Brain and spinal cord (also known as central nervous system, or CNS) tumors are masses of abnormal cells in the brain or spinal cord that have grown out of control. These tumors can either be benign (non-cancerous) or malignant (cancerous).
Unlike cancers that start in other parts of the body, tumors which start in the brain or spinal cord rarely spread to distant organs. They can, however, travel short distances within the brain, causing damage to healthy tissue. Therefore, even benign tumors often need to be removed or destroyed.
Visit the National Cancer Institute where this information and more can be found about Brain Tumors and Brain Cancer, or ask your cancer care team questions about your individual situation.
Signs and symptoms of brain cancer can be either general or specific and depend on:
General symptoms of brain cancer are caused when the tumor is putting pressure on the brain or spinal cord. Specific symptoms are caused when the tumor is inhibiting the function of a specific part of the brain.
Certain symptoms, such as drowsiness, nausea, or fatigue could be related to conditions other than brain cancer. However, if you notice them in combination together or with any of the other symptoms listed, be sure to schedule an appointment with your physician.
Doctors use a variety of tests to detect and diagnose brain tumors. These tests can also show what type of brain tumor it is and if it has spread to other parts of the body. Your doctor may also run certain tests to determine the most effective course of treatment.
Imaging tests are the primary method for detecting and diagnosing a brain tumor. They can also show if the tumor is a primary brain tumor or if it is cancer that has spread to the brain from another location within the body. Imaging diagnostic tests typically include:
Various factors, including the type of brain tumor suspected, signs and symptoms, your age, current medical condition, and previous test results, are all considered when choosing a diagnostic test.
If imaging tests show there may be a brain tumor, the next step would be to perform a biopsy, which is taking a sample of the possible tumor. The sample of tissue will then be tested in a laboratory.
In most cases, brain tumors are not diagnosed until after the patient is experiencing symptoms. An internist or neurologist typically gives the initial diagnosis.
According to the National Brain Tumor Society, there are more than 130 different types of brain tumors, many with their own multitude of subtypes.
There are two more common types of brain and spinal tumors that can occur in adults.
Less common tumors, which either account for a very low percentage of brain and spinal tumors, or are more common among children than adults, may include:
Unlike other cancers, brain cancer is assigned a “grade” rather than a stage, based on how the cells look under the microscope. The most commonly used brain cancer grading system, developed by the World Health Organization (WHO), is as follows:
When it comes to brain tumor care, a team consisting of different types of doctors work together to design a treatment plan for the patient. The treatment plan often includes a combination of treatments. This team of medical professionals is called a multidisciplinary team.
Your multidisciplinary team will take all these factors into consideration before you are presented with a recommended treatment plan and start date.
The most common treatment options for brain tumors include surgery, radiation therapy, chemotherapy, targeted therapy, and active surveillance.
Surgery is typically the first step in brain tumor treatment, especially if the entire tumor can be removed. Surgical procedures involving the brain require a craniotomy, which is the removal of part of the skull. Once the tumor is removed, the opening in the skull will be covered with the patient’s own bone.
In addition to removing or reducing the size of the brain tumor, surgery provides an opportunity for biopsy, which is needed for diagnosis. For cancerous tumors that cannot be cured, removing it can still benefit the patient in that it can relieve symptoms caused by pressure on the brain.
In some cases, the location of the tumor makes it impossible to perform surgery (inoperable). If the tumor is inoperable, other treatment options will be recommended.
Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. It is typically given after surgery and sometimes in combination with chemotherapy.
The most common type of radiation treatment is called external-beam radiation therapy, which is given from a machine outside the body. It can be directed at the tumor in a variety of ways, including:
Chemotherapy (chemo) is a group of medicines used to treat cancer. These drugs are usually given into a vein (IV) or taken orally (by mouth). Many chemo drugs, however, aren’t able to cross the blood-brain barrier and enter the fluid that surrounds the brain and spinal cord. Because of this, your oncologist may suggest another alternative, called intrathecal chemotherapy. In intrathecal chemotherapy, an anticancer drug is injected into the fluid-filled space to kill cancer cells there.
While receiving active treatment, patients are monitored every 2 to 3 months with a brain MRI. The grade of the tumor typically determines how often MRI scans are needed after treatment.
Targeted therapies are drugs or other substances that target the specific genes, proteins, or tissue of a tumor. They differ from chemotherapy in that they can identify cancerous cells and attack them, while leaving the normal, healthy cells alone.
Anti-angiogenesis therapy is commonly used for brain tumors because it “starves” the tumor of nutrients that cause it to grow and spread. Other targeted therapies for brain cancer are being researched.
Active surveillance includes closely watching a patient’s brain tumor(s) but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests are done on a regular schedule. Active surveillance may be used for very slow-growing brain and spinal tumors that do not cause symptoms.
Our cancer care team is here to answer any questions you have about your individual situation. Once a treatment plan is in place, our staff is here to help you or your loved one through every step of cancer treatment.
Many clinical trials evaluating new therapies, such as proton therapy and biological therapy, as well as potential drugs to treat brain tumors, are ongoing. If you would like more information, you may speak with your oncologist regarding the available clinical trials, or you can visit our available cancer clinical trials page.
Primary brain tumors begin in the brain itself or in surrounding tissues, such as the brain-covering membranes (meninges), cranial nerves, pineal gland, or pituitary gland. When normal cells mutate, they grow and divide at increased rates, resulting in a mass of abnormal cells, which form a tumor.
Most brain tumors are not linked with any known risk factors. However, there are a few factors that can raise the risk.
Making healthier lifestyle changes (i.e. quitting drinking and smoking) can help reduce the risk of many cancers in adults, including lung and breast cancers. Regarding brain tumors, however, there are no known lifestyle-related or environmental risk factors other than radiation exposure.