|Information For Patients - Brain Tumors
About Brain Tumors
Primary Brain Tumors
Secondary Brain Tumors
Symptoms of Brain Tumors
Side Effects of Treatment
Living With a Brain Tumor
Each year more than 17,000 people in the United States find out they have a brain tumor. The National Cancer Institute (NCI) has written this booklet to help patients and their families and friends better understand
brain tumors. We also hope others will read it to learn more about these tumors.
This booklet describes the symptoms, diagnosis, and treatment of brain tumors. We know that
booklets cannot answer every question about brain tumors. They cannot take the place of talks with doctors, nurses,
and other members of the health care team, but we hope our information will help with these talks.
Words that may be new to readers appear in
italics. Definitions of these words and other terms related to brain
cancer can be found in the Dictionary. For some words, a "sounds-like" spelling is also given.
Our knowledge about brain tumors keeps increasing. For up-to-date information or to order this publication, call the NCI-supported
Cancer Information Service (CIS)
toll free at 1-800-4-CANCER (1-800-422-6237).
Together, the brain and spinal cord form the
central nervous system.
This complex system is part of
everything we do. It controls the things we choose to do--like walk and talk--and the things our body does
automatically--like breathe and digest food. The central nervous system is also involved with our senses--seeing,
hearing, touching, tasting, and smelling--as well as our emotions, thoughts, and memory.
The brain is a soft, spongy mass of nerve cells and supportive tissue. It has three major parts: the cerebrum, the cerebellum, and the brain stem. The parts work together, but each has special functions.
The cerebrum, the largest part of the brain, fills most of the upper skull.
It has two halves called the left and right
The cerebrum uses information from our senses to tell us what is going on around
us and tells our body how to respond. The right hemisphere controls the muscles on the left side of the body,
and the left hemisphere controls the muscles on the right side of the body. This part of the brain also controls
speech and emotions as well as reading, thinking, and learning.
The cerebellum, under the cerebrum at the back of the brain, controls balance and complex actions like
walking and talking.
The brain stem connects the brain with the spinal cord. It controls hunger and thirst and some of the most
basic body functions, such as body temperature, blood pressure, and breathing.
The brain is protected by the bones of the skull and by a covering of three thin membranes
called meninges. The brain is also cushioned and protected by
cerebrospinal fluid. This watery fluid is produced by special cells in
the four hollow spaces in the brain, called ventricles. It flows through the ventricles and in spaces between
the meninges. Cerebrospinal fluid also brings nutrients from the blood to the brain and removes waste
products from the brain.
The spinal cord is made up of bundles of nerve fibers. It runs down from the brain through a canal in the
center of the bones of the spine. These bones protect the spinal cord. Like the brain, the spinal cord is covered by
the meninges and cushioned by cerebrospinal fluid.
Spinal nerves connect the brain with the nerves in most parts of the body. Other nerves go directly from
the brain to the eyes, ears, and other parts of the head. This network of nerves carries messages back and
forth between the brain and the rest of the body.
About Brain Tumors
The body is made up of many types of cells. Each type of cell has special functions. Most cells in the body
grow and then divide in an orderly way to form new cells as they are needed to keep the body healthy and
working properly. When cells lose the ability to control their growth, they divide too often and without any order.
The extra cells form a mass of tissue called a tumor. Tumors are benign
- Benign brain tumors do not contain cancer cells. Usually these tumors can be removed, and
they are not likely to recur. Benign brain tumors have clear borders. Although they do not
invade nearby tissue, they can press on sensitive areas of the brain and cause symptoms.
- Malignant brain tumors contain cancer cells. They interfere with vital
functions and are life threatening. Malignant brain tumors are likely to grow rapidly and crowd or invade the
tissue around them. Like a plant, these tumors may put out "roots" that grow into healthy brain
tissue. If a malignant tumor remains compact and does not have roots,
it is said to be encapsulated.
When an otherwise benign tumor is located in a vital area of the brain and interferes with
vital functions, it may be considered malignant (even though it contains no cancer cells).
Doctors refer to some brain tumors by grade--from low grade (grade I) to high grade (grade IV). The grade of
a tumor refers to the way the cells look under a microscope. Cells from higher grade tumors are more
abnormal looking and generally grow faster than cells from lower grade tumors; higher grade tumors are more
malignant than lower grade tumors.
The causes of brain tumors are not known. Researchers are trying to solve this problem. The more they can
find out about the causes of brain tumors, the better the chances of finding ways to prevent them. Doctors
cannot explain why one person gets a brain tumor and another doesn't, but they do know that no one can "catch"
a brain tumor from another person. Brain tumors are
Although brain tumors can occur at any age, studies show that they are most common in two age groups.
