What is a glioma?

A glioma is a tumour that grows in the glial cells of the brain and spinal cord. Glial cells surround nerve cells and help them work properly. The chance of survival for a child with glioma depends on the type of tumour, where it is, and whether it is slow or fast growing.

Gliomas can be benign (not cancerous) or malignant (cancerous). In children, they can grow in:

• the cerebrum (the front part of the brain)
• the cerebellum (the back part of the brain)
• the brain stem (the part of the brain connected to the spinal cord)
• the optic nerves (the nerves that control eyesight)

We don’t know why some children develop gliomas. They are more common in children who have a family history of brain cancer, who have been exposed to radiation, or in children with some genetic conditions.

Types of glioma

Gliomas can be slow-growing (called ‘low grade’) or aggressive (called ‘high grade’). If the tumour is Grade 1 or 2 it is low grade; if it is Grade 3 or 4 it is high grade.

There are different types of glioma:

Astrocytomas: These can be high or low grade. The different types of astrocytoma include:

• juvenile pilocytic astrocytoma (JPA), the most common low-grade tumour in children, which usually grows in the back part of the brain
• glioblastoma multiforme (GBM), a high-grade tumour that usually grows in the upper part of the brain
• anaplastic astrocytoma, a high-grade tumour that usually grows in the upper part of the brain

Diffuse intrinsic pontine gliomas (DIPGs): These are tumours that grow in the brain stem, which controls heart rate and breathing.

Optic pathway gliomas: These are gliomas that grow in the optic nerve, which connects the brain with the eyes, or in the nerves that allow you to see.

What are the symptoms of glioma?

The symptoms of a glioma will depend on where the tumour is, how fast it is growing, and the age of the child. Symptoms can be caused by the pressure of the growing tumour on the brain and include:

• headaches, especially in the morning – the headache often goes away after vomiting
• nausea or vomiting
• problems with vision, hearing or speech
• problems with balance and coordination, trouble walking
• being unusually sleepy and not having any energy
• weakness or numbness in a part of the body, especially only on one side
• back pain
• changes in behaviour
• weight loss or gain for no reason
• seizures (fits)
• drowsiness or coma

In babies, symptoms may include a loss of appetite, developmental delays, losing physical or mental abilities they had before, or swelling in the head.

Remember that all these symptoms can be due to other conditions and don’t necessarily mean your child has a glioma. If you are worried about your child’s symptoms, see your doctor.

How is glioma diagnosed?

Several different tests are used to diagnose gliomas. These include blood tests, urine tests, CT or MRI scans, a biopsy, or a lumbar puncture to sample the fluid that sits around the spinal cord.

If your child has a glioma, they will be looked after by a team of health professionals, known as a multidisciplinary team. Specialists they might see include neuro-oncologists (doctors who specialise in treating brain cancer); medical oncologists (doctors who specialise in medicines to treat cancer); radiation oncologists (doctors who specialise in using radiotherapy to treat cancer), surgeons, nurses, social workers, rehabilitation therapists, psychologists and other specialists.

How is glioma treated?

The best treatment will depend on the type of glioma, where it is in the brain, how quickly it’s growing, and how your child reacts to the treatment. Most children have a mix of treatments. Treatment can last for several years.

Options include:

Surgery: Surgical treatment will attempt to remove as much of the glioma as possible. Surgery might not always be possible, for example if the tumour is in a very delicate part of the brain like the brain stem, or if the tumour has spread to other brain tissue.

Surgery might be the only treatment needed, especially if it is a slow growing (low-grade) tumour.

Radiotherapy (radiation treatment) and chemotherapy (cancer medicine): These can shrink the tumour. Radiotherapy is not usually suitable for children under 3.

New treatments: There have been many advances in treating brain cancer recently. Some places in Australia now offer advanced radiotherapy techniques such as radiosurgery, gamma knife and proton beam therapy, or precise surgery techniques, such as cyberknife therapy. There are also targeted therapies that attack cancer cells without harming healthy cells.

Your child might receive other medications such as steroids to reduce swelling and improve symptoms; medications to reduce the chance of seizures and hormones if the treatment has affected their hormone balance.

Your child might also be able to take part in a clinical trial, giving them access to new medicines. To find out about new forms of brain cancer treatment for children, visit the Cure Brain Cancer Foundation website.

After treatment

Steroids can reduce the swelling caused by the tumour, or medicine can be used to stop seizures or give pain relief.

After treatment finishes, the child will need regular check-ups and scans. Gliomas can come back again. If this happens, the medical team might suggest different treatments.

Where to look for information and support

The Cancer Council in your state or territory offers information and support for people with cancer. Call 13 11 20.

CanTeen helps children aged 12 to 25 affected by cancer. To talk to a health professional about information and support for young people, call 1800 835 932.

The Children’s Cancer Foundation provides family support and information about the latest treatments.

Kids with Cancer Foundation Australia provides financial assistance to children with cancer and their families.

Cure Brain Cancer is the peak organisation for brain cancer research, advocacy and awareness in Australia.

Cancer Australia has links to support organisations for children with cancer and their families. The organisation can also help you find clinical trials that your child could join and a list of children’s hospitals in Australia.