Brain and Spinal cord tumor in adults

What are Brain and Spinal Cord Tumors?

A tumor is a mass of abnormal cells that either form into a new growth or the growth was there when someone born (congenital). Tumors occur when something goes wrong with genes that regulate cell growth, allowing cells to grow and divide out of control. Tumors can form anywhere in the body. Brain and spinal cord tumors form in the tissue inside the brain or spinal cord, which makes up the Central Nervous System (CNS). Depending on its type, a growing tumor may not cause any symptoms or can kill or displace healthy cells or disrupt their function. A tumor can also block the normal flow of activity in the brain or signaling to and from the brain. There are more than 120 types of brain and spinal cord tumors.

Tumors can be primary or secondary:

Primary tumors of the CNS are growths that begin in the brain or spinal cord.  They can be either malignant or benign.  

Metastatic tumors, or secondary tumors, of the CNS are caused by the cancer cells that break away from a primary tumor somewhere else in the body and spread to the CNS.  They are more common than primary tumors of the CNS and occur more often in adults than in children.

Who is at Risk?

Anyone can develop a primary brain or spinal cord tumor, but the overall risk is very small. Brain tumors occur more often in males than in females and are most common in middle-aged to older persons. Other risk factors for developing a primary brain or spinal cord tumor include race (Caucasians are prone to develop a CNS tumor) and occupation. Workers in jobs that require repeated contact with ionizing radiation or certain chemicals, including those materials used in building supplies or plastics and textiles, have greater chance of developing brain tumor.

How are Tumors Graded?

World Health Organization (WHO) tumor grades are based on how abnormal the cancer cells look under the microscope and how quickly the tumor is likely to grow and spread.

Grade I – The tumor cells look more like normal cells under a microscope. They rarely spread into nearby tissues and may be cured if they are completely removed by surgery.

Grade II – The tumor cells grow and spread slowly but may spread into nearby tissue and may recur (come back).

Grade III – The tumor cells tend to grow rapidly and can spread quickly into other CNS tissue. Tumor cells will look different than those in surrounding tissue.

Grade IV – The tumor cells do not look like normal cells under a microscope and grow and spread very quickly.  Grade IV tumors usually cannot be cured.

What are the Possible Symptoms?

Brain Tumor

• Headaches are the most common symptom of a brain tumor. 
• Seizures: Seizures that start in adulthood with no underlying cause are a key warning sign of a brain tumor.
• Vision or hearing problems.
• Personality, behavior, and cognitive changes.
• Motor problems, including weakness or paralysis, lack of coordination.
• Balance problems, including dizziness, trouble walking, clumsiness, or loss of equilibrium
• Hydrocephalus and increased intracranial pressure.

Spinal Cord Tumors

• Pain in the specific area along the spine or can radiate from spine to other parts of body.
• Numbness or sensory changes.
• Motor problems and loss of muscle control.
• Problems with bowel or bladder control or sexual dysfunction.

Tests to Diagnose Brain or Spinal Cord Tumor
Physical Exam and History

• Neurological exam
• Visual Field Exam
• Tumor Marker Test

Radiology

• CT Scan
• MRI with gadolinium
• PET scan

Biopsy

• Stereotactic biopsy
• Open biopsy

Treatment for Brain and Spinal Cord Tumor

Neurosurgery: Surgery is usually the first treatment to both obtain tissue for diagnosis and remove as much tumor as can be done safely.  Surgery is considered benign or low grade.

Radiation therapy: It usually involves repeated doses of high-energy beams such as x-rays or protons to kill cancer cells or keep them from multiplying.

Radiosurgery: It is usually a one-time treatment using multiple, sharply focused radiation beams aimed at the brain or spinal cord tumor from multiple angles.  It does not cut into the person butharms a tumor cell’s ability to grow and divide.

Chemotherapy: It uses powerful drugs to kill cancer cells or stop them from growing or spreading. Chemotherapy is given in cycles to more effectively damage and kill cancer cells and give normal cells time to recover from any damage.

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