The first group is children 3 to 12 years old; the second is adults 40 to 70 years old.
By studying large numbers of patients, researchers have found certain
risk factors that increase a person's chance of developing a brain tumor. People with these risk factors have a higher-than-average risk of getting
a brain tumor. For example, studies show that some types of brain tumors are more frequent among workers
in certain industries, such as oil refining, rubber manufacturing, and drug manufacturing. Other studies have
shown that chemists and embalmers have a higher incidence of brain tumors. Researchers also are looking at
exposure to viruses as a possible cause. Because brain tumors sometimes occur in several members of the same
family, researchers are studying families with a history of brain tumors to see whether heredity is a cause. At this
time, scientists do not believe that head injuries cause brain tumors to develop.
In most cases, patients with a brain tumor have no clear risk factors. The disease is probably the result of
several factors acting together.
Primary Brain Tumors
Tumors that begin in brain tissue are known as primary brain tumors. (Secondary tumors that develop
when cancer spreads to the brain are discussed in the Secondary Brain Tumors section.) Primary brain tumors
are classified by the type of tissue in which they begin. The most common brain tumors are gliomas, which begin in the glial (supportive) tissue. There are several types of gliomas:
arise from small, star-shaped cells called astrocytes. They may grow anywhere
in the brain or spinal cord. In adults, astrocytomas most often arise in the cerebrum. In
children, they occur in the brain stem, the cerebrum, and the cerebellum. A grade III astrocytoma
is sometimes called anaplastic
astrocytoma. A grade IV astrocytoma is usually called glioblastoma multiforme.
- Brain stem gliomas
occur in the lowest, stemlike part of the brain. The brain stem controls
many vital functions. Tumors in this area generally cannot be removed. Most brain stem gliomas
are high-grade astrocytomas.
usually develop in the lining of the ventricles. They may also occur in the
spinal cord. Although these tumors can develop at any age, they are most common in childhood
- Oligodendrogliomas arise in the cells that produce myelin, the fatty covering that protects nerves. These tumors usually arise in the cerebrum. They grow slowly and usually do not
spread into surrounding brain tissue. Oligodendrogliomas are rare. They occur most often in
middle-aged adults but have been found in people of all ages.
There are other types of brain tumors that do not begin in glial tissue. Some of the most common are
- Medulloblastomas were once thought to develop from glial cells. However, recent
research suggests that these tumors develop from primitive (developing) nerve cells that normally do
not remain in the body after birth. For this reason, medulloblastomas are sometimes called
primitive neuroectodermal tumors
(PNET). Most medulloblastomas arise in the cerebellum; however,
they may occur in other areas as well. These tumors occur most often in children and are
more common in boys than in girls.
grow from the meninges. They are usually benign. Because these tumors
grow very slowly, the brain may be able to adjust to their presence; meningiomas often grow
quite large before they cause symptoms. They occur most often in women between 30 and 50 years
are benign tumors that begin in Schwann cells, which produce the myelin
that protects the acoustic
nerve--the nerve of hearing. Acoustic neuromas
are a type of schwannoma. They occur mainly in adults. These tumors affect women twice as often as men.
- Craniopharyngiomas develop in the region of the pituitary gland near the
hypothalamus. They are usually benign; however, they are sometimes considered malignant because they can press
on or damage the hypothalamus and affect vital functions. These tumors occur most often
in children and adolescents.
- Germ cell tumors arise from primitive (developing) sex cells, or germ cells. The most
frequent type of germ cell tumor in the brain is the germinoma.
- Pineal region tumors occur in or around the pineal gland, a tiny organ near the center of
the brain. The tumor can be slow growing
pineocytoma) or fast growing (pineoblastoma). The pineal region is very difficult to reach, and these tumors often cannot be removed.
Secondary Brain Tumors
is the spread of cancer. Cancer that begins in other parts of the body may spread to the brain
and cause secondary tumors. These tumors are not the same as primary brain tumors. Cancer that spreads to
the brain is the same disease and has the same name as the original (primary) cancer. For example, if lung
cancer spreads to the brain, the disease is called metastatic lung cancer because the cells in the secondary tumor
resemble abnormal lung cells, not abnormal brain cells.
Treatment for secondary brain tumors depends on where the cancer started and the extent of the spread as
well as other factors, including the patient's age, general health, and response to previous treatment.
