Running head: BRAIN CANCER

Literature Review of Past Research Conducted Regarding Brain Cancer, Primarily in Children
Annie Wold
Portland State University

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Brain tumors, while not the most common type of cancer, constitute 15% of childhood cases of
cancer and the number of cases continues to grow. This disease is most often found in children
and is the second leading cancer in young people, after leukemia. A study conducted between
1974 and 1991 found a significant increase in cases of children with cancer each year the study
was done (Gurney et al. 1996). Treatment for this disease in children and adults is different due
to the harsh effect of many cancer treatments on the body (National Cancer Institute, 2015). Risk
factors, treatments, and psychological implications of cancer are important aspects that required
in depth analysis and research. Although a great deal of research has been done and progress is
made every day, gaining an even better understanding of the causes and implications of this
complex disease will provide better futures for those with brain cancer.

Due to the fact brain cancer is most common in children, numerous studies have been conducted
relating to various potential risk factors. One such study done by Davis, Brownson, Garcia,
Bentz, & Turner (1993) examines the relationship between family use of pesticides and the
children developing brain tumors. This case-control study involved telephone interviews with
forty-five mothers of children who had died from brain cancer regarding any herbicides, flea
collars for pets, or household pesticides that had been used while their child was developing. The
conclusion of this study found no significant correlation between the two factors, though a
similar study conducted by Wilkins & Koutras (1988) found different results. Data was collected
in the case-control study on the occupations of fathers whose children had brain cancer. Although
it is difficult to determine causation, there was a significant correlation found between paternal
occupation and cancer development, especially with an increase among fathers who worked in

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agriculture and metal. This suggests certain environmental agents present during fetal and
childhood development may increase the risk of brain cancer in children. One serious risk factor
of all types of cancer is environment. It is common for brain tumors to be secondary, meaning a
different type of cancer spread from another part of the body to the brain. If exposure to certain
toxins results in cancer of the body, it may spread to the brain.

One risk factor the general public worries about the most in regards to brain cancer is the
harmful effects of cellphone use. A case-control study was done to test the hypothesis that the use
of handheld cellular devices are linked to the development of brain cancer. Subjects from five
medical centers in the United Kingdom were given questionnaires about their disease and time
spent using personal technology. No significant relationship was found though it was concluded
that more testing would need to be completed (Muscat et al., 2000). Another study conducted by
Morgan et al. (2000), which was sponsored by Motorola, found similar results. In a cohort study
of nearly 200,000 Motorola employees, no significant increase in cases of nervous system
tumors or leukemia were found. Even people who worked for a cellular company and were
exposed to higher levels of radiofrequency than the public did not show elevated rates of cancer.
More recent studies are needed to compensate for the significant increase in cell phone use in the
2000s.

Although it is important to know the risk factors of cancer, research regarding treatment is even
more crucial. Studies continue to be done to find the best way to treat cancer patients. A study
conducted by Swerdlow et al. (2000) on 180 children with brain tumors found the use of growth
hormones in treatment had no effect on tumor growth and recurrence, though it was concluded
that more long term research would be necessary to be sure. Radiation and chemotherapy are

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most common for cancer treatment but they are hard on the internal organs as a side effect. This
can be particularly harmful for children, especially radiation. Radiation therapy can result in hair
loss, fatigue, nausea, and increased pain and swelling in the areas affected by the tumor.
Chemotherapy can also result in negative side effects, including weakened immune functioning
and fatigue, but is less harsh on the body (Cancer Research UK, 2015). A study done on the topic
found delaying postoperative radiation therapy in children under the age of three to be beneficial
for their long term health. There was a significant reduction in neurotoxicity, and it was found
that by using only chemotherapy, the use of radiation could be delayed for over a year after
operation (Duffner et al., 1993). Another study done by Packer et al. (1989) on chemoradiation
therapy (CRT) in children with brain cancer examined the relationship between the treatment and
loss in cognitive abilities. Eighteen children with malignant brain tumors were treated with CRT
while a control group of fourteen children in similar conditions were not. They were given
several IQ tests post surgery, after radiation, and one and two years after treatment. The test
group showed statistically significant declines in intelligence and cognition, and went on to have
difficulties learning in school. The research was concluded with the need to find new treatment
for children with brain cancer. As brain cancer is most commonly found in children, safe
treatment is a necessity.

