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Information from PDQ for Patients
Childhood visual pathway and hypothalamic glioma
208/00842
** DESCRIPTION **
-- 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 Tumor Treatment for more informaiton).
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.
** 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.
-- Untreated childhood visual pathway glioma --
Untreated childhood visual pathway glioma means that no treatment has been
given except to treat symptoms.
-- 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.
** TREATMENT OPTION OVERVIEW **
There are treatments for all children with visual pathway gliomas. Three kinds
of treatment are used:
surgery (taking out the cancer in an operation)
radiation therapy (using high-dose x-rays to kill cancer cells)
chemotherapy (using drugs to kill cancer cells).
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). The use of radiation
put into the brain through thin plastic tubes (internal radiation therapy) is
under study. For some types of brain tumors, clinical trials are evaluating
radiation therapy given in several small doses per day (hyperfractionated
radiation therapy). Radiation therapy can affect growth and brain development,
so clinical trials are testing ways to decrease or delay radiation therapy,
especially for younger children.
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.
-- 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 more side effects than
are desired. 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.
** UNTREATED CHILDHOOD VISUAL PATHWAY GLIOMA **
Your child's treatment may be one of the following:
1. For patients without symptoms or progression, observation without
treatment.
2. Surgery.
3. Radiation therapy.
4. Chemotherapy.
5. Clinical trials evaluating chemotherapy to shrink the tumor and delay
radiation therapy.
** 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.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
In the United States, about two-thirds of children with cancer are treated in a
clinical trial at some point in their illness. A clinical trial is a study to
answer a scientific question, such as whether one treatment is better than
another. Trials are based on past studies and what has been learned in the
laboratory. Each trial answers certain scientific questions in order to find
new and better ways to help cancer patients. During treatment clinical trials,
information is collected about new treatments, the risks involved, and how well
they do or do not work. If a clinical trial shows that a new treatment is
better than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. For additional help in
locating a childhood cancer clinical trial, call the Cancer Information Service
at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
The PDQ database contains listings of groups specializing in clinical trials.
The Children's Oncology Group (COG) is the major group that organizes clinical
trials for childhood cancers in the United States. Information about
contacting COG is available on Cancer.gov (http://cancer.gov) or from the
Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at
1-800-332-8615.
The PDQ database contains listings of cancer health professionals and hospitals
with cancer programs.
Because cancer in children and adolescents is rare, the majority of children
with cancer are treated by health professionals specializing in childhood
cancers, at hospitals or cancer centers with special facilities to treat them.
The PDQ database contains listings of health professionals who specialize in
childhood cancer and listings of hospitals with cancer programs. For help
locating childhood cancer health professionals or a hospital with cancer
programs, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237), TTY at 1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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This information has been brought to you by
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