
is a term applied primarily to malignant cancers, and
non-malignant tumors are not usually assigned one.
What is involved in diagnosing a tumor?
Recognizing that your child’s illness is something out
of the ordinary is the first step on the path to a proper
diagnosis. Each type of tumor can produce its own
set of symptoms, ranging from headaches, changes in
behavior, and drowsiness to nausea, vomiting, blurred or
double vision, even seizures. Your doctor will take those
symptoms into account when choosing the techniques
required to make a proper diagnosis.
In most cases, the doctor will employ one or more
of several machines that can take three-dimensional
images of a patient’s brain without the need for surgery.
Among the most common diagnostic techniques
is magnetic resonance imaging, or MRI. It uses
harmless magnetic waves to scan the brain. A special
dye called a contrast agent is injected into the
patient to help the scanner distinguish between healthy
and abnormal tissues. The patient lies in a car-sized
machine, which makes a series of noisy but painless
scans. The entire process usually takes less than an
hour. Like any photograph, it is important for the patient
to remain as still as possible. The presence of a parent,
calming music, or a mild sedative can often help. The
4
Pediatric Brain Tumor Foundation®
contrast agent is also harmless and is broken down by
the body and eliminated soon after the scans.
Computerized tomography, also known as CT or
CAT technology, is similar in design to MRI systems. It
also requires a contrast agent, but uses X-rays instead
of magnetic waves. There is a small risk of cancer that
comes with exposure to X-rays, which must be weighed
against the benefits of the technology, and both should
be discussed with your doctor. Like all aspects of
medicine, CT techniques, including radiation exposure
levels appropriate for children, are constantly being
refined.
Positron emission tomography comes in two
forms, PET or SPECT (for single-photon emission
computed tomography). Both record pictures of brain
activity. While CT or MRI scanners produce images of
what is in the brain, PETs can analyze what those tissues
are doing. Patients are first injected with a radioisotope
tracer, usually a sugar that emits low levels of radiation
as it changes into a stable form. There is no significant
risk from the tracer. After a short wait, the machine
makes its scans. In many cases, doctors will use both a
CT and a PET scan to build a complete picture of what
is going on in the brain.
Specialists study the images produced by the scans
to determine the location and nature of a suspected
tumor. Confirming the initial diagnoses may then
require a biopsy, or the removal of a small piece of
brain tumor tissue. In some cases, all that is needed
is a needle; at other times surgery will be necessary.
Fortunately, the brain itself does not feel pain, and the
procedure is relatively straightforward.
TYPES OF NON-MALIGNANT TUMORS
There are dozens of different types of brain tumors
known to occur in children. They are usually categorized
according to the type of brain cell from which they arose
and the part of the brain in which they are found. A few
of the more common Grade I pediatric brain tumors are
listed below. The list is not comprehensive, but is meant
to serve as an exploration of the issues and challenges
associated with non-malignant tumors. We recommend
reading about all of the tumors, rather than just the one
you are researching, because many issues and terms
are common to more than one type.
Astrocytomas
Tumors that involve the star-shaped cells known as
astrocytes constitute about half of all pediatric brain
tumors. These glial cells connect and support nerves
and help repair brain tissue. Recent research has shown
that astrocytes have a wider range of roles to play than
Pediatric Brain Tumor Foundation®
5
previously thought. Sometimes they even seem to act
as nerves themselves, transmitting signals through the
brain.
One of the most common astrocytomas in children
is the pilocytic astrocytoma. “Pilocytic” refers to the
fiber-like shape of the cells that make up the tumor.
Pilocytic astrocytomas are usually found in
the cerebellum – the part of the brain that sits
immediately above the spinal cord at the rear of the
skull. The cerebellum plays a critical role in integrating
information from the senses, coordinating motor control
or movement and maintaining balance when performing
tasks such as riding a bicycle.