Symptoms of Brain Tumors
The symptoms of brain tumors depend mainly on their size and their location in the brain. Symptoms are
caused by damage to vital tissue and by pressure on the brain as the tumor grows within the limited space in the
skull. They also may be caused by swelling and a buildup of fluid around the tumor, a condition called edema. Symptoms may also be due to
hydrocephalus, which occurs when the tumor blocks the flow of cerebrospinal
fluid and causes it to build up in the ventricles. If a brain tumor grows very slowly, its symptoms may appear
so gradually that they are overlooked for a long time.
The most frequent symptoms of brain tumors include:
- Headaches that tend to be worse in the morning and ease during the day,
- Nausea or vomiting,
- Weakness or loss of feeling in the arms or legs,
- Stumbling or lack of coordination in walking (ataxic gait),
- Abnormal eye movements or changes in vision,
- Changes in personality or memory, and
- Changes in speech.
These symptoms may be caused by brain tumors or by other problems. Only a doctor can make a diagnosis.
To find the cause of a person's symptoms, the doctor asks about the patient's personal and family
medical history and performs a complete physical examination. In addition to checking general signs of health,
the doctor does a neurologic exam. This includes checks for alertness, muscle strength, coordination, reflexes,
and response to pain. The doctor also examines the eyes to look for swelling caused by a tumor pressing on
the nerve that connects the eye and the brain.
Depending on the results of the physical and neurologic examinations, the doctor may request one or both of
- A CT (or CAT) scan is a series of detailed pictures of the brain. The pictures are created by
a computer linked to an x-ray
machine. In some cases, a special dye is injected into a vein
before the scan. The dye helps to show differences in the tissues of the brain.
(magnetic resonance imaging) gives pictures of the brain, using a powerful magnet linked
to a computer. MRI is especially useful in diagnosing brain tumors because it can "see" through
the bones of the skull to the tissue underneath. A special dye may be used to enhance the
likelihood of detecting a brain tumor.
The doctor may also request other tests such as:
- A skull x-ray can show changes in the bones of the skull caused by a tumor. It can also
show calcium deposits, which are present in some types of brain tumors.
- A brain scan reveals areas of abnormal growth in the brain and records them on special film.
A small amount of a radioactive material is injected into a vein. This dye is absorbed by the
tumor, and the growth shows up on the film. (The radiation leaves the body within 6 hours and is
- An angiogram, or arteriogram, is a series of x-rays taken after a special dye is injected into
an artery (usually in the area where the abdomen joins the top of the leg). The dye, which
flows through the blood vessels of the brain, can be seen on the x-rays. These x-rays can show
the tumor and blood vessels that lead to it.
- A myelogram is an x-ray of the spine. A special dye is injected into the cerebrospinal fluid in
the spine, and the patient is tilted to allow the dye to mix with the fluid. This test may be done
when the doctor suspects a tumor in the spinal cord.
Treatment for a brain tumor depends on a number of factors. Among these are the type, location, and size of
the tumor, as well as the patient's age and general health. Treatment methods and schedules often vary for
children and adults. The doctor develops a treatment plan to fit each patient's needs.
The patient's doctor may want to discuss the case with other doctors who treat brain tumors. Also, the
patient may want to talk with the doctor about taking part in a research study
of new treatment methods. Such studies, called
clinical trials, are
discussed in the Clinical Trials section.
Many patients want to learn all they can about their disease and their treatment choices so they can take
an active part in decisions about their medical care. A person with a brain tumor will have many questions, and
the doctor is the best person to answer them. Most patients want to know what kind of tumor they have, how it
can be treated, how effective the treatment is likely to be, and how much it's likely to cost.
Here are some important questions to ask the doctor:
- What type of treatment will I receive?
- What are the expected benefits of treatment?
- What are the risks and possible side effects of treatment?
- What can be done about side effects?
- Would a clinical trial be appropriate for me?
- Will I need to change my normal activities? If so, for how long?
- How often will I need to have checkups?
Many people find it helpful to make a list of their questions before they see the doctor. Taking notes can make
it easier to remember what the doctor says. Some patients find that it also helps to have a family member or
friend with them when they talk with the doctor-- either to take part in the discussion or just to listen.
Patients and their families have a lot to learn about brain tumors and their treatment. They should not feel
that they need to understand everything the first time they hear it. They will have other chances to ask the doctor
to explain things that are not clear.
Decisions about treatment for brain tumors are complex. Before starting treatment, the patient might want
a second doctor to review the diagnosis and treatment plan. There are several ways to find a doctor to consult:
- The patient's doctor may be able to suggest a doctor who specializes in treating brain tumors.
- The Cancer Information Service, at 1-800-4-CANCER, can tell callers about cancer centers
and other NCI-supported programs in their area.
