According to the New York State Department of Health’s Cancer Surveillance Improvement Initiative report, 700 men and 640 women in New York State are diagnosed each year with brain cancer. It is most frequently diagnosed in children under 15 and in adults over 65 years of age. Spinal cord cancer is seen most often in young and middle aged adults.

Most primary cancers of the central nervous system are defined according to the type of cells from which they arise. The most common primary brain tumors in adults are malignant gliomas, which arise from supportive tissues in the brain, and meningiomas, nonmalignant tumors that arise from the membranes that line the skull and enclose the brain.

Meningiomas are the most common nonmalignant brain tumor in adults, and are often curable with surgery. Glioblastomas, the most common malignant brain tumor in adults, are probably the most resistant of all cancers to treatment.

RISK FACTORS

The only known environmental risk factors for primary brain tumors are ionizing radiation and immune suppression. People with certain rare genetic disorders have an increased risk of some brain tumors. 

SYMPTOMS

Whether a central nervous system cancer causes symptoms usually depends on the location of the tumor in the brain or spinal cord. Symptoms can include headache, seizures, numbness, weakness, and gait problems.

DIAGNOSIS

A surgeon, neurologist, radiologist, and neuropathologist work closely as a team to ensure the most accurate diagnosis and, consequently, the best available treatment.

There are more than 100 distinct types of brain and spinal cord cancers.

To diagnose a brain tumor, a doctor usually takes a complete medical history and conducts a neurological examination, as well as an MRI (magnetic resonance imaging) scan of the brain. In addition, other scans may help determine the specific tumor type and characteristics, such as CT (computed tomography) and PET (positron emission tomography).

A biopsy of the tumor tissue is also performed to provide a definitive diagnosis. If the tumor is deep inside or in a critical area of the brain, a needle biopsy may be performed. Stereotactic biopsy allows the neurosurgeon to draw a sample from the tumor while disturbing as little normal brain tissue as possible.

By examining the biopsy, a skilled and experienced neuropathologist can determine the exact type and grade (aggressiveness) of the tumor. A pathologist should read biopsy slides with expertise in brain tumors. Accurate diagnosis is essential to choosing the best treatment.

TREATMENT

The 126 different types of central nervous system cancers recognized by the World Health Organization are extremely diverse, both biologically and in their response to treatment.
Treatment for brain tumors includes:

• Surgery is an operation to remove the cancer
• Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells
• Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body .

These therapies may be delivered alone or in combination. Major brain tumor treatment centers have a multidisciplinary board of brain tumor specialists that reviews each patient's case and develops a treatment plan.

This team should include physicians with expertise in the following specialties:

• neuropathology
• neuroradiology
• neurosurgery
• neurology
• radiation oncology

These doctors are joined by other specialists who ensure that non-medical needs are met, such as rehabilitation services and psycho-social support for patients and their caregivers.

Major brain tumor treatment centers are more likely to provide the most advanced treatment options and have the most experienced medical professionals as compared to hospitals that don't offer specialized brain tumor care. Tumors that some physicians have considered inoperable, for example, have later been successfully removed by specialized neurosurgeons who are trained in the latest technology.