Medulloblastoma

Medulloblastomas are rare in adults and more common in children. This section is about medulloblastomas in adults. The Children’s Cancer and Leukaemia Group provides information about meudullolbastoma in children.

Medulloblastomas develop from poorly developed cells at an early stage of life. This means they’re a type of primitive neuroectodermal tumour (PNET). Medulloblastomas usually start in the cerebellum and sometimes spread to other parts of the brain or spinal cord.

Symptoms may include headaches, sickness, problems with balance and coordination, vision problems.

To find out more about the tumour you need different tests. You will have a MRI scan, or a CT scan and you may have a biopsy and a lumbar puncture.

Your specialist will talk to you about the best treatment for you and explain the benefits and disadvantages. Surgery and radiotherapy are usually the main treatments. Some people may also have chemotherapy. Your doctor may prescribe steroids to help control the symptoms.

Treatments cause side effects. Your doctors will explain what to expect and how side effects can be managed.

Understanding medulloblastoma

A medulloblastoma is a type of brain tumour which is rare in adults, but more common in children. This information is about medulloblastoma in adults. If you need information about medulloblastoma in children you can contact the Children’s Cancer and Leukaemia Group.

This information should be read with our general information about brain tumours. We hope it answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having treatment.

Medulloblastoma is a primitive neuroectodermal tumour (PNET). These tumours develop from poorly developed cells at a very early stage of their life.

Medulloblastoma usually happens in people under 45. They start in the cerebellum. They may sometimes spread to other parts of the brain or to the spinal cord, usually through the cerebrospinal fluid (CSF). CSF is the fluid that surrounds and protects the brain and the spinal cord. It’s very rare for medulloblastomas to spread to any other parts of the body.


The brain and spinal cord

The brain and spinal cord make up the central nervous system (CNS). The brain controls different functions of the body, how we think, feel, learn and move. The spinal cord is made up of nerves that run down the middle of the back (spine). Messages between the brain and other parts of the body travel through the spinal cord..

Brain cross-section detail
Brain cross-section detail

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We have more information about the brain and the different types of brain tumours.


Causes of a medulloblastoma

The cause of medulloblastoma is unknown but research is going on to find out more.


Symptoms of a medulloblastoma

The symptoms will depend on the size and the position of the tumour. Common symptoms are headaches, problems with balance and coordination affecting walking and feeling/being sick. Other possible symptoms are dizziness, eye problems, changes in personality and behaviour.

Sometimes the first symptoms are due to increased pressure in the brain (called raised intracranial pressure). This can be because of swelling around the tumour, or a build-up of cerebrospinal fluid (CSF) that surrounds and protects the brain and spinal cord. Raised intracranial pressure can cause headaches, sickness (vomiting) and sight problems. Vomiting is common first thing in the morning.


Tests

Your doctors need to find out as much as possible about the type, position and size of the tumour, so they can plan the best treatment for you. You will have a number of different tests.

The doctor will examine you and do checks on your nervous system. This includes checking your reflexes and the power and feeling in your arms and legs. They also shine a light at the back of your eyes to check if the optic nerve is swollen, which can be a sign of raised pressure in the brain. Your doctor will ask some questions to check your reasoning and memory. You will also have blood tests taken to check your general health and to see how well your kidneys and liver are working.

You will have MRI or a CT scan to find out the exact position and size of the tumour.


MRI scan

This scan uses magnetism to build up a detailed picture of areas of your body. You may be given an injection of dye, into a vein, to improve the images from the scan. This test is painless and will take around 30 minutes. We have more detailed information about having an MRI scan.


CT scan

A CT (computerised tomography) scan uses x-rays to build a three-dimensional picture of the inside of the body. You may be given either a drink or injection of dye. This is to make certain areas of the body show up more clearly. This scan takes around 30 minutes and is painless. We have more detailed information about having a CT scan.


Biopsy

A sample of cells from the tumour (biopsy) is usually taken and examined under a microscope. The biopsy involves an operation. The doctor will discuss with you whether this is needed and exactly what the operation involves.


Lumbar puncture

You will have a lumbar puncture to see if there are any tumour cells in the cerebrospinal fluid (CSF). It is usually done after surgery to remove the tumour.