- Patients can get the names of specialists from their local medical society, a nearby hospital
or cancer center, or a medical school.
Brain tumors are treated with surgery,
Depending on the patient's needs, several methods may be used. The patient may
be referred to doctors who specialize in different kinds of
treatment and work together as a team. This medical team often includes a
a medical oncologist,
a radiation oncologist,
a nurse, a dietitian, and a social worker. The patient may also work with a physical
therapist, an occupational therapist, and a speech therapist.
Before treatment begins, most patients are given steroids, which are drugs that relieve swelling (edema).
They may also be given anticonvulsant medicine to prevent or control seizures. If hydrocephalus is present,
the patient may need a shunt to drain the cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of
the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a
drainpipe: Excess fluid is carried away from the brain and is absorbed in the abdomen. (In some cases, the fluid
is drained into the heart.)
Surgery is the usual treatment for most brain tumors. To remove a brain tumor, a neurosurgeon makes
an opening in the skull. This operation is called a craniotomy.
Whenever possible, the surgeon attempts to remove the entire tumor. However, if the tumor cannot be
completely removed without damaging vital brain tissue, the doctor removes as much of the tumor as
possible. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor
to be treated by radiation therapy or chemotherapy.
Some tumors cannot be removed. In such cases, the doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains.
This helps the doctor decide which treatment to use.
Sometimes, a biopsy is done with a needle. Doctors use a special headframe (like a halo) and CT scans or
MRI to pinpoint the exact location of the tumor. The surgeon makes a small hole in the skull and then guides a
needle to the tumor. (Using this technique to do a biopsy or for treatment is called
Radiation therapy (also called radiotherapy) is the use of high-powered rays to damage cancer cells and
stop them from growing. It is often used to destroy tumor tissue that cannot be removed with surgery or to kill
cancer cells that may remain after surgery. Radiation therapy is also used when surgery is not possible.
Radiation therapy may be given in two ways. External radiation comes from a large machine. Generally,
external radiation treatments are given 5 days a week for several weeks. The treatment schedule depends on the
type and size of the tumor and the age of the patient. Giving the total dose of radiation over an extended period
helps to protect healthy tissue in the area of the tumor.
Radiation can also come from radioactive material placed directly in the tumor (implant radiation
therapy). Depending on the material used, the implant may be left in the brain for a short time or permanently.
Implants lose a little radioactivity each day. The patient stays in the hospital for several days while the radiation is
External radiation may be directed just to the tumor and the tissue close to it or, less often, to the entire
brain. (Sometimes the radiation is also directed to the spinal cord.) When the whole brain is treated, the patient
often receives an extra dose of radiation to the area of the tumor. This boost can come from external radiation or
from an implant.
Stereotactic radiosurgery is another way to treat brain tumors. Doctors use the techniques described in
the Surgery section to pinpoint the exact location of the tumor. Treatment is given in just one session;
high-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor
without damaging other brain tissue. (This use of radiation therapy is
sometimes called the gamma knife.)
Chemotherapy is the use of drugs to kill cancer cells. The doctor may use just one drug or a
combination, usually giving the drugs by mouth or by injection into a blood vessel or muscle.
involves injecting the drugs into the cerebrospinal fluid.
Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another
treatment period, and so on. Patients often do not need to stay in the hospital for treatment. Most drugs can be
given in the doctor's office or the outpatient clinic of a hospital. However, depending on the drugs used, the way
they are given, and the patient's general health, a short hospital stay may be necessary.
Researchers are looking for treatment methods that are more effective against brain tumors and have fewer
side effects. When laboratory research shows that a new method has promise, doctors use it to treat cancer patients
in clinical trials. These trials are designed to answer scientific questions and to find out whether the new
approach is both safe and effective. Patients who take part in clinical trials make an important contribution to
medical science and may have the first chance to benefit from improved treatment methods.
Many clinical trials of new treatments for brain tumors are under way. Doctors are studying new types
and schedules of radiation therapy, new anticancer drugs, new drug combinations, and combinations of
chemotherapy and radiation.
Scientists are trying to increase the effectiveness of radiation therapy by giving treatments twice a day instead
of once. Also, they are studying drugs called
These drugs make the cancer cells more sensitive
to radiation. Another method under study is
in which the tumor is heated to increase the effect
of radiation therapy.
Many drugs cannot reach brain cells because of the blood-brain barrier, a network of blood vessels and cells
that filters blood going to the brain. Researchers continue to look for new drugs that will pass through the
blood-brain barrier. Studies are under way using different techniques to temporarily disrupt the barrier so that drugs
can reach the tumor.
