Treatmentsfor Medulloblastoma

Just like with most other tumors, medulloblastoma is usually first treated with surgery. During the procedure, the surgeon removes the entire tumor or a part of it, depending on its size and location.

Ideally, the entire tumor will be removed but even if that can’t be done, surgery can still be very beneficial. If a part of the cancerous tumor is removed, the patient will experience a relief of symptoms that were being caused by the medulloblastoma, because the pressure the tumor is making on the brain will be decreased.

Sometimes, surgery is not a feasible option because of its location. These tumors are inoperable because they are located in a part of the brain that can’t be operated on without causing neurological damage or injury.

While removal is the primary reason for performing surgery, it isn’t the only one. There are two more reasons, which are:

• To collect a sample for a biopsy. When the doctors need to diagnose a tumor and determine its subtype, they will surgically remove a piece of tissue from it to be examined under a microscope. This is what’s known as a biopsy, and it can show the molecular structure and characteristics of a tumor.
• To extract a buildup of cerebrospinal fluid. Medulloblastoma often leads to a buildup of CSF in the brain’s cavities. To resolve this issue, doctors will place a ventricular access device during surgery that will allow for the drainage of CSF.

Chemotherapy is a cancer treatment that uses special drugs to destroy tumor cells, and to stop them from growing and dividing, which ultimately stops the production of new cells. Chemotherapy can be given orally in pill form or through an intravenous (IV) line.

This treatment option is often given after surgery (if surgery is performed) and the doctor will determine what regimen is best for the patient. They might be given one drug, or a combination of multiple different drugs, over a specific period of time.

Chemotherapy administered after surgery is called adjuvant chemotherapy, and its main goal is to destroy the remaining cancer cells while reducing the risk of recurrence.

In some cases, chemotherapy is given before surgery in hopes of shrinking the tumor and making it easier for surgeons to perform the operation and extract as much of the tumor as possible. This is what’s known as neoadjuvant chemotherapy.

Radiation therapy, more simply known as radiotherapy, is a treatment option that involves the use of X-rays to destroy cancerous cells. It’s a very effective treatment for all types of brain tumors and is often given after surgery.

In certain cases, however, doctors will avoid radiotherapy altogether because radiation can stunt the growth and development of a child. This is why children under the age of 3 are only given radiotherapy if other treatment options prove to be ineffective.

The doctor will implement external beam radiation therapy, during which a machine sends beams of radiation outside of the body through the patient’s skin until it reaches the cancerous cells.

For medulloblastoma in particular, doctors will sometimes opt for proton therapy, which is a type of radiotherapy that uses protons instead X-rays. When high energy is used in external beam therapy, protons can very effectively treat medulloblastoma.

Radiotherapy is typically delivered in multiple sessions over a period of several weeks. This is done so the patient has as little exposure to radiation as possible.

Targeted therapy is a type of treatment that’s much less invasive than chemotherapy and radiotherapy. This is because, unlike those treatments, targeted therapy doesn’t have any negative effect on the patient’s healthy cells.

As the name suggests, targeted therapy targets only the cancerous cells within the patient’s body. With the use of specialized drugs, it can identify and attack the tumor cells. Apart from destroying cancerous cells, it can also be used to slow down the tumor’s growth and alleviate the patient’s symptoms.

However, this treatment option is very rarely used alone, and it is typically used in combination with chemotherapy or radiotherapy, depending on the individual case.

A bone marrow transplant is a procedure used to replace the bone marrow afflicted by cancerous cells with healthy bone marrow. This procedure encourages the development of healthy cells and strengthens the immune system, giving it a better chance to destroy the tumor.

It’s important to note that this treatment option isn’t frequently used for medulloblastoma, but it can be beneficial in some rare situations, although not as a first-line treatment. Whether or not a doctor will suggest a bone marrow transplant depends on the specific characteristics of the tumor, how the patient responded to previous treatment and their overall health.

In the case of recurrent medulloblastoma, meaning medulloblastoma that was successfully treated but then came back, doctors might suggest a bone marrow transplant. This is often done in conjunction with high dose chemotherapy.

There are two types of bone marrow transplants: allogeneic, which are performed with donated stem cells; and autologous, which use the patient’s own stem cells. For medulloblastoma, doctors typically perform an autologous transplant after high dose chemotherapy.

Follow-Up Care
Battling a brain tumor and going through treatment for it – especially at a very young age, which is the case for most patients suffering from medulloblastoma – is a difficult and harrowing experience. This is why follow-up care is essential when the patient enters remission.

Follow-up care is performed after the patient has been cured and it involves regular visits to a doctor who will keep track of their condition.

Follow-up care mostly consists of regular medical checkups, especially in the first few years after completing treatment. The patient will have regular checkups with their healthcare team, which are meant to monitor the patient’s health, track their symptoms and side effects, and watch out for any tumor recurrence.

Some of the tests that will be performed during these check-ups include:

• Imaging tests such as MRIs or CT scans
• Neurological and neurocognitive assessments
• Hearing and vision tests
• Hormone function tests
• Bone health assessment

Apart from medical checkups and assessments, the patient will also receive psychological and psychosocial support. Dealing with a serious illness such as medulloblastoma can be extremely challenging and take a toll on the patient’s mental wellbeing. After their treatment is complete, it’s important to provide them with the help they need to allow them to easily transition back to a normal routine.