Low-Grade Glioma Treatment

The symptoms of low-grade gliomas can vary and depend on the size of the tumor, where the tumor is, a child’s age, and how fast the tumor grows. The symptoms may include:

• Vision, hearing, or speech problems
• Headaches, especially in the early morning
• Loss of balance or trouble walking
• Weakness, tingling, or changes in the way the body feels on 1 side
• Nausea and vomiting
• Unexplained weight gain or loss
• Seizures
• Changes in personality or behavior
• Increased head size (in infants)

The cause of glioma tumors is unknown, but there are changes (mutations) in the DNA of some of the cells in the brain and spinal cord (central nervous system or CNS).

Diagnosis of low-grade gliomas generally includes:

• Biopsy (obtaining tissue sample) of the tumor
• Careful review of tissue sample under the microscope to make a diagnosis
• Other genetic testing of the tumor to identify potential tumor targets
• Imaging tests like magnetic resonance imaging (MRI), to check the size of the tumor and if it has spread to other areas

Gliomas are graded based on:

• How the cells look under the microscope (features)
• How quickly they are growing or dividing
• The genetic changes that cause the tumor to develop

Grades 1 and 2 are low-grade gliomas that grow slowly.

Grades 3 and 4 are higher-grade gliomas that grow more quickly. These are usually not related to low-grade gliomas in children.

The medical team is often made up of an oncologist, surgeon, and radiation oncologist, along with nurses and other care staff. They will discuss the types of treatment and help you decide on the best option for your child. The most common treatments are surgery, targeted therapy, chemotherapy, and radiation therapy.

• Surgery is needed for diagnosis and treatment. For many low-grade gliomas, surgery can completely remove the tumor. This may help cure the disease. If all the tumor is removed or very little of the tumor remains after surgery, your child may be closely followed without other treatment and have follow-up MRIs to monitor the tumor and see if it grows again. If the tumor cannot be completely removed, or tumor re-growth is noted after surgery, then more therapy is generally needed.
• Targeted therapies are changing the way we treat low-grade gliomas that cannot be completely removed. Recently, new medicines that specifically target tumor cells have caused tumor shrinkage with fewer side effects than traditional chemotherapy or radiation therapy. So, these targeted therapies are becoming our first choice of therapy in this disease.
• Chemotherapy uses medicines that stops tumor and cancer cells from growing.
• Radiation therapy using high-energy x-rays or other types of radiation, such as a proton beam (proton therapy), kill cancer cells or stop them from growing.

St. Jude clinical trials have produced new, groundbreaking treatments for serious childhood diseases. Our doctors and scientists work together to find better ways to treat patients. In many cases, new treatments are being developed right here on the St. Jude campus.

We also take part in trials developed by the Children’s Oncology Group (COG) and the Pediatric Brain Tumor Consortium (PBTC). Many St. Jude staff members play key roles in developing these studies. They are large studies carried out at multiple centers across the United States.

Learn more about clinical research at St. Jude.

Low-grade gliomas grow slowly and do not commonly spread (metastasize). But they may still cause many problems and need medical treatment. Survival rates for low-grade gliomas in children are good, with a 10-year survival rate greater than 85%. But the prognosis may vary and depends on:

• The tumor’s specific type, location, genetic mutations, and grade
• If the tumor was totally removed (resected)
• If the tumor is just in 1 area or if it has spread
• The child’s age
• If the tumor was newly diagnosed or has returned (recurred)

St. Jude provides the highest quality of care for patients with low-grade glioma:

• Our clinic brings together medical experts and specially trained staff to care for your child. We also work with brain surgeons (neurosurgeons) at Le Bonheur Children’s Hospital.
• We have a special team that helps understand the makeup of the tumor. This team includes doctors and scientists who study:
  • Cancer cells
    
  • How the cancer happened
  • Current medicines and treatments to kill cancer cells
  • What makes cancer cells grow and what new medicines can stop them
• New medicines and other therapies to improve how treatments work Our brain tumor clinical trials have led to better therapies in children. These improvements include lower-dose therapies, targeted therapy, and proton therapy. These treatments kill cancer cells while sparing healthy cells and may lessen side effects that affect brain function after treatment for some types of brain tumors.
• The St. Jude Proton Therapy Center is the first center in the world that treats only children with this therapy.
• Along with the treatment studies constantly being developed at St. Jude, the staff also treats patients on studies developed by the Children’s Oncology Group, the Pediatric Brain Tumor Consortium, and the Pacific Pediatric Neuro-Oncology Consortium. Many St. Jude staff members play key roles in developing these studies. They are large trials carried out at multiple centers across the United States. 
• St. Jude offers a dedicated team of specialists to meet the needs of children with brain tumors, including:
  • Surgeons, doctors, and nurses who treat this type of cancer
  • Doctors who specialize in radiation therapy and pathology (making a diagnosis by looking at tumor tissue under the microscope)
  • Experts in diagnostic imaging and nuclear medicine
  • Genetic counselors
  • Clinical dietitians
  • Child life specialists
  • Psychologists
  • Researchers and scientists

More reasons to choose St. Jude for care include:

• We are consistently ranked among the best childhood cancer centers in the nation by US News & World Report.
• At St. Jude, we have created an environment where children can be children and families can be together.
• We lead more clinical trials for childhood cancer than any other hospital in the U.S. 
• St. Jude is the only National Cancer Institute–designated Comprehensive Cancer Center just for children. A Comprehensive Cancer Center meets rigorous standards for research that develops new and better approaches to prevent, diagnose, and treat cancer.
• The nurse-to-patient ratio at St. Jude is about 1:3 in hematology and oncology and 1:1 in the Intensive Care Unit.
• Patients may be able to get expert, compassionate care and treatment closer to their homes at one of our St. Jude Affiliate clinics.

Get more information about the Brain Tumor Treatment program at St. Jude.