Medulloblastoma Treatment
John is a patient on treatment for Medulloblastoma at the local radiotherapy centre (stage T3a, M1). He is 8 years old lives with his mother and 2 younger brothers in Tinseltown, which is a small village 30 miles from the Oncology centre.
Medulloblastoma is a fast-growing and highly malignant tumor of the central nervous system. This illness constitutes 20% of all childhood intracranial tumorsand is the most common type of malignant brain cancer found in children (, , 2001). Environmental exposures during the critical development periods of prenatal and postnatal development could increase the risk of brain tumor, owing to the fact that the cerebellum undergoes rapid growth during these times. Aside from this, exposures to the environment experienced by the father and mother before the child’s birth might also play a role (, , 1998).
The progressive nature of the symptoms of primary brain tumors is the most important feature of the clinical presentation in patients with primary brain tumors such as medulloblastoma is the (, 1994). This progression of symptoms can range from an extremely slow course to an acute hemorrhagic event within a tumor.
During John’s radiation therapy, adverse effects can happen such as the fact that radiation therapy can cause loss of some normal brain tissue. This would result in a decline in intellectual function and long-term problems with certain hormones, such as thyroid and growth hormones. Identifying patients who can safely undergo a milder course of treatment can help minimize these lasting effects of therapy but in John’s case he has to undergo the radiation therapy. John at his young age would be experiencing much pain, changes, and confusion as a result of his illness and the treatment.
Later on during the course of the disease, other problems would occur which is brought about by the illness. John may have difficulty in walking, lose his balance, a worsening condition on his handwriting and slow speech. The child may also experience nausea and vomiting and have a headache that usually goes away after the child is able to vomit (, 2007). The pain is usually of moderate to severe intensity and often lasts for hours at a time. In contrast to typical migraine headache, the headache pain of a primary brain tumor is not always pounding or throbbing, nor is it as consistently associated with nausea, emesis or photophobia (, 1994). The headaches of primary brain tumor differ from cluster headaches; there is no associated unilateral scleral injection, tearing, rhinorrhea or sinus congestion. The intensity of the pain may be increased by coughing, sneezing, straining or other maneuvers that increase intrathoracic (and consequently intracranial) pressure.
There might also be a change in the energy level, with John getting weaker, and an unusual sleepiness. Elevation of intracranial pressure due to tumor mass and edema may result in lethargy, drowsiness, irritability or coma. The most common alteration is excessive daytime sleepiness or lethargy, which is typically noted by a spouse or parent (, 1994).
There would also be weight loss or weight gain with no reasonable explanation. Additionally, there might also be changes in John’s personality or behavior (, 2007). Elevation of intracranial pressure, disruption of central pathways, and mass effect may be the reason for the child’s cognition and personality change. In persons with large tumors, these changes are more pronounced, but may also occur with small tumors. The mild alterations of concentration, memory, and reasoning are commonly noticed by other members of the family (, 1994).
Another effect of the disease and treatment may yet be the loss of reading and spelling skills which shows that children apparently is caused by impairments of the fundamental cognitive processes that are critical to the early development of these skills in a child (, 2001).
During the process not only John would be affected but his family would also have to go through an emotional journey because of any alteration in their usual life routines. A support system of family, friends, and health care professionals who will listen, offer advice, and provide emotional support would benefit John. There are also other support groups available to John and his family, such as those sponsored by national health associations, local hospitals and churches in Tinseltown, support groups from the oncology center, and mental health organizations.
References
Credit:ivythesis.typepad.com
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