The first step in designing a treatment plan for a child with medulloblastoma is determining whether the tumor is in one place or if it has metastasized, or spread.
If the tumor is in one place, the best results for cure begin by removing most or all of it by surgery, followed by chemotherapy and radiation treatments to the brain and spinal cord.
For patients younger than 3, the long-term side effects of radiation are severe, so doctors usually try to avoid it and instead use stronger chemotherapy.
If there is evidence of the tumor in more than one place, surgery is still helpful, as are radiation and chemotherapy, but metastatic disease is much harder to treat and generally has a poor prognosis.