Brain and Spinal Tumors - Pediatric

Overview

City of Hope offers comprehensive, family-centered, leading-edge treatment for children, adolescents and young adults with malignant and benign tumors of the brain and spinal cord.

For nearly two decades, City of Hope has provided lifesaving treatments by bringing basic laboratory research to the patient’s bedside. Gene therapy and stem cell therapy trials are being developed by City of Hope researchers to treat some of the deadliest forms of brain cancer.

City of Hope is also a member of the Children’s Oncology Group, which provides access to the nation’s largest group of pediatric and adolescent clinical trials. In addition, our team of neurosurgeons offers world-class neurosurgical techniques for tumors of both brain and spine.

We were also the first hospital in Southern California to provide helical TomoTherapy, which dramatically decreases the side effects of radiation treatment.

Request a consultation

If your child have been diagnosed with a cancer of the brain or spinal cord or if you are looking for a second opinion consultation about their treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

 

Our board-certified experts in pediatric oncology, radiation therapy and neurosurgery provide treatment for a wide variety of brain and spine tumors including:

  • Glioblastoma multiformae

  • Medulloblastoma/primitive neuroectodermal tumor

  • Brain stem glioma

  • Astrocytoma

  • Retinoblastoma

  • Ependymoma

  • Optic glioma

  • Germ cell tumors of the brain and spine

  • Rare brain tumors

  • Childhood and young adult tumors that have metastasized to the brain

Seamless, coordinated care City of Hope’s team of neurosurgeons, neuro oncologists, researchers, nurses, radiologists and genetic counselors work together closely at all stages to provide seamless, coordinated care. We balance that approach with personalized medicine — not just when it comes to your cancer, but the kind that makes you feel supported throughout your treatment. And our commitment to personalized care means preserving your quality of life is at the heart of your treatment.

City of Hope is internationally recognized for its research and breakthrough treatments, has been named one of America’s top cancer hospitals by U.S. News & World Report for more than a decade, and is a National Cancer Institute-designated comprehensive cancer center.

NEWS & BREAKTHROUGHS

Treatment options

City of Hope is one of only a few dozen centers in the country that treat brain tumors using a comprehensive approach — by a team whose sole focus is treating this type of cancer. Your care includes regular interaction and input from a team that includes neurosurgeons, oncologists, radiologists and pathologists — along with researchers who collaborate with clinical staff regularly to quickly bring potential therapies from the lab to patients.

Surgery

Surgery for brain cancer is often the first step in the treatment process for brain tumors. Deciding whether to remove a tumor depends on if it can be done safely, and how much normal brain tissue is involved. In some cases, surgery may be performed to reduce the tumor size, but may not remove all cancerous tissue. For operable brain tumors, surgically removing cancer could cure early stage disease.

Our neurosurgeons work closely with radiation and medical oncologists so that multiple treatments can be performed during one procedure. For example, applying chemotherapy directly to the tumor site during surgery, which can kill remaining tumor cells and reduce the likelihood of recurrence. Our neurosurgery team’s focus on researching and treating brain tumors also means they can target tumors that elsewhere were considered inoperable.

City of Hope is also developing a miniaturized surgical system to allow brain surgery to be even less invasive, with an even lower risk of complications.

Surgery for brain tumors most often is used to:

  • Remove a small swatch of tumor tissue (a biopsy) for diagnosis.
  • Remove an entire brain tumor.
  • Stop brain tumor cells from spreading.
  • Slow the growth of a brain tumor.
  • Prevent a tumor from returning.
  • Provide direct access for chemotherapy, implants and genetic treatments.
  • Ease symptoms caused by the tumor like headaches or seizures.


Types of brain tumor surgery

  • Biopsy involves taking a small sliver of brain tumor tissue and examining it under a microscope. It is used to determine the type and grade of brain tumor.
  • Craniotomy involves surgically removing a section of the skull so that the neurosurgeon can reach the area of the brain affected by the tumor. The skull section is replaced at the end of surgery.
  • Craniectomy, like craniotomy, involves surgically removing a section of skull, however it is not replaced post surgery.
  • Debulking involves surgically reducing the size of the tumor.
  • Partial removal is removing only part of the tumor so as to not damage normal tissue.
  • Complete removal involves surgically removing the entire tumor.
  • A shunt creates a drainage system by funneling excess fluid from the brain to outside the body.
  • An Ommaya reservoir is a small, dome-shaped device that is place under the scalp. A tube is attached to deliver fluids (like chemotherapy) or extract fluids (like cerebrospinal fluid).
  • Skull base surgery is both a procedure to remove tumor tissue from the skull base area and describes tumors found in that area of the central nervous system.
  • Transphenoidal surgery is a surgical method typically used on pituitary adenomas and craniopharyngiomas.

City of Hope’s neurosurgeons specialize in using minimally invasive procedures whenever possible. By using fewer incisions and making smaller cuts, our surgeons can extract the tumor with minimal impact to surrounding healthy brain tissue.