More than 80 percent of tumors of the cerebellum
are pilocytic astrocytomas. On occasion they appear in
other parts of the central nervous system, including near
the eye, hypothalamus and fluid-filled cavities known as
ventricles. The pressure they may exert on the brain
can lead to headaches, nausea, vomiting, irritability, or
vision problems. When the tumor appears in the optic
pathway of the eyes it is referred to as an optic nerve
glioma.
Most pilocytic astrocytomas grow slowly and have
sharply defined edges. They are therefore easy to
remove, if they are not located in an inaccessible region
of the brain. If one can’t be removed by surgery, then
radiation or chemotherapy may be used.
This type of tumor is often called juvenile
pilocytic astrocytoma (JPA) because it occurs most
commonly in young children. Some experts consider it
a “borderline” tumor that can become malignant, but
in general, the prognosis for patients is good. When the
entire tumor can be removed, survival rates of better
6
Pediatric Brain Tumor Foundation®
than 90 percent are typical. For more information about
this type of tumor, please see our booklets Basic Facts
About Astrocytoma and Basic Facts About Juvenile
Pilocytic Astrocytoma.
Ependymomas
About 6 percent of all childhood tumors of the central
nervous system arise from cells that line the ventricles
and spinal column, and are known as ependymomas.
Most ependymomas in children are malignant and are
located in the posterior fossa and the floor of the fourth
ventricle.
There are two types of the non-malignant
ependymomas: myxopapillary ependymoma and
subependymoma.
Among children, myxopapillary ependymoma is
uncommon. It occurs more often in young adults. It is
comprised of smooth, sausage-shaped cells, usually in
the spinal cord. It is slightly more common in boys than
girls. The majority of these tumors are non-malignant
and slow growing. At the time of surgery, a small
number of these tumors are found to be intact as a baglike tumor. If the tumor cannot be removed completely,
recurrence can occur at the site of the original tumors.
Myxopapillary ependymomas typically cause
nonspecific symptoms, most commonly low back pain
and sometimes lower extremity weakness or bladder
problems.
A related type of tumor is known as
subependymoma, which is also more common in
adults than children. They grow slowly, in clusters of
glial cells that are often attached to the walls of fluidfilled ventricles in the brain’s cerebrum. The cerebrum
is comprised of the familiar folded brain tissue that
occupies most of the skull and sits above and in front of
the cerebellum. Subependymomas are most often found
in the fourth, lateral and third ventricles.
Like pilocytic astrocytomas, subependymomas
are well-defined groups of cells that can often be
completely removed by a surgeon. In many cases,
no radiation therapy is required after the operation,
although in some rare cases where the tumor regrows,
radiation has proven successful. If it is not removed, a
subependymoma can eventually cause hydrocephalus,
a condition involving a dangerous buildup of excess
cerebrospinal fluid (CSF) in the brain. The condition
can produce pressure within the skull and enlargement
of the head. If not removed in time it can prove fatal.
A common method of dealing with hydrocephalus is
the insertion of a small tube, known as a shunt, that
allows CSF to drain out of the ventricles and into the
bloodstream or abdomen, where it is reabsorbed by the
Pediatric Brain Tumor Foundation®
7
body. This is usually a temporary measure, and in some
cases a permanent shunt is needed.
In other cases, subependymomas can lie dormant,
producing no symptoms and remaining undetected
throughout a lifetime. It is common for a patient to
experience no symptoms of a tumor for many years
until hydrocephalus becomes apparent. But even though
a tumor itself is non-malignant, its effects can be lifethreatening. For more information about malignant
ependymomas in general, please see our booklet Basic
Facts About Ependymoma.
Frontal lobe
Meninges
Temporal Lobe
Cerebrum
Choriod Plexus
Cerebellum
Pituitary Gland
Brain Stem
Spinal column
Spinal Cord
Dura Mater
Choroid plexus papilloma
The choroid plexus is a structure in the brain that
produces cerebrospinal fluid. Choroid plexus
papillomas are typically non-malignant and are most
often found in young children, usually no older than
5 or 6. They make up about 3 percent of all pediatric
brain tumors and appear more often in boys. In rare
circumstances these tumors can be difficult to grade.
