This week, Good Morning America television personality Michael Strahan revealed that one of his youngest daughters is battling a malignant brain tumor. On Thursday, Strahan and his 19-year-old daughter, Isabella, opened up about the diagnosis of the rare brain cancer called medulloblastoma on Good Morning America. Isabella was diagnosed in October of 2023 and experienced the following symptoms before her diagnosis: headaches, nausea, couldn’t walk straight, and throwing up blood. After Isabella’s family persuaded her to see a doctor, she was given proper care, including an MRI. As a result, the doctors found a tumor, bigger than a golf ball, nestled at the back of her brain. Luckily for Isabella and Strahan, medical professionals located the tumor early so it could be removed. The doctors at Ced
Cedars-Sinai in Los Angeles removed the tumor on Oct. 27, the day before she turned 19. Next, she underwent a month of rehabilitation and radiation treatment and had to learn to walk again. Next, she’ll continue to be treated in February in Durham, North Carolina, to begin chemotherapy at Duke Children’s Hospital & Health Center.
With the public now learning of Isabella’s condition, many have questions about what a Medulloblastoma tumor is. According to Benjamin Cooper, MD, assistant professor of radiation oncology and director of proton therapy services at NYU Langone Perlmutter Cancer Center, “Medulloblastoma is the most common brain tumor in children. There are approximately 350 patients diagnosed in the US every year, with 140 patients over the age of 14. The treatment usually consists of maximal safe resection followed by total brain and spine radiation, often with proton therapy if available, with extra radiation to the tumor site. In children, chemotherapy is given for many months after radiation. The disease is curable with a cure rate of 70-80% depending on medulloblastoma subtype, patient age, and extent of disease at diagnosis,” he says to ESSENCE.
According to the National Cancer Institute, Medulloblastoma is a primary central nervous system (CNS) tumor. This means it begins in the brain or spinal cord. Usually, to get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue. Medulloblastomas most commonly form in the cerebellum, the bottom part of the brain located at the back of the skull. They are also known as embryonal neuroepithelial tumors because they form in fetal cells that remain after birth. Unfortunately, these types of tumors are very fast-growing and often spread to other areas of the central nervous system through cerebrospinal fluid. Rarely can medulloblastomas spread outside the central nervous system to the bones, or the lymphatic system.
Medulloblastomas are all classified as grade 4 (also written as grade IV) tumors. This means they are malignant (cancerous) and fast-growing.
Symptoms of Medulloblastoma:
Symptoms related to a medulloblastoma depend on the tumor’s location. See some possible symptoms that can occur. People with a medulloblastoma can have:
- Issues with walking, balance, and/or fine motor skills
- If the tumor is blocking the CSF, this can lead to increased pressure inside the skull. This issue is known as hydrocephalus.
Signs and symptoms of hydrocephalus may include:
- Headaches
- Nausea
- Vomiting
- Blurred and double vision
- Extreme sleepiness
- Confusion
- Seizures and even passing out
If medulloblastoma has spread to the spine, symptoms may include:
- Weakness or numbness in the arms and or legs
- A change in normal bowel or bladder habits
- Spinal pain
The treatment options for Medulloblastoma:
The first treatment for medulloblastoma is surgery. The goal of surgery is to obtain tissue to determine the tumor type and to remove as much tumor as possible without causing more symptoms, according to the National Cancer Institute.
Additional treatments may include radiation, chemotherapy, or taking part in clinical trials. Surgery is usually followed by radiation to the brain and spine since this disease tends to spread in the brain and spine. Because of problems with bone marrow and surrounding organs that occur with brain and spine radiation, proton beam radiation therapy is often recommended. Chemotherapy may also be part of the treatment plan, depending on the subtype and amount the tumor has spread. Clinical trials with new chemotherapy, targeted therapy, or immunotherapy drugs can also be a possible treatment option. It is important to seek expert recommendations from a neuro-oncologist with experience in adult medulloblastoma.
We spoke to Benjamin Cooper, MD, assistant professor of radiation oncology and director of proton therapy services at NYU Langone Perlmutter Cancer Center, to learn more about this cancer.
ESSENCE: What is Medulloblastoma? How does this cancer affect the brain?
Benjamin Cooper, MD: Medulloblastoma is the most common brain tumor in children. The tumors start often in the cerebellum, which controls movement, balance, and coordination. The tumor can grow to obstruct the flow of cerebrospinal fluid leading to hydrocephalus or an accumulation of fluid around the brain which can lead to increased pressure causing headaches, nausea, vomiting, and other symptoms.
ESSENCE: How does Medulloblastoma occur?
Cooper: The cause of medulloblastoma is not known in most cases. A small portion of childhood cases may be related to inherited genetic changes.
ESSENCE: Who is more susceptible to this type of cancer?
Cooper: Medulloblastoma is most common in children and young adults with a slight male predominance. There are approximately 350 patients diagnosed in the US every year with 140 patients over the age 14.
ESSENCE: How extensive is the treatment?
Cooper: The treatment usually consists of maximal safe neurosurgical resection followed by total brain and spine radiation, with proton therapy if available, with extra radiation to the tumor site. In children, chemotherapy is given for many months after radiation. The entire treatment course is approximately 1 year with surveillance MRIs afterwards.