Understanding brain and spinal tumors

Spinal Tumor

Brain and spinal cord tumors feature abnormal tissue growth inside the skull or the bony spinal column. Tumors are classified as benign (noncancerous) if the cells that make up the growth are similar to normal cells, grow slowly, and are confined to one location. Tumors are malignant (cancerous) when the cells are different from normal cells, grow quickly, and can spread easily to other locations.

Since the central nervous system (CNS) is housed within rigid, bony quarters (the skull and spinal column), any abnormal growth can place pressure on sensitive nerve tissues and impair function. While malignant cells elsewhere in the body can easily seed tumors inside the brain and spinal cord, malignant CNS tumors rarely spread out to other body parts.

Most spinal cord cancers are metastatic, meaning that they arise from a wide variety of primary cancers. These include lung, breast, prostate, head and neck, gynecologic, gastrointestinal, thyroid, melanoma, and renal cell carcinoma.

When new tumors start to grow within the brain or spinal cord, they are called primary tumors. Primary CNS tumors rarely grow from neurons because once neurons are mature they no longer divide and multiply. Instead, most tumors are caused by out-of-control growth among cells that surround and support neurons.

Primary CNS tumors – such as gliomas and meningiomas – are named by the types of cells comprising them, their location, or both.

Causes

The cause of most primary brain and spinal cord tumors remains a mystery. Scientists don't know exactly why and how cells in the nervous system or elsewhere in the body lose their normal identity and grow uncontrollably.

Some of the possible causes under investigation include viruses, defective genes, and chemicals. Brain and spinal cord tumors are not contagious or, at this time, preventable.

Spinal cord tumors are less common than brain tumors.

About 10,000 Americans develop primary or metastatic spinal cord tumors each year. Although spinal cord tumors affect people of all ages, they are most common in young and middle-aged adults.

Brain tumors affect about 40,000 Americans each year. About half of these tumors are primary and the remainder are metastatic.

Symptoms

Brain and spinal cord tumors cause many diverse symptoms, which generally develop slowly and worsen over time.

Some of the more common symptoms of a brain tumor include:

  • Headaches
  • Seizures, a disruption of the normal flow of brain cell electricity that can lead to convulsions, loss of consciousness, or loss of bladder control
  • Nausea and vomiting
  • Vision or hearing problems

Increased intracranial pressure can also decrease blood flow in the eye and trigger swelling of the optic nerve, which in turn causes blurred vision, double vision, or partial visual loss.

Other symptoms of a CNS tumor may include the following: behavioral and cognitive symptoms, motor or balance problems, pain, sensory changes such as numbness, and decreased skin sensitivity to temperature.

​Diagnosis and treatment

Special imaging techniques, especially computed tomography (CT) and magnetic resonance imaging (MRI), have greatly improved the diagnosis of CNS tumors. In many cases, these scans can detect the presence of a tumor even if it is less than half an inch across.

The three most commonly used treatments are surgery, radiation, and chemotherapy. When a tumor compresses the spinal cord or its surrounding structures, corticosteroids may be given to reduce the swelling and preserve nerve function until the tumor can be removed.

Surgery to remove as much tumor as possible is usually the first step in treating an accessible tumor – as long as there is little risk of neurological damage. Fortunately, neurosurgical advances now make it possible for doctors to reach tumors that were previously considered inaccessible.

Doctors treat most malignant, inaccessible, or inoperable CNS tumors with radiation and/or chemotherapy. Radiation therapy bombards tumor cells with lethal beams of energy. Chemotherapy uses tumor-killing drugs that are given orally or injected into the bloodstream. Doctors often use a combination of drugs for chemotherapy.

The overall outcome of radiation therapy is not always good. Radiation can damage spinal cord myelin, which can lead to paralysis. Researchers are looking for better ways to target radiation or enhance its effectiveness, perhaps by making tumor tissue more vulnerable.

Researchers are studying brachytherapy (small radioactive pellets implanted directly into the tumor) as the optimal way to deliver radiotherapy to the tumor while sparing surrounding normal tissues.

Some cells within tumors are quite resistant to radiation. Using a gene therapy approach, scientists hope to kill these cells by inserting a "suicide" gene that could make the tumor cells sensitive to certain drugs or program the cancerous cells to self-destruct.

Blocking the formation of blood vessels (angiogenesis) is a very promising tool for the treatment of various cancers. Since brain tumors are the most angiogenic of all cancers, blocking their blood supply might prove to be especially effective.

The gamma knife is a newer tool that provides a precisely focused beam of radiation energy that delivers a single dose of radiation on target. The gamma knife does not require a surgical incision. Doctors have found it can help them reach and treat some small tumors that are not accessible through surgery.

Although most primary tumors of the spinal cord are not life threatening, they can cause significant disability. Goals of rehabilitation include functional improvement in mobility, self-care, and pain management.

Resources

If you are looking for more information on brain and spinal tumors or have a specific question, our information specialists are available business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9am to 5pm ET.

Additionally, the Reeve Foundation maintains a brain and spinal tumors fact sheet with additional resources from trusted Reeve Foundation sources. Check out our repository of fact sheets on hundreds of topics ranging from state resources to secondary complications of paralysis.

We encourage you to reach out to spinal tumor support groups and organizations, including:

  • The American Brain Tumor Association (ABTA) supports medical research and offers information and support for people with tumors and their families.
  • National Brain Tumor Society funds research to find treatments and improve clinical care for brain and spinal cord tumors. It offers information and access to quality of life and psychosocial support.
  • Musella Foundation for Brain Tumor Research is dedicated to improving the quality of life and survival times for brain tumor survivors. The Foundation has information on clinical trials, treatment outcomes.
  • Making Headway Foundation offers services and funds research for children with brain or spinal cord tumors.
  • National Cancer Institute, part of the National Institutes of Health and the Department of Health and Human Services, with an annual research budget of about $5 billion, is the leading U.S. agency to fight cancer of all kinds. Includes resources and information on brain and spinal cord cancers.
  • Spinal Cord Tumor Association, Inc. supports tumor survivors and their families.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.