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Some brain tumors grow slowly and may become quite large before causing symptoms. Others may grow quickly and cause a sudden onset of symptoms. While most types of primary brain cancer may spread within the brain, it is rare for a primary brain tumor to spread outside the brain. Because the skull is rigid, providing no room for the tumor to expand, brain tumors may press on parts of the brain that control movement, speech, sight or other vital functions.
Even when brain tumors are benign (not cancer), they can cause serious problems. Although non-cancerous brain tumors usually grow slower than cancerous brain tumors, they may damage and press against normal brain tissue or the spine or spinal cord as they grow, potentially causing symptoms.
Brain structure and function
Emotions, thought, speech, vision, hearing, movement and many more important parts of everyday life begin in the brain. The brain sends messages throughout the body via the spinal cord and cranial nerves in the head. The network of the brain and spinal cord is called the central nervous system (CNS). Tumors can develop in the spinal cord and cranial nerves.
The hard, bony skull protects the brain, and the bones (vertebrae) of the spine protect the spinal cord. A liquid called cerebrospinal fluid surrounds both the brain and the spinal cord.
The brain has four main parts:
Cerebrum: The outer and largest part of the brain. The cerebrum has two halves that are called hemispheres. Each hemisphere has four lobes: frontal, parietal, temporal and occipital. The cerebrum is responsible for:
- Movement of muscles
- Senses of seeing, hearing, smelling, touch
- Perception of pain
Basal ganglia: These are found deeper inside the brain. They play a part in muscle movement.
Cerebellum: This section is at the back of the brain. It helps control and coordinate movement, such as walking and swallowing.
Brainstem: The brain stem is at the base of the brain. Its nerve fibers carry messages between the cerebrum and the rest of the body. This small area is very important and even plays a part in breathing and heartbeat.
Primary Brain Tumor Types
Brain tumors are classified by the types of cells within the tumor. Each type of brain tumor grows and is treated in a different way. Most types of brain tumors are slightly more common in men than women, though meningiomas are more common in women.
Craniopharyngiomas are non-cancerous, slow growing tumors located near the pituitary gland. Craniopharyngioma appears primarily in children and middle-age adults. The tumor itself can be part solid and part fluid-filled cyst. Symptoms can include vision changes and slow growth caused by the tumor’s impact on the pituitary gland. These tumors primarily require treatment with specialized surgery and possibly radiation after surgery.
Dermoid cysts and epidermoid tumors
Dermoid cysts and epidermoid tumors are benign growths that arise from epithelial cells, which form the outer layer of the body and line certain organs and glands. They can develop in various parts of the body, including the central nervous system. Both are slow growing, and are often not noticed for decades. They are treated by surgical removal.
Gliomas are a class of primary brain tumors. They are some of the fastest-growing brain tumors. The different types of gliomas include:
- Astrocytoma: Astrocytomas spread throughout the brain and mix with healthy tissue, making them difficult to treat. There are several types of astrocytoma:
- Low-grade astrocytomas: These include grade I pilocytic astrocytoma and grade II diffuse astrocytoma. Grade I astrocytomas are rarely seen in adults.
- Anaplastic astrocytoma: Grade III astrocytomas are known as anaplastic astrocytoma. These tumors are aggressive, high-grade cancers.
- Glioblastoma: Grade IV astrocytomas are called glioblastoma or GBM. Glioblastoma is the most common malignant (cancerous) adult brain tumor and one of the fastest-growing tumors of the central nervous system.
- Ependymoma: Ependymomas arise from ependymal cells, which line the ventricles of the brain and the center of the spinal cord. The ventricles are chambers in the brain that produce and transport cerebrospinal fluid, which surrounds and protects the brain. Ependymomas may be found in the brain or the spine. Ependymomas are more commonly seen in children and are rare in adults.
- Oligodendroglioma: Oligodendroglioma is generally slow growing. It can be diagnosed as a grade II or grade III tumor.
These slow-growing tumors develop from the cells of blood vessels. A hemangioblastoma typically forms in the brainstem and cerebellum, but can appear in other locations, including the retina. About a quarter of cases are associated with von Hippel Lindau disease, a genetic condition that is tied to the development of multiple types of tumors and cancers.
