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Table of Contents General Information About Childhood Central Nervous System Embryonal Tumors
Staging Childhood Central Nervous System Embryonal Tumors
Recurrent Childhood Central Nervous System Embryonal Tumors
Treatment Option Overview
Treatment Options for Childhood Central Nervous System Embryonal Tumors
To Learn More About Childhood Central Nervous System Embryonal Tumors
Get More Information From NCI
Changes to This Summary (11/07/2008)
About PDQ
General Information About Childhood Central Nervous System Embryonal Tumors
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Central nervous system embryonal tumors begin in embryonic (fetal) cells in the brain and spinal cord.
Central nervous system (CNS) embryonal tumors form in brain cells when the fetus is beginning to develop. The tumors may be benign (not cancer) or malignant (cancer). Most CNS embryonal tumors in children are malignant.
Although cancer is rare in children, brain tumors are the third most common type of childhood cancer, after leukemia and lymphoma.
This summary discusses the treatment of primary brain tumors (tumors that begin in the brain). The treatment of metastatic brain tumors, which begin in other parts of the body and spread to the brain, is not discussed in this summary.
Brain tumors can occur in both children and adults; however, treatment for children may be different than treatment for adults. See the PDQ treatment summary on Adult Brain Tumors for more information.
CNS embryonal tumors may form in different areas of the brain.
Childhood brain tumors are named based on the type of cell they formed in and where the tumor first formed in the brain. There are 6 different types of CNS embryonal tumors:
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Medulloblastoma
Medulloblastomas are fast-growing tumors that form in brain cells in the cerebellum. The cerebellum is at the lower back part of the brain between the cerebrum and the brain stem. The cerebellum controls movement, balance, and posture. Sometimes medulloblastoma spreads to the bone, bone marrow, lymph nodes, liver, or lung.
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Pineoblastoma
Pineoblastoma is a fast-growing tumor that forms in brain cells in or near the pineal gland. The pineal gland is a tiny organ in the brain that makes melatonin, a substance that helps control our sleep cycle.
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Pineal parenchymal tumors
Pineal parenchymal tumors form in pineocytes, a type of cell in the pineal gland. These tumors may be slow- or fast-growing.
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Supratentorial primitive neuroectodermal tumors
Supratentorial primitive neuroectodermal tumors are fast-growing tumors that form in brain cells in the cerebrum. The cerebrum is at the top of the head and is the largest part of the brain. The cerebrum controls thinking, learning, problem-solving, emotions, speech, reading, writing, and voluntary movement.
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Medulloepithelioma
Medulloepitheliomas are fast-growing tumors that form in brain cells that line tubelike spaces in the brain and spinal cord. These rare tumors are most common in infants and young children.
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Ependymoblastoma
Ependymoblastomas are fast-growing tumors that form in brain cells lining the fluid -filled spaces in the brain and spinal cord. These rare tumors are most common in infants and young children.
Certain genetic conditions increase the risk of childhood CNS embryonal tumors.
Anything that increases the risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Parents who think their child may be at risk should discuss this with the child's doctor. Risk factors for CNS embryonal tumors include having the following inherited diseases:
In most cases, the cause of CNS embryonal tumors is not known.
The symptoms of childhood CNS embryonal tumors are not the same in every child.
The following symptoms and others may be caused by a CNS embryonal tumor. Symptoms vary depending on the child's age and where the tumor is located. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
- Loss of balance, trouble walking, worsening handwriting, or slow speech.
- Morning headache or headache that goes away after vomiting.
- Nausea and vomiting.
- General weakness or weakness on one side of the face.
- Unusual sleepiness or change in energy level.
- Change in personality or behavior.
- Unexplained weight loss or weight gain.
An infant or young child may be irritable or grow slowly, and may not eat well or meet developmental milestones such as sitting, walking, and talking in sentences.
Tests that examine the brain and spinal cord are used to detect (find) childhood CNS embryonal tumors.
The following tests and procedures may be used:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a patient's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging) of the brain and spinal cord with gadolinium. A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). Sometimes magnetic resonance spectroscopy (MRS) is
done during the same MRI scan to look at the chemical makeup of the brain tissue.
- Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
- SPECT scan (single photon emission computed tomography): A procedure that uses a special camera linked to a computer to make a 3-dimensional (3-D) picture of the brain. A small amount of a radioactive substance is injected into a vein or inhaled through the nose. As the substance travels through the blood, the camera rotates around the head and takes pictures of the brain. There will be increased blood flow and more chemical reactions (metabolism) in areas where cancer cells are growing. These areas will show up brighter in the picture. This procedure may be done just before or after a CT scan.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Childhood CNS embryonal tumors are usually diagnosed and removed in surgery.
If doctors think your child may have a CNS embryonal tumor, a biopsy may be done to remove a sample of tissue. For brain tumors, the biopsy is done by removing part of the skull and using a needle to remove a sample of tissue. Sometimes, a computer-guided needle is used to remove a sample of tissue. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery.
