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Care for children diagnosed with brain stem glioma doesn’t end when active treatment has finished. Your child’s health care team will continue to check to make sure the tumor has not returned, manage any side effects, and monitor your child’s overall health. This is called follow-up care. All children treated for brain stem glioma should have life-long, follow-up care.
This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. Learn more about the importance of follow-up care .
Watching for recurrence
One goal of follow-up care is to check for a recurrence. A tumor recurs because small areas of tumor cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.
During follow-up care, a doctor familiar with your child’s medical history can give you personalized information about the risk of recurrence. Your doctor will also ask specific questions about your child’s health. Some children may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of tumor originally diagnosed and the types of treatment given.
Managing long-term and late side effects of childhood cancer
Sometimes, side effects may linger beyond the active treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Late effects can occur almost anywhere in the body and include physical problems, such as heart and lung problems and second cancers, and emotional and cognitive (memory, thinking, and attention) problems, such as anxiety, depression, and learning difficulties.
Based on the type of treatment your child received, the doctor will recommend what examinations and tests are needed to check for late effects. The possible late effects from specific treatments are discussed below:
- Radiation therapy to the brain and spine can cause cognitive (thought-process) and endocrine (hormonal) symptoms over time, although the severity can vary depending on the dose given and your child’s age.
- The risks and possible side effects of surgery vary widely, depending on the location and features of the tumor.
- The risks of chemotherapy and the chance of a secondary tumor strongly depend on the specific drugs used and the dosage.
For each of these issues, it is important to discuss the specific aspects of the tumor and the options for treatment with the doctors that are involved in your child's care before, during, and after treatment. Follow-up care should also address your child’s quality of life, including any developmental or emotional concerns.
The Children's Oncology Group (COG) has studied the physical and psychological effects that childhood cancer survivors face. Based on these studies, COG has created recommendations for long-term follow-up care for childhood, adolescent, and young adult cancer survivors that can be found on a separate website: www.survivorshipguidelines.org .
Keeping a child’s personal health record
You are encouraged to organize and keep a personal record of the child’s medical information. The doctor will help you create this. That way, as the child enters adulthood, he or she has a clear, written history of the diagnosis, the treatment given, and the doctor’s recommendations about the schedule for follow-up care. ASCO offers forms to help create a treatment summary to keep track of the treatment your child received and develop a survivorship care plan  once treatment is completed.
Some children continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of tumor, side effects, health insurance rules, and your family’s personal preferences. Talk with your health care team about your child’s ongoing medical care and any concerns you have about his or her future health.
If a doctor who was not directly involved in your child’s care will lead the follow-up care, be sure to share the treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about the specific treatment given are very valuable to the health care professionals who will care for your child throughout his or her lifetime.
The next section in this guide is Survivorship  and it describes how to cope with challenges in everyday life after a diagnosis of brain stem glioma. Or, use the menu on the side of your screen to choose another section to continue reading this guide.