Brain and Spinal
Cord Tumors
Diagnosis
The brain and spinal cord make up the central
nervous system (CNS). The CNS controls all body
functions such as breathing, blood pressure, movement,
balance, coordination and thinking. Tumors that
affect the CNS can be benign (non-cancerous) or
malignant (cancerous). Benign CNS tumors are usually
slow growing and rarely spread to other areas
of the body. Surgery alone may be effective for
some benign CNS tumors. However, even benign tumors
may be life-threatening if they are growing in
a vital area of the brain or spinal cord.
Malignant tumors of the brain or spinal cord
are classified by grade. The grade of a tumor
means the degree to which its cells are different
from normal cells, their tendency to spread and
their rate of growth. The grade of a tumor is
determined by a neuropathologist, a doctor who
specializes in the microscopic evaluation of diseases
of the nervous system. For some tumors a genetic
analysis of the tumor tissue is performed and
this information can impact on the treatment recommendations.
Gliomas or glial tumors (also called astrocytomas
or oligodendrogliomas) are the most common type
of brain and spinal cord tumor. Astrocytomas that
are grade I or II are known as low-grade astrocytomas.
These tumors tend to grow slowly. Grade III astrocytomas
are also called anaplastic astrocytomas. Their
cells divide rapidly and invade nearby CNS tissue.
The most malignant and aggressive astrocytomas
are grade IV or glioblastoma multiforme. These
tumors grow very quickly, their cells look abnormal
under the microscope and they often spread widely
in the brain. There are two types of oligodendrogliomas.
Low-grade oligodendrogliomas tend to be slow growing
and are often sensitive to chemotherapy while
anaplastic oligodendrogliomas are faster growing
and need more aggressive therapy.
Interdisciplinary Neuro-oncology Tumor Board
Precise diagnosis of the type and progression
of the tumor is crucial to the successful treatment
of nervous system tumors. The interdisciplinary
neuro-oncology tumor board consists of all the
doctors and health care professionals needed to
accurately diagnose your particular condition
and oversee your care. The entire team meets during
a weekly conference. At that time, they review
their findings from your clinic visit as well
as any medical documents you have provided such
as magnetic resonance imaging (MRI) or computerized
tomography (CT) scans, pathology slides and medical
reports. Your lead doctor will then discuss with
you the team’s conclusions and recommendations.
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Treatment Options
The goal of any cancer treatment is to eliminate
the cancer and prevent or reduce the chance of
tumor regrowth in the future. Surgery, radiation
therapy, and chemotherapy are used alone or in
various combinations, depending upon the type
of cancer as well as other factors, such as the
grade of tumor and your medical condition. Your
doctor will recommend the best combination of
treatments for your condition and will discuss
experimental treatments (clinical trials). The
neuro-oncology team will assist in making the
choice that’s right for you.
Neurosurgery
Surgery is the treatment of choice for some nervous
system tumors that can be removed without causing
major neurological problems. The goals of this
kind of surgery, also called neurosurgery, are
to:
- Remove as much of the tumor as possible
- To relieve the pressure on your brain from
the tumor
- Provide tissue to establish a precise diagnosis
- Determine the extent of the tumor
- Provide access for other treatments, such
as radiation implants
Radiation Therapy
Radiation therapy is another effective treatment
for brain tumors and other central nervous system
cancers. Radiation therapy uses X-rays or other
high-energy rays to destroy cancer cells and shrink
tumors. Radiation therapy can be used alone, or
in combination with other treatments, such as
chemotherapy.
Penn’s Radiation Oncology Department is
a national leader in the development for advanced
treatment approaches. Our radiation oncologists
are experts in cancer treatment and research,
and have contributed significant advances to the
field.
Chemotherapy
Chemotherapy uses medications to eliminate cancer
cells. Because drugs travel through the bloodstream,
they can kill cancer cells throughout the body
or in separate areas of the brain. Chemotherapy
can be given orally or through a needle in the
vein.
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