In the News: Medulloblastoma

Recently, former NFL star and TV personality Michael Strahan and his 19-year-old daughter revealed that she was diagnosed with and being treated for medulloblastoma, a type of brain cancer.

Medulloblastoma is an aggressive cancer that usually occurs in the 4th ventricle of the brain – the space where spinal fluid is produced and the route it travels between the brain and spinal column. It is rare, with only about 500 people in the United States diagnosed every year – most of them children.

Symptoms of medulloblastomas can include headaches, nausea, vomiting, dizziness, and vision changes. This is primarily because it typically occurs in the cerebellum, located at the back of the head.

These tumors are generally treatable and can be cured in some patients. The likelihood of eradicating these tumors depends on certain risk factors including the patient’s age, whether the tumor has spread to other parts of the brain/spine, how much tumor remains after surgery, and other factors including the molecular profile of the tumor.

MD Anderson Cancer Center at Cooper takes a team approach to caring patients with cancer, with experts from every cancer specialty including surgery, radiation oncology, medical oncology, pathology, imaging, and nursing working together to develop a personalized treatment plan for each patient.

Experts from MD Anderson at Cooper, who care for adults and young adults with medulloblastoma and other brain and spine cancers, shed light on the treatment for this rare cancer.

Treatment generally begins with surgery to aid in an accurate diagnosis.

“Advances in technology and science have led to significant breakthroughs in neurosurgery that result in better outcomes than in the past,” says Navid Redjal, MD, FANNS, Director of Surgical Neuro-Oncology at MD Anderson at Cooper. “Our neurosurgery team uses advanced surgical and imaging technologies, including precise neuro-navigation, minimally invasive neuro-endoscopy, and functional mapping with the capability of doing awake brain tumor surgery to maximize resection of tumor and minimize damage to normal, healthy brain.”

The next step in treatment is usually radiation therapy.

“Following the removal of the tumor, individuals usually undergo a specialized type of radiation known as craniospinal irradiation (CSI), says Justin M. Mann, MD, Radiation Oncologist at MD Anderson at Cooper.

“Radiation therapy uses high-energy x-rays to damage tumor cells and is considered the cornerstone of medulloblastoma treatment. Technological breakthroughs in radiation therapy have furthered the precision and effectiveness of radiation therapy while minimizing damage to surrounding healthy tissue,” says Dr. Mann.

“These advancements allow for better target volume delineation and use of adaptive techniques, including intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), and other options. Stereotactic radiosurgery (SRS) is another type of advanced radiation therapy that can be utilized for patients with disease recurrence, who have previously had radiation therapy,” continues Dr. Mann.

“CSI targets areas at risk for the spread of cancer, including the rest of the brain and the cerebrospinal fluid down the spine,” says Joseph Lombardo, DO, PharmD, Radiation Oncologist at MD Anderson at Cooper. “This specialized radiation is often administered at the same time as chemotherapy treatment. Often, additional chemotherapy is given after completing radiation.”

Neuro-oncologists take many factors into consideration when determining the medical approach to treating a patient with medulloblastomas.

“A key factor in developing a treatment plan is identifying the tumor’s molecular profile or subtype,” says Michael Salacz, MD, neuro-oncologist and Director of Medical Neuro-Oncology at MD Anderson at Cooper.

“We now know that there are four different subtypes of medulloblastoma and they respond differently to certain medical (drug) therapies such as chemotherapy, targeted therapy, and immunotherapy. Knowing the subtype can help develop a treatment plan that results in improved outcomes.”

For many people with medulloblastomas, the powerful combination of surgery, radiation, and chemotherapy has resulted in a complete cure and for others is has proven to is extend their survival and improve their quality of life.

In addition to neurosurgeons, radiation oncologists, and medical oncology experts, our team also includes neurologists, endocrinologists, and rehabilitation medicine specialists, as well as supportive care services so our patients have “360-degree” care.

The supportive care services at MD Anderson at Cooper, include nutrition counseling, palliative care, social work services, pre- and post-treatment physical therapy, and complementary medicine therapies, and provide patients with the resources they need throughout their recovery and survivorship.

To make an appointment with a member of the MD Anderson at Cooper brain and spine tumor team, call 855.MDA.COOPER (855.632.2667).

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