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Adult brain tumor

Table of Contents

DESCRIPTION

What is adult brain tumor?

STAGE EXPLANATION

Types of adult brain tumor

Noninfiltrating astrocytoma

Well-differentiated mildly and moderately anaplastic astrocytoma

Anaplastic astrocytoma

Glioblastoma multiforme

Well-differentiated ependymoma

Anaplastic ependymoma

Ependymoblastoma

Well-differentiated oligodendroglioma

Anaplastic oligodendroglioma

Mixed gliomas

Medulloblastoma

Pineal parenchymal tumors

Germ cell tumors

Craniopharyngioma

Meningioma

Malignant meningioma

Choroid Plexus Tumors

Recurrent

TREATMENT OPTION OVERVIEW

How adult brain tumors are treated

Treatment by type

ADULT NONINFILTRATING ASTROCYTOMA

ADULT WELL-DIFFERENTIATED MILDLY AND MODERATELY ANAPLASTIC ASTROCYTOMA

ADULT ANAPLASTIC ASTROCYTOMA

ADULT GLIOBLASTOMA MULTIFORME

ADULT BRAIN STEM GLIOMA

ADULT WELL-DIFFERENTIATED EPENDYMOMA

ADULT MALIGNANT EPENDYMOMA

ADULT WELL-DIFFERENTIATED OLIGODENDROGLIOMA

ADULT ANAPLASTIC OLIGODENDROGLIOMA

MIXED GLIOMAS

ADULT MEDULLOBLASTOMA

ADULT PINEAL PARENCHYMAL TUMOR

ADULT CENTRAL NERVOUS SYSTEM GERM CELL TUMOR

ADULT CRANIOPHARYNGIOMA

ADULT MENINGIOMA

ADULT MALIGNANT MENINGIOMA

RECURRENT ADULT BRAIN TUMOR

DESCRIPTION

Adult brain tumor is a disease 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.

This PDQ summary covers tumors that start in the brain (primary brain tumors). Often cancer found in the brain has started somewhere else in the body and has spread (metastasized) to the brain. This is called brain metastasis (see the PDQ patient information summary on brain metastasis).

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

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 are tumors that grow slowly and usually do not grow into the tissues around them.

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 have cells that look very different from normal cells and that grow more rapidly.

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 Astrocytoma

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 have cells that look very much like normal cells and grow quite slowly.

Anaplastic ependymomas are ependymal tumors that do not look like normal cells and grow more quickly than well-differentiated ependymal tumors.

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 are slow-growing tumors that look very much like normal cells.

Anaplastic oligodendrogliomas grow more quickly, and the cancer cells look very different from normal cells.

Other Brain Tumors

Mixed gliomas are brain tumors that occur in more than one type of brain cell, including cells of astrocytes, ependymal cells, and/or oligodendrocytes.

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 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 arise from the sex cells. There are different kinds of germ cells, including germinomas, embryonal carcinomas, choriocarcinomas, and teratomas.

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 are tumors that occur in the membranes that cover and protect the brain and spinal cord (the meninges). Meningiomas usually grow slowly.

Malignant meningioma is a rare tumor that grows more quickly than other meningiomas.

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 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

There are treatments for all patients with an adult brain tumor. Three kinds of treatment are used:

• surgery
• radiation therapy
• chemotherapy

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 tries to get the body to fight cancer. It 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 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 ASTROCYTOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery followed by external-beam radiation therapy.

3. 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 ASTROCYTOMA

Treatment may be one of the following:

1. Surgery followed by external-beam radiation therapy.

2. Surgery alone.

3. A clinical trial of surgery followed by radiation therapy and chemotherapy.

ADULT ANAPLASTIC ASTROCYTOMA

Treatment may be one of the following:

1. Surgery followed by external-beam radiation therapy.

2. Surgery followed by external-beam radiation therapy and chemotherapy.

3. 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.

4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

5. A clinical trial of chemotherapy drugs, which are placed in the body during surgery.

ADULT GLIOBLASTOMA MULTIFORME

Treatment may be one of the following:

1. Surgery followed by external-beam radiation therapy and chemotherapy.

2. Surgery followed by external-beam radiation therapy.

3. 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.

4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

5. A clinical trial of chemotherapy drugs, which are placed in the body during surgery.

ADULT BRAIN STEM GLIOMA

Treatment may be one of the following:

1. External-beam radiation therapy.

2. A clinical trial of chemotherapy or biological therapy.

ADULT WELL-DIFFERENTIATED EPENDYMOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery to remove the cancer followed by external-beam radiation therapy.

3. A clinical trial of chemotherapy or biological therapy.

ADULT MALIGNANT EPENDYMOMA

Treatment may be one of the following:

1. Surgery to remove the cancer followed by external-beam radiation therapy.

2. A clinical trial of external-beam radiation therapy with chemotherapy.

3. A clinical trial of chemotherapy or biological therapy.

ADULT WELL-DIFFERENTIATED OLIGODENDROGLIOMA

Treatment may be one of the following:

1. Surgery to remove the cancer followed by external-beam radiation therapy.

2. Surgery to remove the cancer.

3. A clinical trial of radiation therapy plus chemotherapy.

ADULT ANAPLASTIC OLIGODENDROGLIOMA

Treatment may be one of the following:

1. Surgery to remove the cancer followed by external-beam radiation therapy.

2. Surgery followed by external-beam radiation therapy and chemotherapy.

3. 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.

4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

MIXED GLIOMAS

Treatment may be one of the following:

1. Surgery followed by external-beam radiation therapy.

2. Surgery followed by external-beam radiation therapy and chemotherapy.

3. 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.

4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

ADULT MEDULLOBLASTOMA

Treatment may be one of the following:

1. Surgery to remove the cancer plus external-beam radiation therapy.

2. A clinical trial of surgery plus external-beam radiation therapy and chemotherapy.

ADULT PINEAL PARENCHYMAL TUMOR

Treatment may be one of the following:

1. Surgery plus external-beam radiation therapy.

2. Surgery plus external-beam radiation therapy plus chemotherapy.

3. 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.

4. A clinical trial of chemotherapy or biological therapy following radiation therapy.

ADULT CENTRAL NERVOUS SYSTEM GERM CELL TUMOR

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 CRANIOPHARYNGIOMA

Treatment may be one of the following:

1. Surgery to remove the cancer.

2. Surgery to remove the cancer followed by radiation therapy.

ADULT MENINGIOMA

Treatment usually consists of surgery to remove the tumor. If all of the tumor cannot be removed in an operation, a patient may also receive external-beam radiation therapy after surgery.

ADULT MALIGNANT MENINGIOMA

Treatment may be one of the following:

1. Surgery followed by external-beam radiation therapy.

2. 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.

3. A clinical trial of chemotherapy or biological therapy following radiation therapy.

RECURRENT ADULT BRAIN TUMOR

Treatment may be one of the following:

1. Surgery alone.

2. Surgery followed by chemotherapy.

3. External-beam radiation therapy alone, if not used during previous treatment, with or without chemotherapy.

4. Internal radiation therapy.

5. A clinical trial of chemotherapy.

6. A clinical trial of chemotherapy drugs, which are placed in the body during surgery.