In other studies, scientists are exploring new ways to give the drugs. Drugs may be injected into an
artery leading to the brain or may be put directly into the ventricles. Doctors are also studying the effectiveness
of placing tiny wafers containing anticancer drugs directly into the tumor. (The wafers dissolve over time.)
Researchers are also testing the use of very high doses of anticancer drugs. Because these higher doses
may damage healthy
bone marrow, doctors combine this treatment with
bone marrow transplantation to replace the marrow that has been destroyed.
Biological therapy is a new way of treating brain tumors that is currently under study. This type of treatment
is an attempt to improve the way the body's
immune system fights disease.
Patients interested in taking part in a clinical trial should discuss this option with their doctor. They may want
to read Taking Part in Clinical Trials: What Cancer Patients Need To Know
an NCI booklet that explains some of the possible benefits and risks
of treatment studies.
One way to learn about clinical trials is through PDQ, a computerized resource developed by the
National Cancer Institute. This resource contains information about cancer treatment and about clinical trials in
progress all over the country. The Cancer Information Service can provide PDQ information to patients and the public.
Side Effects of Treatment
Cancer treatment often causes side effects. These side effects occur because treatment to destroy cancer
cells damages some healthy cells as well.
The side effects of cancer treatment vary. They depend on the type of treatment used and on the area
being treated. Also, each person reacts differently. Doctors try to plan the patient's therapy to keep side effects to
a minimum. They also watch patients very carefully so they can help with any problems that occur.
A craniotomy is a major operation. The surgery may damage normal brain tissue, and edema may occur.
Weakness, coordination problems, personality changes, and difficulty in speaking and thinking may result.
Patients may also have seizures. In fact, for a short time after surgery, symptoms may be worse than before. Most of
the side effects of surgery lessen or disappear with time.
Most of the side effects of radiation therapy go away soon after treatment is over. However, some side
effects may occur or persist long after treatment is complete.
Some patients have nausea for several hours after treatment. Patients receiving radiation therapy may
become very tired as treatment continues. Resting is important, but doctors usually advise their patients to try to
stay reasonably active. Radiation therapy to the scalp causes most patients to lose their hair. When it grows back,
the new hair is sometimes softer and may be a slightly different color. In some cases, hair loss is permanent.
Skin reactions in the treated area are common. The scalp and ears may be red, itchy, or dark; these areas
may look and feel sunburned. The treated area should be exposed to the air as much as possible but should be
protected from the sun. Patients should not wear anything on the head that might cause irritation. Good skin care
is important at this time. The doctor may suggest certain kinds of soap or ointment, and patients should
not use any other lotions or creams on the scalp without the doctor's advice.
Sometimes brain cells killed by radiation form a mass in the brain. The mass may look like a tumor and
may cause similar symptoms, such as headaches, memory loss, or seizures. Doctors may suggest surgery or
steroids to relieve these problems. About 4 to 8 weeks after radiation therapy, patients may become quite sleepy or
lose their appetite. These symptoms may last several weeks, but they usually go away on their own. Still,
patients should notify the doctor if they occur.
Children who have had radiation therapy for a brain tumor may have learning problems or partial loss of
eyesight. If the pituitary gland is damaged, children may not grow or develop normally.
The side effects of chemotherapy depend on the drugs that are given. In general, anticancer drugs affect
rapidly growing cells, such as blood cells that fight infection, cells that line the digestive tract, and cells in
As a result, patients may have a lower resistance to infection, loss of appetite, nausea, vomiting, or mouth
sores. Patients may also have less energy and may lose their hair. These side effects usually go away gradually
after treatment stops.
Some anticancer drugs can cause infertility.
Women taking certain anticancer drugs may have symptoms
(hot flashes and vaginal dryness; periods may be irregular or stop). Some drugs used to treat
children and teenagers may affect their ability to have children later in life.
Certain drugs used in the treatment of brain tumors may cause kidney damage. Patients are given large
amounts of fluid while taking these drugs. Patients may also have tingling in the fingers, ringing in the ears, or
difficulty hearing. These problems may not clear up after treatment stops.
Treatment with steroids to reduce swelling in the brain may cause increased appetite and weight gain.
Swelling of the face and feet is common. Steroids can also cause restlessness, mood swings, burning indigestion,
and acne. However, patients should not stop using steroids or change their dose without consulting the doctor.
The use of steroids must be stopped gradually to allow the body to adjust to the change.
