What to expect when your child needs brain tumor surgery

When does my child need brain tumor surgery?

There are two times your child may have surgery for a brain tumor. The first time is to diagnose the tumor by learning its type. This is often called diagnostic brain surgery, or a biopsy.

The second time is to remove all or as much of the tumor as possible as part of the treatment.

Sometimes a doctor is able to take out all or most of the tumor during the first surgery so the second surgery isn’t needed.

Is surgery the only treatment for a brain tumor?

Surgery is often required to treat a brain tumor, but it is not the only option. Your child may need surgery only, or a combination of surgery with other treatment options. Radiation and chemotherapy can also be part of your child’s  treatment plan.  Your St. Jude care team will work with you and your family to decide what combination of treatment options is best for your child and his or her tumor.

Brain tumor treatment at St. Jude

The St. Jude/Le Bonheur Brain Tumor Program

Your child will have brain surgery and the care right afterward at Le Bonheur Children’s Hospital. It’s about a mile from St. Jude Children’s Research Hospital. Together, these hospitals form a Brain Tumor Program specifically for children.

Your child’s multidisciplinary team will have staff from both St. Jude and Le Bonheur. For instance, pediatric neurosurgeons from Le Bonheur may work with neuro- and radiation oncologists from St. Jude.

If your child needs chemotherapy or radiation therapy after surgery, it will occur at St. Jude.

Read about the St. Jude/Le Bonheur brain tumor program

What happens during diagnostic brain surgery?

A doctor can’t tell you much more than your child has a brain tumor without actually seeing and testing it. To get a piece of the tumor for a close look requires surgery. Most children who have a brain tumor have surgery to get their diagnosis.

Your doctors make daily rounds to talk to each child and family. Your whole multidisciplinary team will also meet in a weekly conference to discuss your child’s treatment, progress and next steps. We encourage you to ask questions at any point. Your family is an important part of the treatment team.

Before surgery, your child will go to pre-op in the surgery clinic. You and your child will also both give your consent for the surgery to take place. 

Most of the time, one parent can go into the OR with the child. You can stay next to your child until he or she falls asleep. Other family members and friends can stay in a waiting room or a pre-op room during surgery.

The doctor who does the biopsy is a neurosurgeon. These surgeons specialize in operations on the brain and spinal cord.

To get to the tumor, a neurosurgeon must remove part of the skull. To know exactly where the tumor is, the surgeon looks at magnetic resonance imaging (MRI) images taken by a pediatric neuro-radiologist.

Next, the neurosurgeon uses a needle to get a small piece of the tumor. Sometimes the doctor can take out the whole tumor, or at least a lot of it.

Once again, the neurosurgeon uses MRIs as a guide. Advanced technology shows the surgeon the tumor’s edges, called the margins. Knowing the margins helps the surgeon remove the tumor.

The neurosurgeon gives the sample to a pathologist, who uses a microscope to look for cancer cells. Tumors with no cancer are called benign. Tumors with cancer are called malignant.

The pathologist determines the type of the tumor as well as characteristics like how fast it may grow and spread.

Your child’s treatment team uses the information from the pathologist and from your child’s health and medical history to plan how to treat the tumor.

After surgery, your child will go to the Neurosurgical Intensive Care Unit (Neuro ICU), which is designed specifically for the care of children after brain tumor surgery. A room for parents is connected to the ICU. This parent room lets you see your child during the recovery period.

Treatment after surgery

Your child may need other treatment after surgery, such as chemotherapy, radiation therapy, or both.

Your child’s multidisciplinary team works together to decide the order in which your child gets these treatments. The order depends on your child’s age, how much of the tumor the surgeon was able to remove, and the type of cancer as well as its other classifications.

How long your child’s care continues after treatment ends depends on the type of tumor and how far it has advanced. Your child may have ongoing meetings with one or more of these pediatric specialists:

  • Neuro-endocrinologists check to make sure your child has the right amount of hormones for normal metabolism, growth and sexual development. The brain tumor or its treatment may affect how glands in the brain release hormones.
  • Neuro-psychologists follow up on the tests they gave your child at diagnosis. These tests show the change in short- or long-term problems with learning or behavior.
  • Rehabilitation experts help your child relearn whatever the brain tumor or its treatment affected. Your child may see specialists to help with hearing, movement, recreation or speech.

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