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Table of Contents Description
Stage Explanation
Treatment Option Overview
Untreated Childhood Visual Pathway Glioma
Recurrent Childhood Visual Pathway Glioma
Get More Information From NCI
Changes to This Summary (04/04/2008)
About PDQ
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.
The risk of developing visual pathway
gliomas is increased in children with a genetic disorder called neurofibromatosis type
1 (NF-1). NF-1 is a rare genetic condition that causes brown spots and tumors on the skin, freckling in skin areas not exposed to the sun, tumors on the nerves, and developmental changes in the nervous system, muscles, bone, and skin. Children with NF-1 who develop visual pathway gliomas may have a good chance of recovery and may not require treatment until symptoms appear or change.
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 Tumors Treatment for more information).
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. See the PDQ summary on Childhood Brain and Spinal Cord Tumors Treatment for more information about the types of childhood brain tumors.
 Back to Top 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.
There is no staging for childhood visual pathway glioma. The treatment depends
on:
- The location and size of the tumor.
- The child's age and general health.
- Whether or not the child has a condition called neurofibromatosis type 1.
- Whether or not the cancer has just been diagnosed or has recurred (come back).
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.
Back to Top Treatment Option Overview
There are treatments for all children with visual pathway glioma. Four kinds
of standard treatment are used:
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). Because radiation therapy can affect growth and brain development, clinical trials are testing ways to decrease or delay radiation therapy,
especially for younger children.
These include internal radiation therapy, in which radiation is put into the brain through thin plastic tubes, and hyperfractionated radiation therapy, in which
radiation therapy is given in several small doses per day instead of all at once. Conformal radiation therapy uses a computer to create a 3-D picture of the tumor and the radiation beams are shaped to fit the tumor; this helps to keep the radiation away from healthy tissue as much as possible.
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.
Some brain tumors and cancer treatments cause side effects that continue or appear years after cancer treatment has ended. These are called late effects. Late effects of cancer treatment may include physical problems; changes in mood, feelings, thinking, learning or memory; and having second cancers (new types of cancer). Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. Refer to the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information.
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 unwanted side effects. 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.
Back to Top Untreated Childhood Visual Pathway Glioma
Your child’s treatment may be one of the following:
- For patients without symptoms or progression, observation without
treatment.
- Surgery.
- Radiation therapy.
- Chemotherapy.
- Clinical trials evaluating chemotherapy to shrink the tumor and delay
radiation therapy.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood visual pathway glioma.
Back to Top 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.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood visual pathway glioma.
Back to Top Get More Information From NCI
Call 1-800-4-CANCER
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.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 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 to us
For more information from the NCI, please write to this address:
- NCI Public Inquiries Office
- Suite 3036A
- 6116 Executive Boulevard, MSC8322
- Bethesda, MD 20892-8322
Search the NCI Web site
The NCI Web site 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. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find 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. 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.
Back to Top Changes to This Summary (04/04/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
Back to Top About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at 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, nontechnical 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.
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 the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." In the United States, about two-thirds of children with cancer are treated in a clinical trial at some point in their illness.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. 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 the NCI Web site 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.
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