Your doctor uses a local anaesthetic to numb the lower part of your back and then passes a needle gently into the spine. They then take a small sample of CSF to check for tumour cells. A lumbar puncture is usually done as an outpatient and it only takes a few minutes.


Treatment

The main treatments for a medulloblastoma are surgery and radiotherapy. Some people may also have chemotherapy. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about treatment benefits and disadvantages. They will also explain the risks and side effects.

Deciding on the treatments that are right for you is a decision you make in partnership with your doctor. Make sure you have enough information and time to help you make treatment decisions.


Surgery

The aim is to remove as much of the tumour as possible, without damaging the surrounding brain tissue. It is not usually possible to remove the tumour completely, because it can spread through the CSF. You will usually have radiotherapy after surgery to get rid of any remaining tumour cells. Some people also have chemotherapy.

Your surgeon will explain what your operation will involve. They will talk to you about the possible complications and risks.

It can take a while to recover after surgery so it’s important to take good care of yourself. Get plenty of rest, try to eat well and follow the advice given by your surgeon and specialist nurse.

Some people may need extra support to help with their recovery. This may be from a physiotherapist who can help you to improve your balance, walking or strength. Occupational therapists can provide equipment and help you become more independent.


Radiotherapy

Radiotherapy treatment uses high energy rays to destroy the cancer cells. It is used after surgery to destroy any remaining tumour cells. You have radiotherapy to the brain and the spinal cord. This is because medulloblastoma can spread to the spinal cord. You may have a booster dose to the area of the brain where the medulloblastoma started.

Radiotherapy makes you feel very tired and this can carry on for weeks or longer after it finishes. Try to get plenty of rest. The skin in the treated area may become itchy and red or darker and you will lose the hair in the area. This usually grows back after 2-3 months. Your nurse will give you advice on looking after the skin and coping with hair loss. Your cancer doctor and specialist nurse will talk to you about the immediate and possible long term side effects of radiotherapy.


Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Your cancer doctor may talk to you about having chemotherapy to reduce the risk of medulloblastoma coming back or if it has spread.

Side effects include being more at risk of infection, tiredness, hair loss, feeling sick and a sore mouth. Your cancer doctor or nurse will talk to you about the immediate side effects and ways of managing them. They will also discuss any possible long term effects.


Steroids

Steroids are drugs that are used to reduce swelling around the tumour. You may be given steroids before or after surgery and radiotherapy. They improve your symptoms and help you feel better.

Some of the side effects include: indigestion, weight gain, restlessness, agitation and sleep disturbance. Let your doctor or nurse know if these are causing problems or you notice any other effects. Taking steroids with food can help reduce indigestion.

It’s very important to take them exactly as your doctor has prescribed them.


Driving

You may not be allowed to drive for a period of time. Although this can be upsetting it’s important to follow the advice you are given. Your doctor will ask you to contact the Drivers and Vehicle Licensing Association (DVLA). It is your responsibility to contact the DVLA. Your doctor or nurse will explain what you need to do.

You can contact the DVLA by phone on 0300 790 6806 or at dvla.gov.uk.


Back to Types of brain tumour

Acoustic neuromas

An acoustic neuroma is a of brain tumour of the hearing nerve. It is sometimes called a vestibular schwannoma.

Astrocytomas

Astrocytomas, also known as astrocytic tumours, are a type of brain tumour.

CNS lymphoma

Most lymphomas start in lymphatic organs. But CNS lymphoma starts in the central nervous system.

Ependymoma

An ependymoma is a rare type of brain tumour.

Haemangioblastoma

A haemangioblastoma is a rare brain tumour that starts in the cells that line blood vessels in the brain.

Meningioma

A meningioma is a brain tumour that starts in tissues called the meninges that protect the brain. Most are benign.

Mixed gliomas

Mixed gliomas are a type of brain tumour that contains different types of glial cells.

Oligodendroglioma

An oligodendroglioma is a type of brain tumour that starts in the cells that cover nerve cells.

Pineal region tumours

Pineal-region tumours develop in the area of the pineal gland in the brain. They can be benign or malignant.

Pituitary tumours

Pituitary tumours start in the pituitary gland, which is at the base of the brain. They are usually benign.