Minimally invasive procedures used at City of Hope include:

  • Intraoperative cortical mapping, which gives the surgeon a computerized map of key brain regions, including speech, motor and sensory centers. By avoiding these critical areas, the risk of damage to brain tissue is minimized while still allowing as much of the tumor to be removed as possible.
  • Image-guided surgical navigation, which helps to remove tumors that are difficult to visualize, or are located in high-risk areas of the brain, by using preoperative magnetic resonance imaging (MRI).
  • Endoscopic surgery, performed through an endoscope — a thin, lighted tube with a small opening that accommodates tiny surgical tools. Smaller incisions reduce pain and the risk of infection.

 

Spinal surgery excellence

Many cancer patients develop spinal metastases yet few specialists know how to safely navigate this complex region of the body. City of Hope neurosurgeons regularly treat difficult spinal cases — and use their expertise to design innovative surgical approaches. Our team invented a technique designed to reduce the number of incisions needed to perform complex spine surgery, resulting in a safer procedure with fewer complications, less bleeding and faster healing.

Neurosurgeon innovators

All City of Hope neurosurgeons have active research laboratories — with projects ranging from defining the behavior of metastatic brain tumors to refining the delivery of MRI-guided gene therapy to brain tumors to inventing smaller, nimbler tools for hard-to-reach tumors.

Radiation Therapy

Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. City of Hope offers radiation treatments using state of the art technology that directly target cancer cells and minimize harmful effects to the brain. Our advanced radiation techniques include:

  • Helical Tomotherapy, which delivers focused radiation directly to brain tumors while minimizing any impact on surrounding brain tissue
  • TrueBeam radiotherapy, an image-guided radiation system, that delivers ultraprecise beams of radiation directly at tumors while preserving surrounding healthy tissue

Neural Stem Cell Therapy

Even in situations when surgeons can remove a brain tumor, invasive tumor cells can continue to spread throughout the brain. Researchers at City of Hope are engineering neural stem cells — that are naturally drawn to tumor cells — to deliver chemotherapy and other tumor-killing agents to the brain while minimizing side effects and toxicity to normal brain tissue.

Targeted Therapy

City of Hope uses the latest technology to spot genetic vulnerabilities in cancer cells and uses medications to stop them from growing. This approach involves creating targeted therapies: drugs that would work best to treat specific cancers.

Although brain tumors have fewer molecular targets than other cancer types, high-grade brain cancer patients at City of Hope have their tumors molecularly profiled in the event that the cancer can be targeted. Research is ongoing to find new targets for brain tumors.

Chemotherapy

Chemotherapy is cancer treatment that uses drugs to either kill cancer cells or stop them from growing. The blood-brain barrier keeps most chemotherapy drugs from being absorbed by the brain, but advances in gene and immunotherapy at City of Hope are allowing drugs to reach brain tumors

Patients with brain and spinal tumors require a team of professionals to provide comprehensive and family-centered care. The City of Hope team includes social workers; child-life specialists; recreation, occupational and physical rehabilitation specialists; school reintegration specialists; nutritionists; psychologists; neuropsychologists; and spiritual-care specialists.

Neurosurgery

Behnam Badie, M.D., F.A.C.S.

Clinical Specialties

  • Neurosurgery
Mike Y. Chen, M.D., Ph.D.

Clinical Specialties

  • Neurosurgery
Rahul Jandial, M.D., Ph.D.

Clinical Specialties

  • Neurosurgery

Pediatric Hematology-Oncology

Clarke Anderson, M.D.

Clinical Specialties

  • Pediatric Hematology-Oncology

Research

Clinical trials – research studies that involve volunteer patients – are a crucial component to developing new, more effective treatments that save lives. Many of today’s standard therapies are based on the results of previous trials, some of which were initiated at City of Hope.

Brain tumor clinical trials and research

City of Hope is a hub of innovation and progress when it comes to research and treatments for children, adolescents and young adults with brain and spinal tumors.

Our research and clinical teams work together to advance therapies that more effectively — and directly — target brain tumors. We are researching immunotherapy as a way of disabling cancer cells and finding unique ways to allow cancer drugs to cross the blood-brain barrier.

We are world leaders in the field of neural stem cell therapy, a groundbreaking method of delivering chemotherapy drugs directly to tumor sites within the brain — and were the first in the world to apply this exciting breakthrough therapy to brain cancer.

For more information on our pediatric cancer research, including ongoing trials, please call 626-471-9393.

Living with a Brain and Spinal Tumor

In addition to the best medical care available, City of Hope also provides patients and their families access to several programs that include:

Late effects/survivor clinic follows patients long after their treatment to identify, treat and counsel for any issue that can arise related to their lifesaving treatment. When you come to City of Hope, you automatically gain access to an unparalleled array of support services to help you and your family take each step during and after your brain tumor treatment. We can help with all of these concerns, and more:

  • Managing side effects and symptoms
  • Pain management
  • Navigating the health care system
  • Your emotional, social and spiritual health
  • Handling and coping with stress
  • Staying healthy and active
  • Healthy cooking and eating
  • Healing arts
  • Caregiver skills
  • Restoring normalcy in your family, job or school routine

Learn more about these resources at our Living with Cancer or Supportive Care Medicine sites.

Additional Resources:

 

 

 

 

Julie Hara Bio photo

 

 

 

 

 

 

Julie Hara
Senior Development Officer
Phone: 626-218-0869
Email: [email protected]

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