Treatment

In general, cancer in children is uncommon, so it can be hard for doctors to plan treatments unless they know what has been most effective in other children. That’s why more than 60% of children with cancer are treated as part of a clinical trial. Clinical trials are research studies that compare standard treatments (the best treatments available) to newer treatments that may be more effective. Investigating new treatments involves careful monitoring using scientific methods, and all participants are followed closely to track progress.

To take advantage of these newer treatments, all children with cancer should be treated at a specialized cancer center. Doctors at these centers have extensive experience in treating children with cancer and have access to the latest research. A doctor who specializes in treating children with cancer is called a pediatric oncologist. Many times, a team of doctors treats a child with cancer. Pediatric cancer centers often have extra support services for children and their families, such as nutritionists, social workers, and counselors. Special activities for kids with cancer may also be available.

The treatment of ependymoma depends on the size and location of the tumor, whether the tumor has spread, and the child’s overall health.

Surgery

Surgery is usually the first treatment for ependymoma. It is also used to diagnose ependymoma, using a surgical biopsy (see Diagnosis). A neurosurgeon is a doctor who specializes in treating a tumor in the brain or spine with surgery. The goal of surgery is to remove as much of the tumor as possible. Surgery to the brain requires the removal of part of the skull, a procedure called a craniotomy. After the surgeon removes the tumor, the patient’s own bone will be used to cover the opening in the skull. There have been rapid advances in surgery for brain tumors, including the use of cortical mapping (which allows doctors to identify certain areas of the brain that control the senses, language, and motor skills) and enhanced imaging devices to give surgeons more tools to plan and perform the surgery. Sometimes, surgery cannot be performed because the tumor is located in a place that the surgeon cannot reach or is near a vital structure; these tumors are called inoperable. In this case, the doctor will recommend other treatment options.

After surgery, the doctor will create a treatment plan based on the following criteria:

• The amount of tumor removed
  
  
• The age of the child
  
  
• Whether there are metastases (disease-spread)

Side effects from surgery for ependymoma can vary, and patients are encouraged to discuss possible short-term and long-term side effects with their doctor. Learn more about cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.

Radiation therapy may be used after surgery to treat ependymoma. If the tumor has not spread, radiation therapy is directed at the tumor. If the tumor has spread, radiation therapy may be directed to the whole brain and the spine. It may also be used to treat a tumor that cannot be treated with surgery. Even though radiation therapy is not standard treatment for children younger than three years old, there are clinical trials evaluating its usefulness in this age group for this type of tumor.

Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor’s office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time.

Chemotherapy alone is often not effective to treat children with ependymoma, but it may be beneficial if used in combination with other treatments. Clinical trials combining postoperative (after surgery) radiation therapy and chemotherapy are underway.

The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your child’s doctor is often the best way to learn about the medications prescribed for your child, their purpose, and their potential side effects or interactions with other medications. Learn more about your child’s prescriptions by using searchable drug databases.

Find out more about common terms used during cancer treatment.