Brain tumours in children are a serious illness that calls for comprehensive, high-quality treatment. Switzerland currently attracts international attention for its advanced methods of diagnosing and treating this disease.

Tumours of the brain and spinal cord – known as tumours of the central nervous system (CNS) – are the most common type of tumour in children and account for around 20% of all cancers in patients under the age of 15. There are many different types of brain tumour. They may be benign (non-cancerous) or malignant (cancerous). For every child for whom we at CorSwiss recommend a clinic for the treatment of a CNS tumour, our aim remains the same: to select the best doctors and the best clinic, maximising both the chances of a cure and the child’s quality of life.
The place where your child receives primary treatment is decisive for a good prognosis. Complete removal of the tumour without secondary neurological effects is crucial to improving the chances of your child making a full recovery.

Symptoms of tumours

Different areas of the brain control different bodily functions, such as movement, vision, speech and many others. Because space inside the skull is limited, the signs and symptoms of a brain tumour usually develop when the tumour grows and destroys or presses on healthy brain tissue.
The symptoms of a brain tumour in children vary greatly depending on the location and size of the tumour.
Tumours at the base of the brain often cause headaches, vomiting and changes in behaviour, as they block the normal flow of cerebrospinal fluid, raising the pressure inside the skull.
Tumours near the surface of the brain can cause seizures.
Tumours arising in the brainstem often cause weakness in the head and neck.
Bear in mind that the symptoms of a brain tumour often resemble those caused by other conditions. If your child has these symptoms and you are concerned, speak to a doctor.

Diagnosing brain tumours in children

The clinics recommended by CorSwiss experts diagnose and treat children and adolescents with all types of brain tumour. Innovative treatments are selected for each patient according to the particular features of the child and the disease. Making the correct diagnosis is the essential first step in ensuring your child receives the most appropriate treatment.

Once a child develops symptoms that could be caused by a brain tumour, Swiss clinics carry out examinations such as CT or MRI. These tests help doctors determine the location and type of the tumour and plan either its removal or a biopsy. The clinics also perform DNA methylation analysis – a diagnostic tool that significantly increases diagnostic accuracy compared with standard methods.

Before treatment begins, the doctors prepare thoroughly, taking into account the child’s individual characteristics, the stage of the disease and other factors that may influence the outcome of treatment.

Types of tumour

Tumours that form in the tissues and cells of a child’s brain are called primary brain tumours. In some cases, tumours arise in other parts of the body and spread to the brain through the blood, but this is uncommon in children. Below is a list of some of the common types of primary brain tumour found in children.

Astrocytomas (gliomas)

Accounting for almost half of all childhood brain tumours, astrocytomas arise from brain cells resembling astrocytes, the star-shaped cells of the CNS. Historically, astrocytomas were divided into the following types:

  • Low-grade astrocytomas, which include grade 1 (juvenile pilocytic astrocytomas) and grade 2 (diffuse astrocytomas);
  • High-grade astrocytomas, which include grade 3 (anaplastic astrocytomas) and grade 4 (glioblastoma multiforme).

Recently, however, the traditional classification has changed thanks to molecular genetic markers, which have been shown to significantly improve diagnosis, prognosis and treatment.
Diffuse intrinsic pontine gliomas (DIPG) are highly malignant astrocytomas that arise in a very delicate part of the brain.
Surgery is often contraindicated, and patients are generally treated with radiotherapy alone.

Ependymomas

Ependymomas develop from the ependymal cells that line the ventricles of the brain (a series of cavities filled with cerebrospinal fluid). Children whose ependymomas cannot be completely removed surgically are often treated with chemotherapy. Although there is no treatment specific to ependymoma alone, radiotherapy is an extremely important part of the typical treatment plan.

Medulloblastomas and other embryonal brain tumours (formerly known as PNET)

Accounting for around 20% of childhood brain tumours, medulloblastomas and other embryonal tumours are tumours that doctors believe arise from undeveloped stem cells in part of the brain. They are highly malignant, yet with appropriate treatment many children can be cured. Medulloblastomas are usually accompanied by headache and vomiting. Sometimes the child’s behaviour changes and their performance at school declines. The diagnosis is made by CT or MRI and confirmed by pathological examination after surgical removal of the tumour. Treatment of medulloblastoma usually combines surgery, radiotherapy and chemotherapy.

Germ cell tumours

Germ cell tumours, as the name suggests, arise from germ cells, which during normal embryonic development form either egg cells or sperm cells. In germ cell tumours located in the brain, embryonic germ cells travel through the blood to the brain, where they develop into tumours. Occurring most often in children, germ cell tumours include several different tumour types (germinomas, endodermal sinus tumours and choriocarcinomas). Although their symptoms depend on their location, germ cell tumours in the pineal region are usually accompanied by headache and vomiting, particularly in the morning. Tumours in the pituitary region are usually accompanied by hormonal disturbances, especially increased urination and thirst. Sometimes the child shows changes in behaviour and declining performance at school. Most are malignant tumours, yet they can often be cured with modern treatment, which may include surgery, radiotherapy and chemotherapy.

Diffuse intrinsic pontine glioma (DIPG)

Diffuse intrinsic pontine glioma, or DIPG, is a rare and aggressive malignancy that grows in the brainstem, the area connecting the brain to the spinal cord. DIPG is usually diagnosed between the ages of five and seven and is one of the most aggressive CNS tumours.
Because it grows rapidly, symptoms appear very quickly and often intensify. DIPG usually causes problems with the child’s vision and balance.
To treat all types of cancer, doctors harness the body’s natural immune system and direct it towards the cancer cells, fighting the malignancy in the same way the body fights a virus.
In the immunotherapy of neuroblastoma, laboratory-developed monoclonal antibodies identify and destroy cancer cells that have survived chemotherapy or radiotherapy. Thanks to advances in treatment, more than 50% of children treated at the clinics overcome neuroblastoma, compared with fewer than 5% in the 1980s.