The following tests may be done on the sample of tissue that is removed:
- Immunohistochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer tissue to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
- Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
- Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.
Some pineoblastoma and pineal parenchymal tumors are diagnosed by brain imaging tests.
Sometimes, it is not possible to do a safe biopsy or completely remove the tumor in surgery, because of where it is in the brain. These tumors are diagnosed based on the results of imaging tests and other procedures.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on:
- The age of the child when the tumor is found.
- The type of tumor and where it is in the brain.
- Whether there is tumor left after surgery.
- Whether the cancer has spread within the brain and spinal cord or to other parts of the body, such as the bones.
- Whether the tumor has just been diagnosed or has recurred (come back).
Back to Top Staging Childhood Central Nervous System Embryonal Tumors
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Treatment is based on the child’s risk group.
Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.
There is no standard staging system for childhood central nervous system (CNS) embryonal tumors. Instead, treatment depends on the child’s risk group:
Average risk
Childhood CNS embryonal tumors are called average risk when all of the following are true:
- The child is older than 3 years of age.
- The tumor is at the very back of the brain.
- All of the tumor was removed by surgery or there was only a very small amount remaining.
- The cancer has not spread to other parts of the
body.
High risk
Childhood CNS embryonal tumors are called high risk if any of the following are true:
- The child is 3 years of age or younger.
- The tumor is not at the very back of the brain.
- Some of the tumor was not removed by surgery.
- The cancer has spread to other parts of the
body.
In general, cancer is more likely to recur (come back) in patients in the high-risk group.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The information from tests and procedures done to detect (find) childhood CNS embryonal tumors is used to plan cancer treatment.
Some of the tests used to detect childhood CNS embryonal tumors are repeated after the tumor is removed by surgery. (See the General Information section.) This is to find out how much tumor remains after surgery. Other tests and procedures may be done to find out if the cancer has spread:
Back to Top Recurrent Childhood Central Nervous System Embryonal Tumors
A recurrent childhood central nervous system (CNS) embryonal tumor is a tumor that recurs (comes back) after being treated. Childhood CNS embryonal tumors most often recur within 18 months after treatment but may come back many years later. Recurrent childhood CNS embryonal tumors may come back in the same place as the original tumor or in a different place in the brain or spinal cord.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood brain tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Back to Top Treatment Option Overview
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There are different types of treatment for children who have CNS embryonal tumors.
Different types of treatment are available for children with central nervous system (CNS) embryonal tumors. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical trials are open only to patients who have not started treatment.
Children who have CNS embryonal tumors should have their treatment planned by a team of health care providers who are experts in treating brain tumors in children.
Treatment will be overseen by a pediatric oncologist, a doctor who specializes in treating children with cancer. The pediatric oncologist works with other pediatric health care providers who are experts in treating children with brain tumors and who specialize in certain areas of medicine. These may include the following specialists:
Childhood brain tumors may cause symptoms that begin before diagnosis and continue for months or years.
Symptoms caused by the tumor may begin before diagnosis. These symptoms may continue for months or years. It is important to talk with your child's doctors about symptoms caused by the tumor that may continue after treatment.
Some cancer treatments cause side effects months or years
after treatment has ended.
Side effects from cancer treatment that begin during or after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include the following:
- Physical problems.
- Changes in mood, feelings, thinking, learning, or memory.
- Second cancers (new types of cancer).
Children diagnosed with medulloblastoma may have cerebellar mutism syndrome after surgery. Symptoms of this syndrome include the following:
- Not being able to speak.
- Trouble swallowing and eating.
- Loss of balance, trouble walking, and worsening handwriting.
- Loss of muscle tone.
- Mood swings and changes in personality.
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer for more information).
Three types of standard treatment are used:
Surgery
Surgery is used to diagnose and treat a childhood CNS embryonal tumor as described in the General Information section of this summary.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Radiation therapy to the brain can affect growth and development in young children. For this reason, clinical trials are studying new ways of giving radiation that may have fewer side effects than standard methods. For childhood CNS embryonal tumors, radiation therapy may be given in the following ways:
- Conformal radiation therapy uses a computer to make a 3-dimensional (3-D) picture of the tumor and the radiation beams are shaped to fit the tumor. This allows a high dose of radiation to reach the tumor and causes less damage to normal tissue around the tumor.
- Stereotactic radiation therapy uses a rigid head frame attached to the skull to aim radiation directly to a tumor, causing less damage to normal tissue around the tumor. The total dose of radiation is divided into several smaller doses given over several days. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.
The way the radiation therapy is given depends on the type of cancer being treated.
Because radiation therapy can affect growth and brain development in young children, especially children who are three years old or younger, chemotherapy may be given to delay or reduce the need for radiation therapy.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type of cancer being treated.