Loss of appetite can be a problem for patients during therapy. People may not feel hungry when they are
uncomfortable or tired. Some of the common side effects of cancer treatment, such as nausea and vomiting, can
also make it hard to eat. Yet good nutrition is important because patients who eat well generally feel better and
have more energy. Eating well means getting enough calories and protein to help prevent weight loss, regain
strength, and rebuild normal tissues. Many patients find that eating several small meals and snacks during the day
works better than trying to have three large meals.
Patients being treated for a brain tumor may develop a blood clot and inflammation in a vein, most often in
the leg. This is called thrombophlebitis.
A patient who notices swelling in the leg, leg pain, and/or redness in the
leg should notify the doctor right away.
Doctors, nurses, and dietitians can explain the side effects of cancer treatment and can suggest ways to deal
Rehabilitation is a very important part of the treatment plan. The goals of rehabilitation depend on the
patient's needs and how the tumor has affected his or her daily activities. The medical team makes every effort to
help patients return to their normal activities as soon as possible.
Patients and their families may need to work with an occupational therapist to overcome any difficulty in
activities of daily living, such as eating, dressing, bathing, and using the toilet. If an arm or leg is weak or
paralyzed, or if a patient has problems with balance, physical therapy may be necessary. Speech therapy may be helpful
for individuals having trouble speaking or expressing their thoughts. Speech therapists also work with patients
who are having difficulty swallowing.
If special arrangements are necessary for school-age children, they should be made as soon as possible.
Sometimes, children have tutors in the hospital or after they go home from the hospital. Children who have
problems learning or remembering what they learn may need tutors or special classes when they return to school.
Regular followup is very important after treatment for a brain tumor. The doctor will check closely to make
sure that the tumor has not returned. Checkups usually include general physical and neurologic exams. From time
to time, the patient will have CT scans or MRIs.
Patients who receive radiation therapy to large areas of the brain or certain anticancer drugs may have an
increased risk of developing leukemia or a second tumor at a later time. Also, radiation that affects the eyes
may lead to the development of cataracts. Patients should carefully follow their doctor's advice on health care
and checkups. If any unusual health problem occurs, they should report it to the doctor as soon as it appears.
Living With a Brain Tumor
The diagnosis of a brain tumor can change the lives of patients and the people who care about them.
These changes can be hard to handle. Patients and their families and friends may have many different and
sometimes confusing emotions.
At times, patients and those close to them may feel frightened, angry, or depressed. These are normal
reactions when people face a serious health problem. Most patients, including children and teenagers, find it helps
to share their thoughts and feelings with loved ones. Sharing can help everyone feel more at ease and can open
the way for others to show their concern and offer their support.
Worries about tests, treatments, hospital stays, rehabilitation, and medical bills are common. Parents may
worry about whether their children will be able to take part in normal school or social activities. Doctors, nurses,
social workers, and other members of the health care team may be able to calm fears and ease confusion. They
can also provide information and suggest helpful resources.
Patients and their families are naturally concerned about what the future holds. Sometimes they use statistics
to try to figure out whether the patient will be cured or how long he or she will live. It is important to
remember, however, that statistics are averages based on large numbers of patients. They cannot be used to predict
what will happen to a certain patient because no two cancer patients are alike. The doctor who takes care of
the patient and knows that person's medical history is in the best position to discuss the patient's outlook (prognosis).
People should feel free to ask the doctor about their prognosis, but it is important to keep in mind that not
even the doctor can tell exactly what will happen. When doctors talk about recovering from a brain tumor, they
may use the term remission
rather than cure. Even though many people recover completely, doctors use this
term because a brain tumor can recur.
Support for Cancer Patients
Living with a serious disease is not easy. Everyone involved faces many problems and challenges. Finding
the strength to cope with these difficulties is easier when people have helpful information and support services.
The doctor can explain the disease and give advice about treatment, going back to work or school, or
other activities. If patients want to discuss concerns about the future, family relationships, and finances, it may
also help to talk with a nurse, social worker, counselor, or clergy member.
Friends and relatives who have had personal experience with cancer can be very supportive. Also, it helps
many patients to meet and talk with other people who are facing problems like theirs. Cancer patients often get
together in self-help and support groups, where they can share what they have learned about cancer and its
treatment and about coping with the disease. In addition to groups for adults with cancer, special support groups
for children or teens with cancer or for parents whose children have cancer are available in many cities. It's
important to keep in mind, however, that each patient is different. Treatments and ways of dealing with cancer
that work for one person may not be right for another--even if they both have the same kind of cancer. It's always
a good idea to discuss the advice of friends and family members with the doctor.
