Male1: What are the types of tumors that you see?
Male2: Ependymoma is another common childhood tumor and this is a tumor that comes from cells called ependymal cells which line the ventricles and the interior of the spinal cord and this is the cavity where the spinal fluid flows through the brain and then out and around the brain and the spinal cord. These are challenging tumors in many respects because they do not respond well to chemotherapy and so we are left with surgery and radiation. They often occur in the rear of the brain in the cerebellum and can wrap themselves around the important nerves and so the neurosurgeons have to take great care and precision in trying to take these out. they often spend many, many hours working to take the tumor out from--
Male1: Sometimes, it can be almost a 24-hour surgery?
Male2: I have seen 24 hours long, but I have seen 14-hour surgeries commonly and in order to get them off and around these nerves—what we call skeletonize the nerve, they will go in and spend hours just taking the tumor out, although it is not cell by cell, but millimeter by millimeter to get as much tumor as possible and by doing that, it increases the likelihood of cure and then we can come in and radiate them in certain situations if we need to. again, in a very young child, we do not like to do that, we rely on surgery and sometimes on chemotherapy to keep things at bay until they can receive radiation.
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