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What are adult brain tumors?
Adult brain tumors are diseases in which cancer (malignant) cells begin to
grow in the tissues of the brain. The brain controls memory and learning, senses
(hearing, sight, smell, taste, and touch), and emotion. It also controls other
parts of the body, including muscles, organs, and blood vessels.
A doctor should be seen if the following symptoms appear: frequent headaches,
vomiting, or difficulty walking or speaking.
If there are symptoms, a doctor may order a computed tomographic scan, a
special x-ray that uses a computer to make a picture of the brain. A magnetic
resonance imaging scan, which uses magnetic waves to make a picture of the
brain, may also be done. Often surgery is required to determine if there is a
brain tumor and to see what type of tumor it is.
The chance of recovery (prognosis) and choice of treatment depend on the type
of brain tumor and the patient's general state of health.
Stage Explanation
Types of adult brain tumor
Once adult brain tumor is found, more tests will be done to determine the
type of tumor. A doctor will also need to know how different the tumor cells are
from the cells that are near it, which is called the histologic grade of the
tumor. To plan treatment, the doctor needs to know the type and grade of brain
tumor. The following types are used to group adult brain tumors.
Astrocytomas
Astrocytomas are tumors that start in brain cells called astrocytes. There
are different kinds of astrocytomas, which are defined by how the cancer cells
look under a microscope.
Noninfiltrating astrocytomas
Noninfiltrating astrocytomas are tumors that grow slowly and usually do
not grow into the tissues around them.
Well-differentiated mildly and moderately anaplastic astrocytomas
Well-differentiated mildly and moderately anaplastic astrocytomas are
slow growing, but grow more quickly than noninfiltrating astrocytomas. They
start to grow into other tissues around them.
Anaplastic astrocytomas
Anaplastic astrocytomas have cells that look very different from normal
cells and that grow more rapidly.
Glioblastoma multiforme
Glioblastoma multiformes are tumors that grow very quickly and have
cells that look very different from normal cells. Glioblastoma multiforme is
also called grade IV astrocytoma.
Brain Stem Gliomas
Brain stem gliomas are tumors located in the bottom part of the brain
that connects to the spinal cord (the brain stem).
Cerebellar Astrocytomas
Cerebellar astrocytoma occurs in the area of the brain called the
cerebellum, which is just above the back of the neck. Cerebellar astrocytomas
usually grow slowly and do not usually spread from where they began to other
parts of the brain or body.
Ependymal Tumors
Ependymal tumors are tumors that begin in the ependyma, the cells that line
the passageways in the brain where special fluid that protects the brain and
spinal cord (called cerebrospinal fluid) is made and stored. There are different
kinds of ependymal tumors, which are defined by how the cells look under a
microscope.
Well-differentiated ependymomas
Well-differentiated ependymomas have cells that look very much like
normal cells and grow quite slowly.
Anaplastic ependymomas
Anaplastic ependymomas are ependymal tumors that do not look like normal
cells and grow more quickly than well-differentiated ependymal tumors.
Ependymoblastomas
Ependymoblastomas are rare cancers that usually occur in children. They
may grow very quickly.
Oligodendroglial Tumors
Oligodendroglial tumors begin in the brain cells called oligodendrocytes,
which provide support and nourishment for the cells that transmit nerve
impulses. There are different types of oligodendroglial tumors, which are
defined by how the cells look under a microscope.
Well-differentiated oligodendrogliomas
Well-differentiated oligodendrogliomas are slow-growing tumors that look
very much like normal cells.
Anaplastic oligodendrogliomas
Anaplastic oligodendrogliomas grow more quickly, and the cancer cells look
very different from normal cells.
Other Brain Tumors
Mixed gliomas
Mixed gliomas are brain tumors that occur in more than one type of brain
cell, including cells of astrocytes, ependymal cells, and/or oligodendrocytes.
Medulloblastoma
Medulloblastomas are brain tumors that begin in the lower part of the
brain. They are almost always found in children or young adults. This type of
cancer may spread from the brain to the spine.
Pineal parenchymal tumors
Pineal region tumors are tumors found in or around a tiny organ located
near the center of the brain (the pineal gland). The tumors can be slow growing
(pineocytomas) or fast growing (pineoblastomas). Astrocytomas may also start
here.
Germ cell tumors
Germ cell tumors arise from the sex cells. There are different kinds of
germ cells, including germinomas, embryonal carcinomas, choriocarcinomas, and
teratomas.
Craniopharyngiomas
Craniopharyngiomas are tumors that occur near the pituitary gland. The
pituitary gland is a small organ about the size of a pea; this gland is located
just above the back of the nose and controls many of the body's functions.
Meningiomas
Meningiomas are tumors that occur in the membranes that cover and
protect the brain and spinal cord (the meninges). Meningiomas usually grow
slowly.
Malignant meningiomas
Malignant meningioma is a rare tumor that grows more quickly than other
meningiomas.
Choroid Plexus Tumors
The choroid plexus is tissue located in the spaces inside the brain
called ventricles. The choroid plexus makes the fluid that fills the ventricles
and surrounds the brain and spinal cord. Tumors of the choroid plexus can grow
slowly (choroid plexus papilloma) or grow more rapidly (anaplastic choroid
plexus papilloma). The rapidly growing tumors are more likely to spread to other
places in the brain and to the spinal cord.
Recurrent
Recurrent disease means that the cancer has come back (recurred) after it
has been treated. It may come back in the brain or in another part of the body.
Treatment Option Overview
How adult brain tumors are treated
There are treatments for all patients with an adult brain tumor. Three kinds
of treatment are used:
- Surgery
- Radiation therapy
- Chemotherapy
Surgery is the most common treatment of adult brain tumors. To take out the
cancer from the brain, a doctor will cut a part of the bone from the skull to
get to the brain. This operation is called a craniotomy. After the doctor
removes the cancer, the bone will be put back or a piece of metal or fabric will
be used to cover the opening in the skull.