Often, a social worker at the hospital or clinic can suggest local and national groups that will help with
rehabilitation, emotional support, financial aid, transportation, or home care.
acoustic (ah-KOOS-tik): Having to do with sound or hearing.
anaplastic (an-ah-PLAS-tik): A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells.
angiogram (AN-jee-o-gram): An x-ray of blood vessels; the person receives an injection of dye to outline the vessels on the x-ray.
anticonvulsants (an-tee-kon-VUL-sants): Drugs that prevent, reduce or stop convulsions or seizures.
astrocytoma (as-tro-sye-TOE-mas): A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes.
ataxic gait (ah-TAK-sik): Awkward, uncoordinated walking.
benign (beh-NINE): Not cancerous; does not invade nearby tissue or spread to other parts of the body.
biological therapy (by-o-LAHJ-i-kul): Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also called immunotherapy or biological response modifier (BRM) therapy.
biopsy (BY-ahp-see): A procedure used to remove cells or tissues in order to look at them under a microscope to check for signs of disease. When an entire tumor or lesion is removed, the procedure is called an excisional biopsy. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.
bone marrow: The soft, sponge-like tissue in the center of bones that produces white blood cells, red blood cells, and platelets.
bone marrow transplantation (trans-plan-TAY-shun): A procedure to replace bone marrow destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (the person's marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).
brain stem: The part of the brain that is connected to the spinal cord.
brain stem glioma (glee-O-ma): A tumor located in the part of the brain that connects to the spinal cord (the brain stem). It may grow rapidly or slowly, depending on the grade of the tumor.
central nervous system: CNS. The brain and spinal cord.
cerebellum (sair-uh-BELL-um): The portion of the brain in the back of the head between the cerebrum and the brain stem. The cerebellum controls balance for walking and standing, and other complex motor functions.
cerebral hemispheres (seh-REE-bral HEM-iss-feerz): The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body.
cerebrospinal fluid (seh-REE-bro-SPY-nal): CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain.
cerebrum (seh-REE-brum): The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning.
chemotherapy (kee-mo-THER-a-pee): Treatment with anticancer drugs.
clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease.
craniopharyngioma (KRAY-nee-o-fah-rin-jee-O-ma): A benign brain tumor that may be considered malignant because it can damage the hypothalamus, the area of the brain that controls body temperature, hunger, and thirst.
craniotomy (kray-nee-AH-toe-mee): An operation in which an opening is made in the skull.
CT scan: Computed tomography scan. A series of detailed pictures of areas inside the body; the pictures are created by a computer linked to an x-ray machine. Also called computed axial tomography (CAT) scan.
edema (eh-DEE-ma): Swelling caused by excess fluid in body tissues.
encapsulated (en-KAP-soo-lay-ted): Confined to a specific, localized area and surrounded by a thin layer of tissue.
ependymomas: Brain tumors that usually begins in the central canal of the spinal cord. Ependymomas may also develop in the cells lining the ventricles of the brain, which produce and store the special fluid (cerebrospinal fluid) that protects the brain and spinal cord. Also called ependymal tumors.
gamma knife: Radiation therapy in which high-energy rays are aimed at a tumor from many angles in a single treatment session.
germ cell tumors: Tumors that begin in the cells that give rise to sperm or eggs. They can occur virtually anywhere in the body and can be either benign or malignant.
germinoma (jer-mih-NO-ma): The most frequent type of germ cell tumor in the brain.
glioblastoma multiforme (glee-o-blas-TOE-ma mul-tih-FOR-may): A type of brain tumor that forms from glial (supportive) tissue of the brain. It grows very quickly and has cells that look very different from normal cells. Also called grade IV astrocytoma.
glioma (glee-O-ma): A cancer of the brain that comes from glial, or supportive, cells.
hair follicles (FOL-i-kuls): Shafts or openings on the surface of the skin through which hair grows.
hydrocephalus (hye-dro-SEF-uh-lus): The abnormal buildup of cerebrospinal fluid in the ventricles of the brain.
hyperthermia (hye-per-THER-mee-a): A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells, or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.
hypothalamus (hye-po-THAL-uh-mus): The area of the brain that controls body temperature, hunger, and thirst.
immune system (im-YOON): The complex group of organs and cells that defends the body against infection or disease.
infertility: The inability to produce children.
intrathecal chemotherapy (in-tra-THEE-kal KEE-mo-THER-a-pee): Anticancer drugs infused into the thin space between the lining of the spinal cord and brain to treat or reduce the risk of cancers in the brain and spinal cord.
malignant (ma-LIG-nant): Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body.
medical oncologist (on-KOL-o-jist): A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormone therapy, and biological therapy. A medical oncologist often serves as the person's main caretaker and coordinates treatment provided by other specialists.
