- Overview Brain & Spinal Tumors
- Risk Factors, Signs & Symptoms
- Diagnosing Brain & Spinal Tumors
What are Brain & Spinal Tumors?
Cancers that begin in tissue in the brain or spinal cord are often referred to as central nervous system cancers. Tumors that start in the brain are called primary brain tumors. (Sometimes tumors that started in other parts of the body will spread, or metastasize, to the brain.)
Brain tumors can be benign or malignant. Benign brain tumors grow and press on nearby areas of the brain, but rarely spread to other tissue. However, they can recur, sometimes more than once. Malignant brain tumors typically grow quickly and often spread into other brain tissue.
The Anatomy of the Brain and Spinal Cord
The brain is composed of three main sections:
- The cerebrum - The largest part of the brain, at the top of the head. It controls thinking, learning, problem solving, emotions, speech, reading, writing, and voluntary movement.
- The cerebellum - In the lower back of the brain, near the middle of the back of the head. It controls movement, balance, and posture.
- The brain stem - Connects the brain to the spinal cord. It is in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating.
- The spinal cord - Connects the brain to nerves in most parts of the body. Spinal cord nerves carry messages between the brain and the rest of the body.
The most common brain and spinal cord tumors are:
- Mixed Gliomas
- Ependymal Tumors
- Pineal Parenchymal Tumors
- Meningeal Tumors
- Germ Cell
- Sellar Region
Risk Factors, Signs & Symptoms
We still don’t know the main risk factors for brain cancer. However, studies have shown:
These conditions may increase the risk of developing certain types of brain tumors:
- Being exposed to vinyl chloride may increase the risk of glioma.
- Past treatment with radiation therapy to the scalp or brain may increase the risk of meningioma.
- Infection with the Epstein-Barr virus; being HIV-positive and developing AIDS, or receiving an organ transplant may increase the risk of primary CNS lymphoma.
These genetic syndromes may increase the risk of developing the following types of brain tumors:
- Neurofibromatosis type 1 or 2
- von Hippel-Lindau
- Tuberous Sclerosis
- Li-Fraumeni Syndrome
- Turcot Syndrome type 1 and type 2
- Klinefelter Syndrome
- Nevoid Basal Cell Carcinoma Syndrome
Signs and Symptoms
The symptoms of adult brain and spinal cord tumors are not the same in every person. They depend on where the tumor formed in the brain, the functions controlled by that part of the brain, and the size of the tumor. You should consult a doctor if you experience these symptoms:
- Morning headache or headache that goes away after vomiting
- Frequent nausea and vomiting
- Vision, hearing, and speech problems
- Loss of balance and trouble walking
- Weakness on one side of the body
- Unusual sleepiness or change in activity level
- Unusual changes in personality or behavior
Spinal Cord Tumors
- Back pain or pain that spreads from the back towards the arms or legs.
- A change in bowel habits or trouble urinating
- Weakness in the legs
- Trouble walking
Diagnosing Brain & Spinal Tumors
If you are experiencing symptoms that suggest you might have a brain or spinal cord tumor, you doctor will likely to do a number of tests. These will typically include:
Physical Exam - Your doctor will assess your overall health, testing for fever, high blood pressure and swollen lymph nodes.
Neurological Exam - You will answer questions and perform tests that check brain, spinal cord, and nerve function. Your doctor will see if you are walking normally, and how well your muscles, senses, and reflexes work. This may be referred to as a neurological or “neuro” exam.
Visual Field Exam - This exam will check your field of vision—the total area in which you can see objects. It measures central vision (how much you can see when looking straight ahead) and peripheral vision (how much you can see in all other directions while staring straight ahead). Any loss of vision may be a sign of a tumor that has damaged or pressed on the parts of the brain that affect eyesight.
Gene Testing - If you have a family history of brain tumors, your doctor may recommend that you be tested for an inherited syndrome.
Your doctor may also recommend that you have one or more imaging tests of your brain.
Imaging Tests for Brain Cancer
If you are experiencing symptoms that suggest you might have a brain or spinal cord tumor, your doctor may recommend that you have imaging tests such as:
CT scan - This is an X-ray test that produces detailed cross-sectional images of your brain and spinal cord. During the procedure the CT scanner takes many pictures as it rotates around you while you lie on a table to create detailed images of the soft tissues in the body.
MRI or NMRI (Nuclear Magnetic Resonance Imaging) - During this procedure a substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture.
Magnetic Resonance Spectroscopy - This procedure may also be done during the MRI. MRS is used to diagnose tumors based on their chemical make-up.
SPECT Scan - This procedure uses a special camera linked to a computer to make a 3-D picture of the brain. A small amount of a radioactive substance is injected into a vein or inhaled through the nose. As the substance travels through the blood, the camera rotates around the head and takes pictures of the brain. There will be increased blood flow and more chemical reactions (metabolism) in areas where cancer cells are growing. These areas will show up brighter in the picture. This procedure may be done just before or after a CT scan.
PET Scan - During this procedure a small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Angiogram - This procedure uses X-rays to looks at blood vessels and the flow of blood in the brain.
If you have a brain or spinal tumor, you are likely to be treated by a team of specialists. This team can include a neurosurgeon, neurologist, radiation oncologist, medical oncologist, and endocrinologist. These doctors will get together to discuss your tumor and your treatment options. The options will depend on the type of tumor you have, whether it is benign or malignant, the tumor’s size, and how far the tumor may have spread (if it is malignant).
After getting a treatment recommendation from one team, you may want to get a second opinion from another team of doctors. Getting a second opinion can be affirming if both teams agree. Or, the second team may have other suggestions, which can open up new options.
Several types of treatment are used to treat brain or spinal cord tumors. These include surgery, radiation and chemotherapy. If the tumor is causing symptoms, like headaches, swelling or seizures, you may receive radiation to reduce the size of the tumor or be given medications to help with these side effects.