Having cancer not only affects the body, but it takes a toll on the mind as well. An assessment
done by Taphoorn et al. (2010) translated a preexisting test for cancer patients regarding their
psychological well being to twelve other languages besides the original English in order to
determine the validity of the test. Using two experimental groups and a control group, it was
concluded that psychometrics (a technique for psychological measurement) are valid for testing
cancer patients. More research was conducted by Zebrack et al. (2004) regarding the

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psychological states of childhood brain cancer survivors and their families. 1100 survivors and
3000 siblings of survivors were asked for information on their mental health, demographic
positions, and general health. The conclusion of the study stated the reason for increased stress in
the test subjects was not due to the illness and treatment itself, but the decreased ability to
socialize and function normally in daily lives.

Despite the numerous studies that have been conducted regarding treatment, wellbeing of
patients, and risks for brain cancer, there are still questions left unanswered. Even more research,
time, and commitment is required to determine causation, validate risk factors, and develop safe
treatments for children. This is important not only for the patients themselves, but for their
families and the knowledge of the general public. Without dedication to research, scientific
advancement is impossible.

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Works Cited
Cancer Research UK. (2015, October 22). Brain tumors. Cancer Research UK. Retrieved from
http://www.cancerresearchuk.org/about-cancer/type/brain-tumour/
Davis, J. R., Brownson, R. C., Garcia, R., Bentz, B. J., Turner, A. (1993). Family pesticide use
and childhood brain cancer. Archives of Environmental Contamination and Toxicology,
24 (1). Retrieved from http://link.springer.com/article/10.1007/BF01061094
Duffner, P. K., Horowitz, M. E., Krischer, J. P., Friedman, H. S., Burger, P. C., Cohen, M. E., . . .
Kun, L. E. (1993). Postoperative chemotherapy and delayed radiation in children less
than three years of age with malignant brain tumors. New England Journal of Medicine,
328 (24). Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJM199306173282401
Gurney, J. G., Davis, S., Severson, R. K., Fang, J. Y., Robinson, L. L., Ross, J. A. (1996) Trends
in cancer incidence among children in the U.S. Cancer. American Cancer Society.
Retrieved from
https://www.researchgate.net/profile/James_Gurney/publication/227790253_Trends_in_c
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Morgan, R. W., Kelsh, M. A., Zhao, K., Exuzides, K. A., Heringer, S., Negrete, W. (2000).
Radiofrequency Exposure and mortality from cancer of the brain and
lymphatic/hematopoietic systems. Epidemiology, 11 (2). Retrieved from
http://journals.lww.com/epidem/Fulltext/2000/03000/Radiofrequency_Exposure_and_Mo
rtality_from_Cancer.7.aspx
Muscat, J. E., Malkin, M. G., Thompson, S., Shore, R. E, Stellman, S. D., McRee, D., . . .
Wynder, E. L. (2000). Handheld cellular telephone use and the risk of brain cancer. The

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Journal of the American Medical Association, 284 (23). Retrieved from

http://jama.jamanetwork.com/article.aspx?articleid=193377
National Cancer Institute. (2015). Brain cancer - patient version. National Institute of Health.
Retrieved from http://www.cancer.gov/types/brain
Packer, R. J., Sutton, L. N., Atkins, T. E., Radcliffe, J., Bunin, G. R., DAngio, G., . . . Schut, L.
(1989). A prospective study of cognitive function in children receiving whole-brain
radiotherapy and chemotherapy: 2-year results. Journal of Neurosurgery, 70 (5).
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Swerdlow, A. J., Reddingius, R. E., Higgins, C. D., Spoudeas, H. A., Phipps, K., Qiao, Z., . . .
Shalet, S. M. (2000). Growth hormone treatment of children with brain tumors and risk of
tumor recurrence. Journal of Clinical Endocrinology & Metabolism, 85 (12). Retrieved
from http://press.endocrine.org/doi/abs/10.1210/jcem.85.12.7044
Taphoorn, M. J. B., Claassens, L., Aaronson, N. K., Coens, C., Mauer, M., Osoba, D., . . .
Bottomley, A. (2010). An international validation study of the EORTC brain cancer
module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms
in brain cancer patients. European Journal of Cancer, 46 (6). Retrieved from
http://www.sciencedirect.com/science/article/pii/S0959804910000316
Wilkins, J. R. & Koutras, R. A. (1988). Paternal occupation and brain cancer in offspring.
American Journal of Industrial Medicine, 14 (3). Retrieved from
http://onlinelibrary.wiley.com/doi/10.1002/ajim.4700140308/abstract
Zebrack, B. J., Gurney, J. G., Oeffinger, K., Whitton, J., Packer, R. J., Mertens, A., . . . Zeltzer, L.
K. (2004). Psychological outcomes in long-term survivors of childhood brain cancer: A

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report from the childhood cancer survivor study. Journal of Clinical Oncology 22 (6).
Retrieved from http://jco.ascopubs.org/content/22/6/999.short