Brain tumours (clinicians)
About brain & CNS tumours
Brain and central nervous system (CNS) tumours are the most common solid childhood tumour, with around 680 new cases occurring in children and young people every year in the UK. They account for a quarter of all childhood cancers.
Brain tumours are often picked up later than other childhood cancers due to their varied and often initially subtle symptoms.
Signs and symptoms
- Persistent or recurrent vomiting, especially in the morning
- New problems with coordination or balance
- Behaviour or personality change
- Tiredness
- Frequent or persistent headaches
- Unusual eye movements or a new squint
- Blurred vision
- Diplopia
- New onset of seizures (non-febrile)
Within consultations, be aware of children or young people presenting with worsening headaches, morning vomiting, unsteadiness and visual symptoms. In addition, young children that are losing skills that they previously managed, for example fine or gross motor skills.
Please see
The Headsmart Clinical Decision Tool for more information and resources on the signs and symptoms of brain tumours and how they may present.
Astrocytoma
This is the most common brain tumour type in children, accounting for 40% (155) of cases. Around 75% are low grade and have a 5-year survival of 95%.
Sadly, high grade astrocytoma has a much poorer prognosis with under 20% of children alive at 5 years.
Embroyonal tumours
These include medulloblastoma and PNET (primitive neuroectodermal tumours). They are most common in the very young, accounting for 70 cases a year in the UK. Medulloblastoma has a 5-year survival of 64%, with PNET only having 36% 5-year survival.
Ependymoma
Ependymoma makes up about 10% of childhood CNS tumours, with a 5-year survival of 71%.
Diffuse intrinsic pontine glioma (DIPG)
This is rare, but unfortunately has the worst prognosis of all paediatric tumours.
It has very poor survival rates with almost all children dying within 9 months of diagnosis. Radiation can prolong life in some cases.
Treatment of brain tumours
The main treatment for most CNS tumours is surgery (if feasible) with or without radiotherapy. Surgery is often major and life threatening, leaving children with neurological disabilities, some severe.
Radiotherapy is avoided if possible, in children under the age of 3 years due to the damage it causes to the developing brain. Proton beam radiotherapy is used in some cases because it can pinpoint and target a smaller area. Currently it is available in Manchester and at UCLH in London. Some families however may still need to go abroad to access proton beam radiotherapy for their child, usually in Essen, Germany or in the US.
Brain tumour survivors often suffer hormonal problems such as precocious puberty or poor growth resulting from damage to the developing brain.