A choroid plexus papilloma may cause no
symptoms as it expands and fills up the ventricle
8
Pediatric Brain Tumor Foundation®
because the brain has some ability to compensate for
the gradually restricted flow of spinal fluid. Eventually,
however, the tumor will likely block the flow of CSF
entirely. Loss of CSF circulation presents serious
challenges to the brain and its normal functioning, and
hydrocephalus or other complications are much more
likely if the tumor is left to grow for long.
Craniopharyngioma
Craniopharyngioma is another slow-growing tumor
that usually originates near the pituitary gland at the
base of the skull. It develops from ordinarily inactive
tissue called the pharyngeal duct. Although the duct
was once important to human ancestors and begins
to develop before birth, it does not have a function in
modern humans and may disappear altogether during
childhood. If it doesn’t, however, there is a small chance
it will develop into a tumor.
Unlike many other non-malignant tumors,
craniopharyngiomas have a tendency to spread to
surrounding parts of the brain, and may even reappear
after surgical removal. They take the form of one or
more fluid-filled cysts. They are typically restricted to the
base of the brain, but on occasion have been found as
far away as the spine.
Almost a quarter of all cases of craniopharyngioma
occur in children younger than 15. They represent about
4 percent of all childhood tumors. Because of their
location, craniopharyngiomas often reach large sizes
before being discovered. Often they are more than an
inch in diameter by the time symptoms develop. Those
symptoms include headaches, poor hormone function,
vision problems, a halt in normal growth and delayed
puberty. In some cases, treatment with radiation therapy
is needed following surgery.
Schwannoma
Among children, the most frequently diagnosed tumor
of the nerves is vestibular schwannoma, a tumor
that affects the balance and hearing nerves in the inner
ear. It is named after the onion skin-like Schwann cells
that wrap around the nerves, and is also known as an
acoustic neuroma. When too many Schwann cells
are produced, the affected nerve can lose its ability to
process signals, leading to dizziness and poor balance,
tinnitus (ringing in the ear), and deafness, most often in
one ear.
If a schwannoma continues to grow, it can also
produce facial numbness or paralysis. If left untreated, it
may eventually press on the cerebellum and brain stem,
a life-threatening condition.
Because the early signs are similar to a variety of
other middle and inner ear problems, many children
Pediatric Brain Tumor Foundation®
9
with schwannoma are not properly diagnosed quickly.
Ear examinations and hearing tests are often not
sufficient for a true diagnosis, and only with CT or MRI
scans does the tumor become evident. Surgical removal
of the abnormal Schwann cells is the usual choice of
treatment, particularly if the tumor is still relatively small.
In that case, hearing can often be saved. Radiation
therapy is used only if the tumor has already damaged
nerves that cannot be removed without worsening the
patient’s condition.
Mixed neuronal-glial tumors
Among the more difficult tumors to diagnose without
surgery are those that involve both neurons and their
supporting glial cells. The most common tumors in
this category are gangliogliomas, which can occur
in almost any part of the central nervous system, but
typically in the temporal lobes and cerebellum. They
arise from neurons and astrocytes, and can take a
variety of forms. Ganglioglioma tumors are firm, gray
masses that may be accompanied by even harder cysts.
Although rare in adults, some 10 percent of pediatric
brain tumors are gangliogliomas. Specially named
variants are recognized and are discussed below.
As with many other non-malignant tumors,
gangliogliomas grow slowly. They are one of the least
aggressive brain tumors, taking years to develop to the
point where symptoms, such as headaches, fatigue and
seizures, are felt. Once identified, complete removal
is the most preferred course of action, after which
recurrence is extremely rare. No radiation follow-up
therapy is usually required.
The hypothalamic hamartoma is a tumor
composed of neurons that arise in the base of the
brain near the third ventricle in a region known as
the hypothalamus. This tumor is associated with early
onset of puberty and occasionally other endocrine
abnormalities.
