What is Diffuse Midline Glioma?
Diffuse Midline Glioma, also known as Diffuse Intrinsic Pontine Glioma or ‘DIPG’, is the second most common type of primary, high grade brain tumour in children. Primary brain tumours are those which originate in the brain rather than having spread there from another part of the body.
Diffuse Midline Glioma is a type of high grade brain tumour. High grade brain tumours tend to grow quickly and are more likely to spread to other parts of the brain or spinal cord. They are sometimes referred to as being ‘malignant’ or ‘cancerous’.
Diffuse Midline Gliomas originate in an area of the brain, and more specifically the brainstem, called the pons. The pons is an area deep within the lower part of the brain which is responsible for a number of critical bodily functions, such as breathing, sleeping and blood pressure.
The cause of brain tumours, including Diffuse Midline Glioma, is not yet known. This can be one of the most difficult things to accept as a parent as it can leave you feeling helpless. Brain tumours are nobody’s fault. There is no research that shows that anything you may have done during pregnancy or in your child’s early infancy could have caused your child’s brain tumour.
What are the signs and symptoms of DMGs?
The signs and symptoms can vary as area of the brain where DMGs are found is responsible for a variety of different functions. A child with a DMG may experience:
- abnormal alignment of the eyes
- double vision
- weakness of facial muscles or one side of the face appearing different from the other
- arm and leg weakness
- unstable balance and co-ordination
- difficulties walking and speaking.
In a relatively small number of cases, growth of a DMG might block the drainage of cerebrospinal fluid and cause a build up of pressure in the head – this is known as hydrocephalus. Hydrocephalus is very common in other types of brain tumour and can cause other symptoms, like headache (especially in the morning), nausea and fatigue.
It’s important to note that not all cases are identical and a child might show a combination of these symptoms.
What are the treatments for Diffuse Midline Gliomas?
If your child is diagnosed with a Diffuse Midline Glioma, having surgery to remove the tumour may not always be a viable option due to the dangers of operating on critical areas of the brain.
The standard of treatment for Diffuse Midline Glioma is radiotherapy, which is usually administered over 3 to 6 weeks depending on the type of radiotherapy that is deemed best for your child (with a daily dose given Monday to Friday). Your child might also be given steroids during this period to help reduce some of the pressure caused by the tumour and radiation treatment.
Based on the findings of various studies, chemotherapy drugs currently used to treat adult high grade gliomas in other parts of the brain have been shown not to be effective in treating childhood Diffuse Midline Gliomas, so your child is unlikely to receive this type of treatment.
Given the relative lack of treatment options for Diffuse Midline Gliomas, you may want to consider looking for an available clinical trial your child could join. Even if your child is not given a new treatment whilst on a clinical trial, they will be given conventional (standard) treatment while also having their health monitored very closely.
Questions you may want to ask your child’s doctor:
- What treatment options are available for my child?
- What might be the short and long term complications of treatment?
- What services may be available to help my child and family cope?
- When should I contact my child’s medical team?
- How can I contact my child’s medical team?
- Are there any clinical trials my child could take part in?
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Our FREE Brain Tumour Information Pack has been designed to help you through this difficult time, to guide you through the healthcare system, answer your questions, and reassure you that you’re not alone so that you feel confident when discussing treatment and care options with your medical team.
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