Radiation therapy uses x-rays produced by a machine called a linear
accelerator or a cobalt machine to kill cancer cells from the outside and shrink
tumors (external-beam radiation therapy). Radiation therapy may also be used by
putting materials that produce radiation (radioisotopes) through thin plastic
tubes into the tumor to kill cancer cells from the inside (internal radiation
therapy).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in the vein or muscle.
Chemotherapy is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells throughout the
body.
Biological therapy (using the body's immune system to fight cancer) is also
being studied in clinical trials. Biological therapy uses materials made by the
body or made in a laboratory to boost, direct, or restore the body's natural
defenses against disease. Biological therapy is sometimes called biological
response modifier therapy or immunotherapy.
Treatment by type
Treatment of adult brain tumor depends on the type and stage of the disease,
and the patient's age and overall health.
Standard treatment may be considered because of its effectiveness in past
studies, or participation in a clinical trial may be considered. Not all
patients are cured with standard therapy, and some standard treatments may have
more side effects than are desired. For these reasons, clinical trials are
designed to find better ways to treat cancer patients and are based on the most
up-to-date information. Clinical trials are ongoing in most parts of the country
for most types of adult brain tumor. To learn more about clinical trials, call
the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Adult Noninfiltrating Astrocytomas
Treatment may be one of the following:
Surgery to remove the cancer.
Surgery followed by external-beam radiation therapy.
If anaplastic astrocytoma comes back (recurs) after surgery,
treatment may be radiation therapy if it was not given before. If radiation
therapy was given before, clinical trials of chemotherapy or biological
therapy should be considered.
Adult Well-Differentiated Mildly and Moderately Anaplastic Astrocytomas
Treatment may be one of the following:
Surgery followed by external-beam radiation therapy.
Surgery alone.
A clinical trial of surgery followed by radiation therapy and
chemotherapy.
Adult Anaplastic Astrocytomas
Treatment may be one of the following:
Surgery followed by external-beam radiation therapy.
Surgery followed by external-beam radiation therapy and
chemotherapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
A clinical trial of chemotherapy drugs, which are placed in
the body during surgery.
Adult Glioblastoma Multiforme
Treatment may be one of the following:
Surgery followed by external-beam radiation therapy and
chemotherapy.
Surgery followed by external-beam radiation therapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
A clinical trial of chemotherapy drugs, which are placed in
the body during surgery.
Adult Brain Stem Gliomas
Treatment may be one of the following:
External-beam radiation therapy.
A clinical trial of chemotherapy or biological therapy.
Adult Well-Differentiated Ependymomas
Treatment may be one of the following:
Surgery to remove the cancer.
Surgery to remove the cancer followed by external-beam
radiation therapy.
A clinical trial of chemotherapy or biological therapy.
Adult Malignant Ependymomas
Treatment may be one of the following:
Surgery to remove the cancer followed by external-beam
radiation therapy.
A clinical trial of external-beam radiation therapy with
chemotherapy.
A clinical trial of chemotherapy or biological therapy.
Adult Well-Differentiated Oligodendrogliomas
Treatment may be one of the following:
Surgery to remove the cancer followed by external-beam
radiation therapy.
Surgery to remove the cancer.
A clinical trial of radiation therapy plus chemotherapy.
Adult Anaplastic Oligodendrogliomas
Treatment may be one of the following:
Surgery to remove the cancer followed by external-beam
radiation therapy.
Surgery followed by external-beam radiation therapy and
chemotherapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
Mixed Gliomas
Treatment may be one of the following:
Surgery followed by external-beam radiation therapy.
Surgery followed by external-beam radiation therapy and
chemotherapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
Adult Medulloblastoma
Treatment may be one of the following:
Surgery to remove the cancer plus external-beam radiation
therapy.
A clinical trial of surgery plus external-beam radiation
therapy and chemotherapy.
Adult Pineal Parenchymal Tumors
Treatment may be one of the following:
Surgery plus external-beam radiation therapy.
Surgery plus external-beam radiation therapy plus
chemotherapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
Adult Central Nervous System Germ Cell Tumors
Treatment depends on whether the cancer can be removed in an operation, the
kind of cells, the location of the tumor, and other factors.
Adult Craniopharyngiomas
Treatment may be one of the following:
Surgery to remove the cancer.
Surgery to remove the cancer followed by radiation therapy.
Adult Meningiomas
Treatment may be one of the following:
Surgery to remove the tumor.
Surgery plus radiation therapy.
Radiation therapy for patients with tumors that cannot be
removed with surgery.
Adult Malignant Meningiomas
Treatment may be one of the following:
Surgery followed by external-beam radiation therapy.
A clinical trial of new forms of radiation therapy, such as
internal radiation, radiation given during surgery, or radiation given with
drugs to make the cancer cells more sensitive to radiation.
A clinical trial of chemotherapy or biological therapy
following radiation therapy.
Recurrent Adult Brain Tumors
Treatment may be one of the following:
Surgery alone or followed by chemotherapy.
External-beam radiation therapy alone, if not used during
previous treatment, with or without chemotherapy.
Internal radiation therapy.
Chemotherapy.
A clinical trial of chemotherapy drugs, which may placed in
the body during surgery.
Clinical trials are taking place in many parts of the country. Information
about ongoing clinical trials is available from the NCI
Cancer.gov Web site. Choosing the most appropriate cancer treatment is a
decision that ideally involves the patient, family, and health care team.
Source: National Institutes of Health; National Cancer Institute
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