Rare tumours

From time to time, pathologists diagnose certain types of central nervous system tumour that occur only rarely. Working with partner clinics around the world, our team of doctors proposes clinics that treat rare cases. Examples of these tumours include atypical teratoid/rhabdoid tumour (AT/RT), choroid plexus carcinoma, dysembryoplastic neuroepithelial tumours and craniopharyngioma.

Genetic testing

Swiss clinics offer patients the most advanced genetic tests. These tests make it possible to identify genetic mutations and other changes that can cause cancer. They can provide a wealth of information that is important for diagnosis, prognosis and the choice of the right treatment.

Treating brain tumours in children in Switzerland

The clinics recommended by CorSwiss offer treatment for every type of brain and spinal cord tumour. A team of experts will work together with the clinic’s doctors and with your family to create a personalised treatment plan. To treat your child, the clinic brings together neuro-oncologists, neurosurgeons, neurologists, radiation oncologists and neuroradiologists.

This medical team works together to achieve the best outcome for your child, doing everything possible to give your child the best chance of a cure and a high quality of life.

A child’s recovery depends on a number of factors. These include the type and location of the tumour and whether it has spread to other parts of the body (metastasis). CorSwiss experts work with you at every step to ensure you have information and support during and after treatment.

We understand that you may have questions and doubts about your child’s treatment plan. Our specialists are available around the clock, seven days a week, to answer your questions.

Surgery

The best outcomes for children with brain and spinal cord tumours depend on the right treatment strategy. Our aim is to select the most effective treatment with minimal risk. The recommended paediatric neurosurgeons are among the most experienced in the field. They are renowned specialists who use the most advanced techniques for treating brain and spinal cord tumours in children.

Radiotherapy

The aim of radiotherapy is to safely shrink or eliminate tumours, including those that cannot be removed surgically. There are many types of radiotherapy and radiosurgery. The treatments best suited to your child depend on the type of cancer, the location of the tumour and whether it has spread to other areas of the body. For children who may benefit from radiotherapy, we take great care to protect as much healthy tissue as possible. New techniques and a high level of expertise allow our paediatric radiation oncologists to treat brain and spinal cord tumours more effectively. In this way we can eliminate the tumour with the least damage to healthy cells and the lowest risk of side effects.

Let us look at the most common types of radiotherapy.

Stereotactic radiosurgery

This specialised form of treatment delivers a high dose of radiation. It usually takes one to five sessions, instead of several smaller doses over a long period on a conventional machine.

Intensity-modulated radiotherapy (IMRT)

Using computer programs, we can calculate and deliver varying doses of radiation directly to the tumour from different angles, at higher and more effective doses. IMRT reduces side effects and minimises the impact on surrounding healthy tissues and organs.

Intraoperative radiotherapy (IORT)

This intensive treatment is given during surgery. The machine delivers radiation directly to the tumour while sparing the surrounding healthy tissue. IORT can treat tumours that are difficult to remove completely during surgery. It allows higher, more effective doses of radiation than conventional radiotherapy. During IORT, the surgeon can temporarily move neighbouring organs aside, protecting them from radiation exposure.
These types of radiotherapy are available thanks to the innovative Varian system (USA), installed in leading cancer centres.
Proton therapy: this form of radiotherapy has emerged recently. A narrowly focused beam destroys tumours by delivering charged particles – protons – directly to the cancer cells. The ultra-precise nature of proton therapy minimises radiation exposure to nearby healthy tissue. This also reduces the risk of side effects.

Chemotherapy

Chemotherapy is the use of medicines to destroy, stop or slow the spread of cancer cells. Chemotherapy can be effective for certain types of brain and spinal cord tumour. There are many chemotherapy drugs. If our doctors recommend chemotherapy for your child, we draw up a personalised treatment plan that offers the best chance of successful treatment.

Molecular tumour analysis

In addition to conventional biopsies, we recommend examining the tumour’s genetic mutations and molecular make-up. These tests can provide information that helps refine the child’s treatment plan. We offer the most advanced genetic tests.

Assessing treatment outcomes and rehabilitation in Swiss clinics

A distinctive feature of treating brain tumours in children in Switzerland is the multifactorial approach to each patient. Doctors develop individual treatment programmes that take into account both the biological characteristics of the tumour and the psychological state and needs of the child and family.

We involve experts in every aspect of the child’s development: academic, emotional and social. Brain tumours, radiotherapy, chemotherapy and hormone therapy can lead to cognitive impairment. Our paediatric neuropsychology specialists carry out regular neurocognitive assessments to detect any changes in your child’s attention, memory or other aspects of thinking. We can identify the most likely causes and make recommendations to help your child. We can discuss any support your child may need at school because of these changes. In some cases, medication can help to reduce certain aspects of cognitive difficulty.
Treating brain tumours in children requires highly qualified medical specialists, modern equipment and innovative techniques. Switzerland offers world-class medical care in this field, giving children with brain tumours access to advanced diagnostic and treatment methods, as well as a comprehensive approach to rehabilitation and support.

Treatment of brain tumours in children in Switzerland is directed at fighting the disease and, equally, at ensuring the best possible quality of life for the patient after treatment.