Medulloblastoma is the most common pediatric malignant brain tumor, with about 500 children diagnosed a year in the United States. In adults, medulloblastoma is a rare tumor, with about 200 diagnoses each year. Learn more on our medulloblastoma page.
Meningioma is the most common primary brain tumor. These tumors develop from cells in the meninges, the protective layer of tissue surrounding the brain and spinal cord. Most are benign and slow growing. Some, though, are malignant and aggressive. Surgery is usually the first treatment for meningiomas that grow and cause symptoms.
Pineal Gland Tumors
The pineal gland is located deep in the brain and makes the sleep regulating hormone melatonin. Tumors of the pineal gland can be benign or malignant. Pineal tumors include pineocytoma and pineoblastoma.
Pituitary tumors, also called pituitary adenomas, are usually benign (non-cancerous) growths on the pituitary gland. The pituitary gland is a key part of the endocrine system, which controls the growth and development. Learn more on our pituitary tumor page.
Sarcomas are broad category of tumors that form in bones and the body’s soft tissues, including cartilage, fat, and muscle. Soft tissue sarcomas are more common than bone sarcomas. Bone sarcoma types include Ewing’s sarcoma and osteosarcoma. Some gliomas have sarcoma-like characteristics and are called gliosarcomas. Gliosarcomas behave aggressively similar to glioblastomas.
Sarcomas may also be found in the spine or skull base, including chordoma. Chordomas are rare sarcoma tumors that grow in the base of the skull and bones of the spine. Doctors believe they develop from the leftover cells that served as the framework for the skull base and spine when the patient was a developing embryo. When chordomas form in the skull, they can push into the brain and cause many of the same symptoms as brain tumors, including headaches, dizziness and confusion. Chordomas can involve multiple critical nerves and arteries, making them difficult to treat. Treatment may require the use of specialized surgery, radiation therapy and/or chemotherapy.
Primary Brain Tumor Risk Factors
Anything that increases your chance of getting a brain tumor is a risk factor. Research is ongoing into the causes and risk factors of brain tumors. While no definite risk factors have been found for brain tumors, some factors may put you at increased risk, including:
- Prior radiation exposure to the brain, often as treatment for another cancer
- Family history of certain conditions including:
Some types of brain tumors may be passed down from one generation to the next, if you have a family history of the conditions listed above. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Learn more about brain tumors:
Why choose MD Anderson for brain tumor treatment?
Each patient who comes to MD Anderson’s Brain and Spine Center for brain tumor treatment receives customized care from some of the nation’s top experts.
From diagnosis through treatment and follow-up, you are the focus of a team of specialists who personalize your therapy for your unique situation.
We have one of the most active programs in the country for treatment of benign (non-cancerous) and malignant (cancer) brain tumors. This gives us a level of expertise and experience that can translate into more successful outcomes for many brain tumor patients.
Our team approach to care brings together more than 70 highly trained physicians from some 14 areas, all dedicated to brain tumor care or research. Each team is joined by a specially trained support staff. They all work together closely to be sure you receive individualized care.
Specialized, Comprehensive Brain Tumor Care
Successful brain tumor care depends on accurate diagnosis. At the Brain and Spine Center, four neuropathologists focus only on diagnosing brain and spine tumors. This sets us apart from many other cancer centers and helps us target each tumor for optimal outcomes.
Pioneering Brain Tumor Research
Several brain tumor treatments that are standard care around the world were discovered here, including:
- Berubicin, the first blood-brain penetrating agent
- Temozolomide, a drug to treat glioblastoma
And, we continue to look at new diagnostic and treatment approaches, including attacking disease on a molecular basis. We are able to offer clinical trials of target therapies in some cases.
We are proud to be one of the few cancer centers in the nation to house a prestigious federally funded brain tumor SPORE (Specialized Program of Research Excellence) program. We’re studying new ways to prevent and treat brain tumors to give patients everywhere futures filled with hope.