The desmoplastic infantile ganglioglioma
(DIG) can occur in infants as young as 1 year of age
and can be quite large. Although DIGs are often first
identified as meningiomas because they are attached to
the superficial covering of the brain known as the dura,
they are also attached to the underlying brain. A second
tumor with a very similar microscopic appearance and
believed to be related to the DIG is the desmoplastic
astrocytoma, a tumor that lacks the neurons of the
DIG.
Dysembryoplastic neuroepithelial tumors
(DNTs) also consist of malfunctioning neurons,
astrocytes and the oligodendrocytes that insulate
neurons. They occur in the cerebrum, the primary
thought control center of the brain. Most arise in the
10
Pediatric Brain Tumor Foundation®
temporal lobes and a few in the frontal lobe at some
point during the first 19 years of life.
Although similar to, and sometimes misdiagnosed
as, a ganglioglioma, a DNT has very different
consequences. The most frequently described symptom
is repeated seizures originating in the temporal lobe,
usually beginning before age 10. Like most other nonmalignant tumors, however, the prognosis following
surgical removal is good.
Another tumor composed of malfunctioning
neurons and glial cells is the rosette-forming
glioneuronal tumor (RGNT), which occurs near the
fourth ventricle in children. It can mimic a malignant
medulloblastoma (see the booklet Basic Facts about
Medulloblastoma/PNET) in both location and
microscopic appearance, but it comes with a much
better prognosis. Hydrocephalus with headaches, nausea
and vomiting are the most common symptoms.
Meningioma
The membranes that wrap around the central nervous
system are collectively known as the meninges. Tumors
found on the spider web-like layer that covers the
brain are called meningiomas. Just what constitutes a
meningioma is still subject to some debate, as several
varieties of tumor can arise from the meninges. In
addition, it is possible for patients to live for many years
without experiencing any symptoms. As a result, their
true prevalence is uncertain.
When symptoms are apparent they take the form
of seizures brought on when the tumor irritates or
compresses the brain, as well as facial numbness, loss
of hearing, or changes in behavior.
Depending on the location of the tumor, it may
be possible to cure a child with meningioma through
surgical removal. Follow-up radiation therapy is
frequently employed if only a portion of the tumor can
be excised. About 90 percent of meningiomas are nonmalignant, and they recur in less than a tenth of the
patients who had the tumor completely removed.
Pituitary adenoma
The garbanzo bean-shaped pituitary gland regulates
many vital functions in the body by releasing hormones.
It is located at the base of the brain attached to the
hypothalamus. A malfunctioning pituitary can wreak
havoc with anyone’s metabolism, and a tumor presents
a serious threat. Children are particularly at risk as many
of the physical changes they go through require a
properly functioning pituitary. The most common nonmalignant tumors associated with the gland are known
as pituitary adenomas.
Pediatric Brain Tumor Foundation®
11
These tumors can come in many forms, most
secreting one or more hormones themselves, although
between 25 and 30 percent do not. Both kinds can
cause serious damage, however, by compressing the
pituitary or preventing it from functioning properly. A long
list of symptoms are associated with pituitary adenomas,
ranging from headaches, nausea and weakness to
seizures and blindness. If the tumor itself secretes a
growth hormone, developmental problems for children
are likely.
Pituitary tumors are among the more challenging
to treat. Some tumors are too close to vital regions of
the brain for surgery and may require tightly targeted
radiation therapy. Even after removal, however, they
frequently recur. The most important consideration is to
stop the tumor from secreting hormones, which may be
possible with hormone therapy. Fortunately, many are
relatively easy to remove. If the tumor is small enough,
a doctor can excise it through the nose and sinuses,
avoiding the need for surgery. Larger tumors may require
an incision in the scalp.
SUMMARY
The most important thing to remember is that all brain
tumors in children present a threat, including nonmalignant tumors, sometimes referred to as benign.
