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tumors
Definition
A brain tumor is an abnormal growth of cells
(neoplasm) in the skull. A spinal tumor is a
growth associated with the spinal cord.
Tumors are classified as noncancerous
tumors (benign tumors) or cancerous
tumors (malignant tumors).
Description
Primary tumors
Tumors that initially arise and grow within the
brain are termed primary tumors. Most adult brain
cancers are not primary tumors, but are the result
of primary cancer that has spread from other
areas of the body. Most brain tumors in children,
however, are primary tumors. The cells that
nourish and support the neurons that compose
the brain are most often those cells that exhibit
the uninhibited division and growth that results in
primary tumor formation. A glioma is a tumor that
originates in the cells supporting and nourishing
brain neural tissue (glial cells). The most common
primary brain tumors include gliomas such as
astrocytomas, ependymomas, and
oligodendrogliomas.
Demographics
Brain and spinal tumors occur in people of all races and sexes, but
are slightly more common in Caucasian people than other races.
About 40,000 people are diagnosed with a brain tumor each year in
the United States. Overall, brain tumors tend to occur more
frequently in males than females. Meningiomas, however, occur
more frequently in females. Most brain tumors occur in people
over 70 years of age, and most brain tumors in childhood occur
before age eight. Brain and spinal cord tumors in children are the
second most common form of childhood cancer, with about 1,500
children developing these tumors each year. Family history may be
predictive, especially with regard to chromosomal abnormalities or
changes that may result in the loss of tumor suppressor genes.
People with family members who have glioma may be at higher
risk of developing a brain tumor.
Long-term exposure to certain chemicals may increase the risk of
developing a brain tumor. People exposed to acrylonitrile and vinyl
chloride while manufacturing some textiles and plastics,
pathologists exposed to formaldehyde, and workers in the nuclear
industry may all be at higher risk of developing malignant brain
tumors.
Almost 10,000 Americans are diagnosed each year with a spinal
cord tumor. Primary spinal cord tumors are rare; most are the
result of metastasis (spread) from another site of primary cancer in
the body. Most primary spinal tumors are not malignant, but as
they occupy space surrounding the spinal cord, they may cause
pain and disability.
Diagnosis
Brain and spinal tumors may be diagnosed by a
combination of neurological examination and imaging such
as magnetic resonance imaging (MRI) scans, computed
tomography (CT) scans, and positron emission tomography
(PET). Other diagnostic tests include laboratory tests
(including blood and spinal fluid analysis), myelography,
radionucleotide bone scan, biopsy, and microscopic
examination of tissues.
Brain and spinal tumors are usually confirmed by
computerized axial tomography (CAT) scan, or via the more
accurate MRI or PET scans.
MRI scans provide the ability to image and anatomically
pinpoint tumors of the brain and spinal cord and thus
provide accurate diagnosis without surgery. Both the MRI
and CAT scans produce segmental images of the brain that
allow physicians to determine the location and extent of
tumors, as well as the extent of damage to neural or
surrounding tissue. PET scans use a glucose-and-tracer
mixture that is injected into the bloodstream to form a
picture of metabolic activity of the brain. As tumor tissue
uses more glucose than normal tissue, the tumor presents a
brighter image than normal tissue in the picture generated
by the scan
Treatment team
In addition to the primary physician, neurologists, and
neurosurgeons, treatment often involves oncologists,
chemotherapists, and radiation oncologists who can assist
the patient and family with treatment decisions. Physical,
occupational, and respiratory therapists provide specialized
care, as do nurses. Social service consultants coordinate
hospital care and community support services.
Treatment
Clinical trials
Persons with recurrent tumors or tumors resistant to
treatment are often offered participation in an experimental
protocol or clinical trial. Experimental treatments include
gene therapy that introduces substances into the brain
tumor, changing the genetic makeup of the tumor cells.
Another experimental therapy involves new forms of
brachytherapy, where radioactive pellets are implanted
directly into the tumor.
The scientific community continually conducts clinical trials
in the effort to find new drugs and treatments that are
effective against cancer, including those types most often
occurring in the brain and spinal cord. As of mid-2004, the
National Institutes of Health (NIH) and related agencies were
sponsoring more than 200 ongoing studies and trials
specific for the treatment of brain and spinal cord tumors.
Updated information on these and other trials can be found
at the NIH website for clinical trials at .
Prognosis