medulloblastoma (MED-yoo-lo-blas-TOE-ma): A malignant brain tumor that begins in the lower part of the brain and can spread to the spine or to other parts of the body. Medulloblastomas are sometimes called primitive neuroectodermal tumors (PNET).
membrane: A very thin layer of tissue that covers a surface.
meninges (meh-NIN-jeez): The three membranes that cover and protect the brain and spinal cord.
meningioma (meh-nin-jee-O-ma): A type of tumor that occurs in the meninges, the membranes that cover and protect the brain and spinal cord. Meningiomas usually grow slowly.
menopause (MEN-o-pawz): The time of life when a woman's menstrual periods stop for at least a year. Also called "change of life."
metastasis (meh-TAS-ta-sis): The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases.
MRI: Magnetic resonance imaging (mag-NET-ik REZ-o- nans IM-a-jing). A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body.
myelin (MYE-eh-lin): The fatty substance that covers and protects nerves.
myelogram (MYE-eh-lo-gram): An x-ray of the spinal cord following an injection of dye into the space between the lining of the spinal cord and brain.
neuroma (noo-RO-ma): A tumor that arises in nerve cells.
neurosurgeon (NOO-ro-SER-jun): A doctor who specializes in surgery on the brain, spine, and other parts of the nervous system.
oligodendroglioma (OL-ih-go-den-dro-glee-O-ma): A rare, slow-growing tumor that begins in brain cells called oligodendrocytes, which provide support and nourishment for cells that transmit nerve impulses. Also called oligodendroglial tumor.
pathologist (pa-THOL-o-jist): A doctor who identifies diseases by studying cells and tissues under a microscope.
pineal gland (PIN-ee-al): A small gland located in the cerebrum that produces melatonin. Also called pineal body or pineal organ.
pineal region tumors (pIN-ee-al...TOO-mers): Types of brain tumors that occur in or around the pineal gland, a tiny organ near the center of the brain.
pineoblastoma (PIN-ee-o-blas-TOE-ma): A fast growing type of brain tumor that occurs in or around the pineal gland, a tiny organ near the center of the brain.
pineocytoma (PIN-ee-o-sye-TOE-ma): A slow growing type of brain tumor that occurs in or around the pineal gland, a tiny organ near the center of the brain.
pituitary gland (pih-TOO-ih-tair-ee): The main endocrine gland; it produces hormones that control other glands and many body functions, especially growth.
primitive neuroectodermal tumors (NOO-ro-ek-toe-DER-mul): PNET. A type of bone cancer that forms in the middle (shaft) of large bones. Also called Ewing's sarcoma/primitive neuroectodermal tumor.
prognosis (prog-NO-sis): The likely outcome or course of a disease; the chance of recovery.
radiation oncologist (ray-dee-AY-shun on-KOL-o-jist): A doctor who specializes in using radiation to treat cancer.
radiation therapy (ray-dee-AY-shun): The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from material called radioisotopes. Radioisotopes produce radiation and are placed in or near a tumor or near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy.
radiosensitizers: Drugs that make tumor cells more sensitive to radiation.
recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after it had disappeared.
remission: Disappearance of the signs and symptoms of cancer. When this happens, the disease is said to be "in remission." A remission may be temporary or permanent.
risk factor: Anything that increases the chance of developing a disease.
schwannoma (shwah-NO-ma): A type of benign brain tumor that begins in the Schwann cells that produce the myelin that protects the acoustic nerve (the nerve of hearing).
seizures (SEE-zhurz): Convulsions; sudden, involuntary movements of the muscles.
shunt: A surgically created diversion of fluid, for example blood or cerebrospinal fluid, from one area of the body to another area of the body.
stereotaxis (stair-ee-o-TAK-sis): Use of a computer and scanning devices to create three-dimensional pictures. This method can be used to direct a biopsy, external radiation, or the insertion of radiation implants.
steroids (STEH-roidz): Drugs used to relieve swelling and inflammation.
surgery: A procedure to remove or repair a part of the body or to find out if disease is present.
thrombophlebitis (throm-bo-fleh-BY-tis): Inflammation of a vein that occurs when a blood clot forms.
tissue (TISH-oo): A group or layer of cells that together perform specific functions.
tumor (TOO-mer): An abnormal mass of tissue that results from excessive cell division. Tumors perform no useful body function. They may be either benign (not cancerous) or malignant (cancerous).
ventricles (VEN-trih-kulz): Fluid-filled cavities in the heart or brain.
vital: Necessary to maintain life. Breathing is a vital function.
x-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer.