Brain and Spinal Cord Tumors

What Are Brain and Spinal Cord Tumors?

Malignant (cancerous) or benign (non-cancerous) brain and spinal cord tumors are abnormal tissue growths originating from brain or spinal cord cells. Tumors in the spinal cord are rarer than brain tumors, but both types of tumors behave similarly.

A benign tumor does not contain cancer cells and generally does not recur once removed. Most benign brain tumors have clear boundaries, meaning they do not invade surrounding tissues. However, due to their size and location in the brain, these tumors can cause symptoms similar to cancerous tumors.

Malignant brain tumors contain cancer cells, often grow rapidly, and invade surrounding tissues. Malignant brain tumors rarely spread to other parts of the body but may recur after treatment.

Brain tumors are the most common solid tumors in children. Those occurring in infants and children differ from adult brain tumors both in terms of cell type and response to treatment.

Types of Brain and Spinal Cord Tumors

There are numerous types and subtypes of brain and spinal cord tumors. Some of the more common ones include:

Gliomas

Gliomas are the most common type of brain and spinal cord tumors, developing from parts of the brain known as glial cells. These cells make up more than half of the brain and assist in the normal functioning of neurons. There are several types of glial cells, and glioma tumors are named based on the specific glial cell type they originate from.

Medulloblastoma

Relatively common, this Grade IV tumor is highly malignant and often leads to rapidly progressing symptoms. Medulloblastomas are treated with a combination of surgery, radiation, and chemotherapy. Despite their aggressive nature, most medulloblastomas can be effectively treated.

Embryonal Tumors

These tumors develop from embryonal cells in the central nervous system during fetal development. After birth, most embryonal tumors in children become malignant. These tumors tend to grow rapidly and may spread to other parts of the brain and spinal cord.

Mixed Neuroglial Tumors

These brain tumors tend to be small and slow-growing. They are rare and mostly benign.

Tumors Arising from Non-Neuroepithelial Tissues

These tumors develop at the base of the brain and are generally benign, although not always.

Choroid Plexus Papilloma/Carcinoma

These tumors typically arise in the ventricles (fluid-filled spaces in the depths of the brain). They can be either benign or malignant.

Meningeal Tumors

These tumors develop from the meninges, the membranes surrounding the brain and spinal cord. Meningeal tumors are usually benign but can become malignant. They are rare in children and more common in adults.

Ependymoma

These tumors consist of cells covering the brain’s ventricles and the center of the spinal cord.Spinal cord tumors can originate from tissues surrounding the spinal cord and push inward. They can come from surrounding muscles or bones, exerting pressure on the spinal cord. Examples of these tumors include:

Neuroblastomas: Arise from primitive nerve cells in small children.

Sarcomas: Tumors originating from muscle tissue. Osteochondromas: Tumors originating from bone.

Causes of Brain and Spinal Cord Tumors

The exact cause of brain and spinal cord tumors is not fully understood. Researchers have found that some chemical changes in normal brain cells may lead to the development of brain tumors. Most brain tumors involve abnormalities in genes that control the cell cycle (growth, division, and death). These abnormalities result in uncontrolled cell growth.

Apart from exposure to radiation, childhood brain tumors have no known lifestyle or environmental causes. It’s important to remember that if your child has a brain tumor, there is nothing you or your child can do to prevent it.

Symptoms of Brain Tumors

Symptoms of a brain or spinal cord tumor depend on the tumor’s size, type, and location. A tumor causing pressure on a nerve or damaging a part of the brain can lead to symptoms. Additionally, a tumor blocking the flow of cerebrospinal fluid can result in hydrocephalus or brain swelling.

Common symptoms of brain and spinal cord tumors include:

Balance problems

Back pain or numbness

Changes in mood, personality, or concentration

Changes in speech, vision, or hearing

Headaches (usually worse in the morning)

Memory problems

Nausea and vomiting

Numbness or tingling in the arms or legs

Seizures

Scoliosis (curvature of the spine)

Other conditions can cause similar symptoms, so consulting your child’s doctor for an accurate diagnosis is crucial.

