North America
United States of America
Unlike countries where children's cancer care is concentrated in one or a few national centers, pediatric neurosurgery in the United States is offered at many hospitals, and their experience with posterior fossa tumors varies widely. In the United States, you can choose where your child is treated, and many families travel for surgery. If the best option isn't nearby, ask your team whether a transfer is safe and possible. Call your insurance company to ask what it covers for out-of-network or out-of-state care.
Cancer care and clinical trials
Surgery is usually the first step. Depending on the tumor type, many children go on to have chemotherapy, radiation therapy, or both, planned by a pediatric oncologist. Many are treated on a clinical trial: a research study that compares the current best treatment with a promising new approach. The Children's Oncology Group (COG) is the largest pediatric cancer research network in North America, and its trials are open only at its member hospitals. Other networks, such as the Pediatric Brain Tumor Consortium, run trials for specific brain tumors at a smaller number of centers.
Joining a trial is always your choice. Once the tumor type is confirmed after surgery, the oncology team can tell you whether a trial fits your child, explain how it differs from standard treatment, and ask for your written consent. You can say no, or leave a trial later, and your child will still receive standard treatment. Some trials must start within a few weeks of surgery and need tumor tissue and MRI scans collected in specific ways during and after the operation, so having surgery at a COG member hospital helps keep these options open. The map below marks COG member hospitals, and you can also search for trials on the National Cancer Institute's website.
For answers to more common questions about clinical trials, see What is a Clinical Trial? from the Children's Oncology Group.