Brain Cancer

There are many different types of brain tumors, based on what cells are affected and how they appear under a microscope. Tumors can be classified into four general categories:

Gliomas

These tumors occur in the glial cells, which help support and protect critical areas of the brain. Gliomas are the most common type of brain tumor in adults, responsible for about 42% of all adult brain tumors. Gliomas are further characterized by the types of cells they affect:

Astrocytoma: Star-shaped cells that protect neurons. Tumors of these cells can spread from the primary site to other areas of the brain, but rarely spread outside the central nervous system. Astrocytomas are graded from I to IV depending on the speed of progression:

Grade I (pilocytic astrocytoma): Slow growing, with little tendency to infiltrate surrounding brain tissue. Most common in children and adolescents.

Grade II (diffuse astrocytoma): Fairly slow-growing, with some tendency to infiltrate surrounding brain tissue. Mostly seen in young adults.

Grade III (anaplastic/malignant astrocytoma): These tumors grow rather quickly and infiltrate surrounding brain tissue.

Grade IV (glioblastoma multiforme, GBM): An extremely aggressive and lethal form of brain cancer. Unfortunately, it is the most common form of brain tumor in adults, accounting for 67% of all astrocytomas.

Oligodendroglioma: These cells make myelin, a fatty substance that forms a protective sheath around nerve cells. Oligodendrogliomas, which make up 4% of brain tumors, mostly affect people over 45 years of age. Some subtypes of this tumor are particularly sensitive to treatment with radiation therapy and chemotherapy. Half of patients with oligodendrogliomas are still alive after five years.

Ependymoma: These tumors affect ependymal cells, which line the pathways that carry cerebrospinal fluid throughout the brain and spinal cord. Ependymomas are rare and make up 2% of all brain tumors, however they are the most common brain tumor in children. They generally don’t affect healthy brain tissue and don’t spread beyond the ependyma. Although these tumors respond well to surgery, particularly those on the spine, ependymomas cannot always be completely removed. The five-year survival rate for patients over age 45 approaches 70%.

Meningiomas

These tumors affect the meninges, the tissue that forms the protective outer covering of the brain and spine. One-quarter of all brain and spinal tumors are meningiomas, and up to 85% of them are benign. Meningiomas can occur at any age, but the incidence increases significantly in people over age 65. Women are twice as likely as men to have meningiomas. They generally grow very slowly and often don’t produce any symptoms. In fact, many meningiomas are discovered by accident. Meningiomas can be successfully treated with surgery, but some patients, particularly the elderly, may be candidates for watchful waiting to monitor the disease.

Acoustic Neuroma / Schwannomas

Schwann’s cells are found in the sheath that covers nerve cells. Vestibular schwannomas, also known as acoustic neuromas, arise from the 8th cranial nerve, which is responsible for hearing. Specific symptoms of vestibular schwannoma include buzzing or ringing in the ears, one-sided hearing loss and/or balance problems. Schwannomas are typically benign and respond well to surgery.

Medulloblastoma

This a common brain tumor in children, usually diagnosed before the age of 10. Medulloblastoma occurs in the cerebellum, which has a crucial role in coordinating muscular movements. Some experts believe that medulloblastomas arise from fetal cells that remain in the cerebellum after birth. Tumors grow quickly and can invade neighboring portions of the brain, as well as spreading outside the central nervous system. Medulloblastoma is slightly more common in boys. Read more about medulloblastoma

Brain Tumor Symptoms

Depending on the location and size of the tumor, symptoms experienced by each patient may vary. Most of the common symptoms are due to increased intracranial pressure as the growing tumor affects surrounding structures:

• Frequent headaches (reported by 50% of patients)
• Blurry vision
• Nausea and/or vomiting
• Personality or cognitive changes

Other symptoms are site-specific, including seizures, speech impairment, weakness or numbness on one side and problems with coordination, balance or mobility.

Risk Factors

Most brain tumors are sporadic, meaning they have no known cause. However, there are some risk factors that have been studied.

Radiation exposure: people exposed to large doses of radiation either on the job or as a cancer treatment may be at increased risk.

Genetic syndromes: people with von Hippel Lindau disease or neurofibromatosis type 2 may be more susceptible to developing brain tumors.

Cell phone use: a number of small studies have failed to prove any definitive connection between cell phones and brain tumors.

Screening

Currently, there are no blood tests or screening exams in place to detect brain tumors before they start causing symptoms. Tumors are typically found only after a person starts experiencing associated symptoms. A patient's survival chances are determined in most cases not by how early the disease is detected, but rather by the patient’s age, type of tumor and its location. But, as with any disease, the earlier problems are detected and treated, the more helpful treatment is likely to be.