Take it one day at a time, and never give up.
BY Colin Clarke
My brain tumor symptom came on Feb. 15, 2015. I was playing in a soccer match with my team -- Express -- at Meyer Park in Spring, Texas. I burst though our opponent’s defense and calmly knocked the ball home for a goal. Seconds after the restart, I headed the ball.
What happened next was the first of multiple seizures. After passing out, I woke up on a stretcher as I was being put into an ambulance. This was not part of an elaborate goal celebration, as some of my teammates thought. This was for real.
I was admitted to a local ER, where they found the cause of my seizures: a brain tumor. A biopsy a few days later revealed I had a glioma. We decided to visit MD Anderson.
Accepting my brain tumor treatment plan
Our first appointment at MD Anderson was with radiation oncologist David Grosshans, M.D., Ph.D., in the Proton Therapy Center. To say he was positive was an understatement. “We’ll have you back on the soccer field,” he promised.
Our next stop was MD Anderson’s Brain and Spine Center, where we met neurosurgeon Sherise Ferguson, M.D., and neuro-oncologist Barbara O’Brien, M.D. They recommended a pretty intensive treatment plan that involved surgery to remove more of my brain tumor. I wasn’t thrilled and was in complete and utter denial, but reluctantly agreed.
Awake craniotomy and a new diagnosis
I had my surgery -- an awake craniotomy — on April 9, 2015. Dr. Ferguson explained how I would be woken up during surgery to map the motor areas of my brain, but that I wouldn’t feel anything. During the operation, I talked to anesthesiologist Ian Lipski, M.D. We discussed cars, cycling to work, Jack Reacher, JK Rowling’s “The Casual Vacancy,” traveling to Korea and – who knows why – cosmetic dentistry too.
That Saturday evening, Dr. Ferguson braved strong thunderstorms to personally deliver the good news about my diagnosis: post-operative pathology revealed my tumor was actually a grade II oligodendroglioma, a low-grade brain tumor.
Caring providers make all the difference
After MD Anderson helped convince my insurance provider to cover my proton therapy treatment, I started on proton therapy with Dr. Grosshans. Seeing people from all over the planet in the waiting room made me realize I was being treated in a world-class facility. Six weeks and one terrible haircut later, I rang the gong and said goodbye to my proton family -- the techs and nurses.
Under Dr. O’Brien’s supervision, I then started temozolomide, an oral chemotherapy for brain cancer. Maintaining my blood count was a delicate balancing act at times, but I had the utmost confidence in my care team. They’re just really good at what they do. Throughout my chemotherapy, I had several MRI scans and frequent labs. Doing blood work near my home at MD Anderson in The Woodlands was extremely convenient.
When I completed treatment, Dr. O’Brien explained that I was not cured, but in a new phase of monitoring. I started with more MRIs and checkups every two months, then less often as my condition remained stable.
I’m now more than two years out from my initial diagnosis. Visits to the Brain and Spine Center are not nearly as daunting. I could describe the folks there as awesome, but that would only be half the story. They genuinely care. Yes, they give you the proper medicine, but it’s the rapport they build and the humor they dispense with treatment that makes the visits enjoyable. When your doctor takes the time to laugh with you, or the nurse asks if you have any more jokes, you know you’re in the best place.
A promise kept
At Dr. O’Brien’s urging last year, my family and I participated in Head for the Cure Houston, a 5K race that supports brain tumor research at MD Anderson. You can join team MD Anderson at the 5th Annual Head for the Cure Houston 5K on Saturday, Oct. 14. I was never likely to set a world record. In fact, Dr. O’Brien vanished over the horizon after the first mile marker. But I did finish.
This reminded me of Dr. Grosshans’ promise that I’d “be back on the soccer field.” I wasn’t, but I was up and running, and it was my choice not to play soccer -- not the tumor’s.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Glioblastoma Moon Shot
MD Anderson’s Glioblastoma Moon Shot® aims to rapidly and dramatically improve the disease’s survival rates and reduce suffering through powerful new treatment approaches and research.Learn more about the Glioblastoma Moon Shot