There is usually a delay in getting a child’s brain tumor diagnosed.

Unfortunately, it’s an exception to the rule when a child’s brain tumor is quickly identified as the cause of their symptoms.

The Parents

First off, according to Sumeer Sathi, MD, a neurosurgeon who treats brain tumors, and founding member of Long Island Neuroscience Specialists, the delay relating to parents has multiple causes.

No parent wants to ever consider that their child might have a brain tumor.

This is perhaps the main reason why, when parents first become aware of their child’s symptom, the last thing they consider is cancer in the brain.

Their mind, instead, gravitates towards a harmless cause, especially since children all the time get ailments that quickly clear up.

For instance, a brain tumor may first present as a slight stumble or momentary loss of balance, or recurring nausea.

The parent’s initial thought will be an innocent stumble, especially if the child was playing when it happened, or a digestive issue, respectively.

The stumble may go ignored, and the first doctor the child sees for the nausea might be a general pediatrician, who then might refer to a pediatric gastroenterologist. 

Another possibility is that the parents may not think that the symptom (e.g., headache, nausea, moodiness) is serious.

They may instead simply treat it with an over-the-counter medication, or just assume that it’s from something the child ate or a sinus infection and tell the child to just take it easy for a while.

A busy parent may also take the approach of waiting things out, not having time to take their child to the doctor.

Another delay scenario is when a parent doesn’t have medical coverage.

Dr. Sathi says that the delay on the parents’ part averages 14 days – from the time the symptom is first observed — before taking the child to a doctor.

The Physician

Brain tumor symptoms “can be very common in other diseases,” says Dr. Sathi.

Hence, unless the symptom is overtly concerning, such as the parent reporting that their child had a seizure, or the doctor clearly sees one side of the child’s face drooping, a doctor isn’t going to immediately be thinking of a brain tumor.

Furthermore, Dr. Sathi says, “Usually as a new patient, it takes one month to see a brain specialist.”

However, general pediatricians have been known to order a brain MRI on that first office visit.

The Child

“Children usually cannot explain themselves well; the younger, the worse,” says Dr. Sathi.

All in all, what is the median time it takes for a child’s brain tumor to be diagnosed, from the time a symptom first becomes apparent?

It is 60 days, says Dr. Sathi.

“Only 33% of brain tumors were diagnosed within the first month after the onset of signs/symptoms.”

Factors that Influence the Time It Takes to Diagnose a Pediatric Brain Tumor

The length of time between first observable symptom and diagnosis correlates “significantly with patients’ age and tumor histology [type of tumor],” says Dr. Sathi.

Gender and tumor location are not factors.

As mentioned, age is a factor. Dr. Sathi explains, “This is very relevant since brain tumors present with subtle neurological symptoms when tumors may be small; and severe obvious deficit, headaches, vomiting or lethargy when large.

“Depending on age of child, they may not be able to demonstrate that easily, especially if they are not able to walk or talk and communicate.”

Why is it that sometimes, a pediatrician will quickly suspect a brain tumor when a symptom has many benign causes?

This will depend on the physician’s level of training regarding brain tumors.

This extra level of training means that the practitioner is more likely to ask certain questions to the young patient or parents to screen for the possibility of a brain tumor.

It may also be because, by coincidence, the physician recalls the same symptom in a previoius young patient who ultimately was diagnosed with a brain tumor, or read of a similar case in a medical journal or even an online article.

Finally, another possible scenario that can reduce delay of diagnosis is if the parent — by chance — mentions to the pediatric gastroenterologist the few incidents of stumbling.

The pediatric gastroenterologist might then wonder about a connection between the two symptoms, and refer to a neurologist.

Pediatric Brain Tumor Symptoms

• Headache, especially if it’s getting worse or more frequent

• Head pressure

• Nausea, vomiting

• Loss of appetite

• Sudden vision problems

• Seizure

• Abnormal eye movement

• Bulging eye

• Slurred speech

• Problems swallowing

• Balance problems, clumsiness

• Trouble walking

• Hearing loss

• Weakness in a leg or arm

• Loss of sensation in a leg or arm

• Sleepiness

• Increased head size

• Confusion

• Behavior change, irritability, depression

• Memory problems

Symptoms depend on the location of the tumor. For example, the benign acoustic neuroma grows in the inner ear canal, and its hallmark symptom is hearing loss.

Dr. Sathi’s expertise includes spine surgery and treating brain tumors including metastasis, gliomas, meningiomas and acoustic neuromas using gamma knife radiosurgery. Long Island Neuroscience Specialists is a multidisciplinary group of neuro-spine surgeons and an interventional pain management anesthesiologist.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

 

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Top image: ©Lorra Garrick