Diagnosis of Brain and Spinal Cord Tumors

The diagnosis of a brain tumor begins with a physical examination and medical history. Further procedures and tests, including the following, may be required to diagnose a brain tumor:

Computed tomography (CT): An X-ray that shows the inside of the brain from different angles.

Lumbar puncture: A test checking the fluid surrounding the brain and spinal cord.

Magnetic resonance imaging (MRI): An imaging scan using powerful magnets to create detailed pictures of internal body tissues.

Detailed neurological examination: An assessment of the body’s nervous system, including motor responses such as neurons and reflexes.

Positron emission tomography (PET) scan: An imaging test using mild radiation to produce images of processes in the body.

Biopsy: If a tumor is found, samples of tumor cells are removed for microscopic examination to obtain more information about the specific type of brain or spinal cord tumor.

Treatment of Brain Tumors

A customized treatment plan is created for your child based on:

• Type of brain or spinal cord tumor
• Tumor location and size
• Your child’s age and overall health
• Your child’s tolerance and response to treatment
• Your and your child’s preferences

Treatment for a brain tumor may include one or a combination of the following options:

Surgery: The initial step in brain tumor treatment is often surgery to remove the tumor.

Antibiotics: These medications may be prescribed to treat and prevent infections.

Anticonvulsant medications: Prescribed to alleviate nerve pain and prevent or stop seizures.

Chemotherapy: Chemotherapy targets dividing cells, commonly found in growing tumors. The type of drug used depends on the tumor.

Radiation: This treatment uses high-energy particles or waves to damage cancer cells’ DNA, killing them. Radiation can be focal (concentrated in a single area) or general (treating the entire brain and spinal cord), depending on the tumor type.

Proton therapy: A form of radiation treatment using proton beams to destroy cancer cells.

Steroids: These medications can temporarily alleviate symptoms like edema around the tumor.

Ventriculoperitoneal (VP) shunt: A surgical procedure to relieve hydrocephalus (excess fluid in the brain’s ventricles). The shunt is a thin tube allowing excess fluid to flow to another part of the body.

Treatment for spinal cord tumors depends on the tumor type and may include:

• Surgery to remove the tumor
• Radiation
• Chemotherapy

Secondary treatments for brain and spinal cord tumors include:

Speech-language pathology: Brain and spinal cord tumors and their treatments can affect your child’s speech and swallowing ability. Speech-language pathology helps patients regain or compensate for these skills.

Physical therapy: Brain and spinal cord tumors and their treatments can impact your child’s balance, range of motion, and strength. Physical therapy assists patients in regaining or compensating for these skills.

Occupational therapy: Brain and spinal cord tumors and their treatments can affect your child’s ability to perform daily life functions such as eating, going to the toilet, dressing, and bathing. Occupational therapy helps patients manage these daily tasks.

Rehabilitation: Rehabilitation involves treatments that help your child regain lost or diminished physical functions due to a brain or spinal cord tumor or its treatment. Rehabilitation may include speech-language pathology, physical therapy, and occupational therapy.

Follow-up care: This includes regular monitoring for symptom worsening, treatment effectiveness, and potential tumor recurrence.

Your child’s prognosis (long-term outcome) depends on:

• Tumor type
• Tumor size and location
• Metastasis (spread of cancerous tumors)
• Tumor response to treatment
• Your child’s age and overall health
• Your child’s tolerance to specific medications, procedures, or therapies

Each child’s prognosis is unique to their individual situation. Swift and aggressive treatment based on accurate diagnosis provides the best chance of overcoming the tumor and potential damage it may cause. Treatment may sometimes lead to side effects, which can also impact your child’s prognosis. Recurrence of the tumor is sometimes possible and can have a significant effect as well.