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Brain Stem Gliomas Defined

Originally published on April 18, 2011
Most recently updated on April 10, 2013

A glioma is a tumor that grows from glial cells, a supportive cell in the brain.  Brain stem glioma grows specifically in the brain stem which is the part of the brain that controls many of the body’s basic functions, such as motor skills, sensory activity, coordination and walking, the beating of the heart, and breathing.  Brain stem glioma is most often diffused (spread freely) through the brain stem by the time of diagnosis. This type of tumor is typically very aggressive, meaning that it grows and spreads quickly.

Types

Brain stem gliomas are typically divided into types based on how they spread:

Diffuse brain stem glioma:
spreads freely throughout the pons and often into the midbrain and medulla, it is aggressive and often has abnormal looking cells

Focal brain stem glioma:
localized to one portion of the brain stem (usually the midbrain or medulla), is less aggressive and has more normal looking cells

Symptoms:

Common symptoms of brain stem gliomas include:

- Double vision or an inability to close the eyelids
- Drooping of the face
- Difficulty chewing and swallowing food
- Weakness in the arms and legs, clumsiness or wobbliness, and difficulty walking
- Difficulty talking
- Headache
- Vomiting

Common Treatments:

Radiation therapy is the most common treatment for brain stem glioma. Radiation therapy is the use of high-energy x-rays or other particles to kill tumor cells.  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 therapy is given using implants, it is called internal radiation therapy or brachytherapy.

Chemotherapy alone is not an effective treatment for brain stem glioma; however, sometimes, a doctor may use chemotherapy at the same time as or after radiation therapy. Chemotherapy is the use of drugs to kill tumor cells. Systemic chemotherapy is delivered through the bloodstream, targeting tumor cells throughout the body.

Surgery is used to treat brain stem glioma only when the tumor is focal, which means that it may be possible to remove the tumor without damaging the brain, such as when a tumor grows out from the brain stem. For most children with diffuse types of brain stem glioma, surgery is not recommended or possible because of the location of the tumor and the risk involved.

Clinical Trials are another treatment option in which new treatment methods are being tested to find out if the new cancer treatments are safe and effective or better than the standard treatment.  More than 60% of children with cancer are treated as a part of a clinical trial.

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