Diagnosis

Although many brain tumors can easily be seen with a CT scan or MRI, a stereotactic biopsy is sometimes needed to confirm the diagnosis and type of tumor. A special frame is attached to the patient’s head and adjusted to the tumor coordinates provided by a CT scan or other image of the brain. A small hole is drilled into the skull and a needle is inserted to obtain a sample of the tumor for inspection under a microscope. Advances in imaging technology have allowed stereotactic biopsies to be done without the frame.

Surgery

Surgery is the most common treatment for brain tumors. However, with more aggressive brain cancers, complete removal of the tumor is not possible, and surgery is done to “debulk” or reduce the tumor as much as possible. Surgery may be combined with radiation therapy or followed with chemotherapy to destroy any remaining cancer cells.

BrainSUITE® iMRI, a state-of-the-art operating room, combines surgery with real-time magnetic resonance imaging (MRI). This advanced technology allows surgeons to take scans (pictures) during surgery while patients are still in the operating room. The MRI scans are available within minutes, allowing the surgeon to make immediate decisions based on current information.

At M. D. Anderson, BrainSUITE is used for selected surgery patients. The surgeon can temporarily stop surgery, perform a MRI, and analyze the images to determine if the tumor has been removed completely, or if surgery should continue. The benefits of  BrainSUITE® include:

• Surgeon is able to remove more tumor
• MRI during surgery can help identify normal tissue in critical parts of the brain that need protection during tumor removal
• In some patients, it may reduce the need for another surgery

Other Treatments

Radiation may be used as a primary treatment for brain tumors in difficult or critical locations in the brain.

M. D. Anderson researchers are studying new treatments for brain tumors, including the development of drugs that make the tumor more sensitive to radiation treatment, innovative therapies using the body’s immune system, and the introduction of tumor-destroying viruses.

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Listed below are just some of the ways to find help...and hope.

Learn more about patient and family support programs

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.

Find a support group

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression and traditional Eastern medicine such as acupuncture.

Find complementary therapies at M. D. Anderson

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Listed below are just some of the ways to find help...and hope.

Learn more about patient and family support programs

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.

Find a support group

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression, and traditional Eastern medicine such as acupuncture.

Find complementary therapies at M. D. Anderson

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers. 

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.

Cancer is a journey that no one needs to take alone. There are many forms of support to help you through every stage: diagnosis, treatment and survivorship. Whether you meet with other cancer survivors like yourself, use complementary therapies or individual coping mechanisms, support is available. Listed below are just some of the ways to find help...and hope.

Learn more about patient and family support programs

Support Groups

Getting together with other cancer patients in a support group is a valuable coping tool. Support groups are usually focused on a single disease or topic, such as breast cancer survivors or people coping with life-changing side effects from their cancer or cancer therapy. These groups allow participants to meet others like themselves and seek strength from each other. Most major cities and cancer hospitals offer support groups that meet weekly or monthly. There are also dozens of online support web sites or message boards for those who may not have access to a traditional meeting.

Find a support group

Complementary Therapies

Complementary therapies are used in conjunction with cancer treatment, in an effort to reduce treatment side effects, ease depression and anxiety and help cancer patients take their mind off the negative aspects of their situation. Complementary therapies may include mind-body exercises like yoga, tai chi and Qi gong; visualization or guided imagery; using art or music as therapy and self-expression, and traditional Eastern medicine such as acupuncture.

Find complementary therapies at M. D. Anderson

Physical Activity

Staying physically active as much as possible during cancer treatment has many positive benefits. Physical activity stimulates the release of endorphins, a hormone that helps elevate mood, as well as decreasing feelings of fatigue.

Exercises for cancer patients can range from simple stretches done in the bed or chair, to more active pursuits such as walking or light gardening work. However, it’s important not to push yourself too hard. Check with your doctor before attempting any physical activity to make sure you are up to it.

Journaling/Blogging

Many people find it helpful to keep a journal of their cancer treatment experience. It may be as simple as recording symptoms and side effects into a notebook, or may include personal emotions and opinions about what they may be going through. Journals can be private, like a diary, or shared with loved ones and even strangers.

Increasingly, people are turning to the Internet to share their cancer journey with the world at large and to seek out others with similar experiences. Many cancer patients have begun their own web log, or “blog” to publicize their battle with cancer. Twitter, a mini-blogging technology that limits posts to 140 characters, has also proven to be a helpful tool for cancer patients to keep friends updated and reach out to others.