Each non-malignant tumor presents its own
diagnostic and treatment challenges. Many of the
tumor types described here can interfere with the
production and circulation of cerebral spinal fluid and
lead to swelling of the brain. Others make themselves
felt by affecting the senses, including vision or hearing.
Symptoms may not always suggest a brain tumor, but
they can, if left untreated, do significant damage to the
brain of the child.
Knowledge of how to respond to a specific tumor
and which treatments offer the best hope for each
child continues to expand. Much work remains before
physicians can offer a guarantee of a cure, even when
a non-malignant tumor is completely removed. But
researchers are getting ever closer, treatments are
ever more manageable and survival rates are always
increasing.
Each new child diagnosed with a brain tumor,
has the benefit of all that has been learned about the
disease to this point. The likelihood of a complete
recovery has never been better.
12
Pediatric Brain Tumor Foundation®
CONCLUSION: HOPE FOR TODAY
AND TOMORROW
By now, you have probably discovered that when you
are dealing with a brain tumor or spinal cord tumor, you
do not travel in a straight line from beginning to end.
Instead, one step forward can be followed by two steps
backward, followed by three steps forward, and so on.
An attempt to treat one complication may create other
problems, which then must be solved. Yet you also
experience small triumphs along the way, and you are
always aware that a major victory may be just around the
corner.
As you continue on this difficult journey, we
encourage you to ask questions and express your
concerns. At the same time, seek out people and places
that give you energy and hope. Only when you are
nourished can you give of yourself to those who need
you.
We are making progress. Every study and clinical
trial increases our understanding of a tumor's origin and
behavior, improving our ability to destroy it. One day,
we will leam how to prevent it. And with each advance,
more and more children will be able to enjoy a long and
productive life.
(See back cover for a list of booklets on various
types of tumors and audio CDs available to families.)
Pediatric Brain Tumor Foundation®
13
Pediatric Brain Tumor Foundation®
Reference Library
The following resource literature and audio compact discs are
available at no charge to patient families, medical professionals
and social services specialists. To place an order, or for
information on the availability of these materials in Spanish, call
800-253-6530 or e-mail [email protected].
Brochures
1. Questions for Your Medical Care Team When Your Child
Has a Brain Tumor
2. Basic Facts about Pediatric Brain and Spinal Cord Tumors
3. Basic Facts about Medulloblastoma/PNET
4. Basic Facts about Juvenile Pilocytic Astrocytoma
5. Basic Facts about Astrocytoma
6. Basic Facts about Glioma
7. Basic Facts about Ependymoma
8. Basic Facts about Non-Malignant Brain Tumors
9. Basic Facts About Late Effects of Pediatric Brain Tumors and Treatments
Informed Parent & Survivor Internet Conference Series (audio CDs)
1. The Importance of a Multidisciplinary Approach to Treating Children with Brain Tumors
2. The Clinical Trials Process
3. School Re-entry Following the Diagnosis and Treatment of Your Child’s Brain Tumor
4. Healing the Family
5. Growth and Development: Endocrine Issues Facing Pediatric Brain Tumor Survivors
6. Post-traumatic Stress: Helping Families Survive Childhood Cancer
7. Sibling Issues: The Impact of Cancer on Healthy Siblings
8. Brothers and Sisters and Brain Tumors: A Child’s Point of View for Coping with Cancer in the Family
9. Combining Curative and Palliative Care for Children with Brain Tumors
10. The Price of Survivorship: Loss and Living
11. Risk Factors and Pediatric Brain Tumors
12. The Role of the Pediatric Oncology Social Worker in Assisting Families
13. Finding Fertility: Parenthood Options and Childhood Cancer
Newsletters
The Caring Hand (for patient families, caregivers, and medical and social work professionals)
The Helping Hand (for Ride for Kids® participants)
302 Ridgefield Ct.
Asheville, NC 28806
828-665-6891 • 800-253-6530
fax 828-665-6894
e-mail [email protected]
[email protected]
[email protected]
website pbtfus.org
This publication made possible through a generous
grant from the Janirve Foundation.