Brain Cancer Center

The National Cancer Institute reports that more than 17,000 Americans are diagnosed with primary brain cancer each year. While brain tumors can develop at any age, studies show that they occur most commonly in children younger than eight years old and adults over age 65.

Tumors that originate in brain tissue are called primary brain tumors. When cancer develops elsewhere in the body and spreads (metastasizes) to the brain, it is known as a secondary brain tumor. The brain and spinal cord together make up the central nervous system.

Types of Brain Tumors

Primary brain tumors are categorized by the type of tissue in which they first develop. The most common brain tumors are called gliomas, which originate in the glial (supportive) tissue.

There are a number of different types of gliomas, including the following:

• Astrocytomas develop from small, star-shaped cells called astrocytes. They may arise anywhere in the brain or spinal cord. In adults, astrocytomas most often occur in the cerebrum, which is the largest part of the brain. The cerebrum fills most of the upper skull, and uses sensory information to tell us what is going on around us, and tell our body how to respond. The left hemisphere controls the muscles on the right side of the body, while the right hemisphere controls the muscles on the left. The cerebrum also controls speech and emotions, as well as reading, thinking and learning.
• Glioblastomas (also called glioblastoma multiforme or grade IV astrocytoma) are malignant astrocytomas that grow and spread aggressively. Glioblastomas occur most often in adults between the ages of 45 and 70.
• Brain stem gliomas arise in the brain stem, which controls many vital functions such as body temperature, blood pressure, breathing, hunger, and thirst. The brain stem connects the brain with the spinal cord. Tumors in this area can be difficult to treat. Most brain stem gliomas are high-grade astrocytomas.
• Ependymomas usually occur in the lining of the ventricles, or spaces in the brain and around the spinal cord. Although ependymomas can develop at any age, these tumors most commonly arise in children and adolescents.
• Oligodendrogliomas develop in the cells that produce myelin, the fatty covering that protects nerves in the brain and spinal cord. These tumors are very rare, and usually occur in the cerebrum. They are slow growing and generally do not spread into surrounding brain tissue. While they occur most often in middle-aged adults, these tumors have been found in people of all ages.

There are other types of brain tumors that do not begin in glial tissue, including the following:

• Meningiomas grow from the meninges, which are the three thin membranes that surround the brain and spinal cord. These tumors are usually benign. Because these tumors tend to grow very slowly, the brain may be able to adjust to their presence. Meningiomas frequently grow quite large before they cause symptoms. They occur most often in women ages 30 to 50.
• Craniopharyngiomas develop in the area of the brain near the pituitary gland (the main endocrine gland which produces hormones that control other glands and many body functions, especially growth) near the hypothalamus. These tumors are usually benign. However, they may sometimes be considered malignant because they may create pressure on, or damage, the hypothalamus and affect vital functions (such as body temperature, hunger and thirst). These tumors occur most often in children and adolescents or in adults over age 50.
• Germ cell tumors arise from developing sex (egg or sperm) cells, also known as germ cells. The most common type of germ cell tumor in the brain is the germinoma. Aside from the brain, germinomas can form in the ovaries, testicles, chest, and abdomen. Most germ cell tumors occur in children.
• Pineal region tumors occur in or around the pineal gland, a small organ located in the center of the brain. The pineal gland produces melatonin, a hormone that plays an important role in the sleep-wake cycle. These tumors can be slow growing (pineocytoma) or fast growing (pineoblastoma). Since the pineal region is very difficult to reach, it is often difficult to remove these tumors.
• Medulloblastomas are fast-growing brain tumors that develop from the neurons of the cerebellum in the lower back of the brain. These tumors are usually found in children or young adults.

Brain Cancer Risk Factors

It is not known what causes brain tumors. Scientists have identified certain risk factors that increase a person's chance of developing a brain tumor. Exposure to toxic chemicals is one such risk factor. Studies show that some types of brain tumors are more frequent among workers in oil refining, rubber manufacturing, and drug manufacturing. Chemists and embalmers also have a higher incidence of brain tumors.

Researchers are also looking at exposure to viruses as a possible cause. In addition, people receiving radiation therapy to the head during childhood may also be at increased risk for developing brain tumors. Since brain tumors may occur in several members of the same family, scientists are also studying families with a history of brain tumors to see whether heredity is a cause. In most cases, brain cancer patients have no clear risk factors.

Brain Cancer Treatment

Prior to treatment, many patients with brain tumors are given steroids, which are drugs that relieve swelling (edema). Patients may also be given anticonvulsant medication to prevent or control seizures.

If hydrocephalus (an accumulation of cerebrospinal fluid within the brain) is present, the patient may need a shunt to drain the fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe, in which excess fluid is carried away from the brain and is absorbed in the abdomen, or in some cases, into the heart.

At Cancer Treatment Centers of America (CTCA), our physicians use many tools to help you fight brain cancer on all fronts. Our cancer experts provide a powerful combination of traditional and new, innovative therapies. At CTCA, your care team will work closely with you to determine the appropriate combination of therapies for you, which may include:

• Surgery is the most common treatment for brain tumors that can be reached surgically (if the tumor is not too deep within the brain). Surgery may also be used to relieve pressure of the tumor on the brain, which can in turn reduce symptoms. If the tumor can not be removed in its entirety without damage to the surrounding tissue, radiation and/or chemotherapy may be used to treat the remaining cancer cells.
• Intensity Modulated Radiation Therapy (IMRT) is a form of 3D conformal radiotherapy. IMRT employs a powerful, advanced computer program that plans a precise dose of radiation. Then, beams of radiation of different intensities are aimed at the tumor in three dimensions, based on individual tumor size, shape and location. IMRT can allow for higher radiation doses than traditional radiotherapy methods, while at the same time helping to spare surrounding healthy tissue.

In addition to the therapies described above, CTCA enriches your treatment by offering complementary medicine therapies, such as naturopathic medicine, nutrition therapy, mind-body medicine, oncology rehabilitation, and spiritual counseling. At CTCA, we are here for you every step of the way in the fight against brain cancer.

Next Topic: Conventional Treatments for Brain Cancer