Anticancer drugs given by mouth or vein to treat central nervous system tumors cannot cross the blood-brain barrier and enter the fluid that surrounds the brain and spinal cord. Instead, an anticancer drug is injected into the fluid-filled space to kill cancer cells that may have spread there. This is called intrathecal chemotherapy.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
High-dose chemotherapy with stem cell transplant
High-dose chemotherapy with stem cell transplant is a way of giving high doses of chemotherapy and replacing blood -forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the blood or bone marrow of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body’s blood cells.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. (See the General Information section for a list of tests.) Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the brain tumor has recurred (come back). If the tumor recurs in the brain, a biopsy may also be done to find out if it is made up of dead tumor cells or if new cancer cells are growing. These tests are sometimes called follow-up tests or check-ups.
Back to Top Treatment Options for Childhood Central Nervous System Embryonal Tumors
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Newly Diagnosed Childhood Medulloblastoma
In newly diagnosed childhood medulloblastoma, the tumor itself has not been treated. The child may have received drugs or treatment to relieve symptoms caused by the tumor.
Average risk
Standard treatment of average-risk childhood medulloblastoma is usually surgery followed by radiation therapy to the brain and spinal cord. Sometimes chemotherapy is given at the same time as radiation therapy or after radiation therapy.
Clinical trials are studying new combinations of radiation therapy and chemotherapy.
High risk
Standard treatment of high-risk childhood medulloblastoma is usually surgery followed by radiation therapy to the brain and spinal cord.
Sometimes chemotherapy is given at the same time as radiation therapy or after radiation therapy.
Clinical trials are studying new combinations of radiation therapy and chemotherapy.
Children 3 years old or younger
Standard treatment of childhood medulloblastoma in children 3 years old or younger is usually surgery followed by chemotherapy. Other treatments may include the following:
Treatment of medulloblastoma in children 3 years old or younger is often within a clinical trial. Clinical trials are studying new combinations of chemotherapy with stem cell transplant.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood medulloblastoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Newly Diagnosed Childhood Pineoblastoma and Pineal Parenchymal Tumors
In newly diagnosed childhood pineoblastoma or pineal parenchymal tumors, the tumor itself has not been treated. The child may have received drugs or treatment to relieve symptoms caused by the tumor.
Children older than 3 years
Standard treatment of childhood pineoblastoma and pineal tumors in children older than 3 years is usually surgery. It is usually not possible to remove all of the tumor, because of where it is in the brain. Surgery is usually followed by radiation therapy to the brain and spinal cord. Sometimes chemotherapy is given at the same time as radiation therapy or after radiation therapy.
Clinical trials are studying new treatments for high-risk childhood pineoblastoma, including combinations of chemotherapy, radiation therapy, and stem cell transplant.
Children 3 years old or younger
Treatment of pineoblastoma and pineal tumors in children 3 years old or younger may include surgery followed by chemotherapy. Radiation therapy may be given when the child is older.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood pineoblastoma and childhood pineal parenchymal tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Newly Diagnosed Childhood Supratentorial Primitive Neuroectodermal Tumors
In newly diagnosed childhood supratentorial primitive neuroectodermal tumors, the tumor itself has not been treated. The child may have received drugs or treatment to relieve symptoms caused by the tumor.
Children older than 3 years
Standard treatment of supratentorial neuroectodermal tumors in children older than 3 years is usually surgery followed by radiation therapy to the brain and spinal cord.
Sometimes chemotherapy is given at the same time as radiation therapy or after radiation therapy.
Children 3 years old or younger
Standard treatment of supratentorial neuroectodermal tumors in children 3 years old or younger, is usually surgery followed by chemotherapy. Other treatments may include the following:
Treatment of supratentorial primitive neuroectodermal tumors in children 3 years old or younger is often within a clinical trial. Clinical trials are studying new combinations of chemotherapy with stem cell transplant.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood supratentorial primitive neuroectodermal tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Newly Diagnosed Childhood Medulloepithelioma and Ependymoblastoma
In newly diagnosed childhood medulloepithelioma and ependymoblastoma, the tumor itself has not been treated. The child may have received drugs or treatment to relieve symptoms caused by the tumor.
Children older than 3 years
Standard treatment of childhood medulloepithelioma or ependymoblastoma in children older than 3 years is usually surgery followed by radiation therapy to the brain and spinal cord.
Sometimes chemotherapy is given at the same time as radiation therapy or after radiation therapy.
Children 3 years old or younger
Standard treatment of childhood medulloepithelioma or ependymoblastoma in children 3 years old or younger is usually surgery followed by chemotherapy. Other treatments may include the following:
Treatment of childhood medulloepithelioma or ependymoblastoma in children 3 years old or younger is often within a clinical trial.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with childhood ependymoblastoma and childhood medulloepithelioma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Recurrent Childhood Central Nervous System Embryonal Tumors
Treatment of recurrent childhood CNS embryonal tumors may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood central nervous system embryonal tumor. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Back to Top To Learn More About Childhood Central Nervous System Embryonal Tumors
For more information from the National Cancer Institute about childhood central nervous system embryonal tumor, see the following:
For more childhood cancer information and other general cancer resources from the National Cancer Institute, see the following:
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.
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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.
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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 (11/07/2008)
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.
Changes were made to this summary to match those made to the health professional version.
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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