Tumors of the brain and spinal cord

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What is it about ?

The central nervous system (CNS) includes the brain and the spinal cord. Tumors can develop there, both benign and malignant tumors. We don’t know what causes them. Immune system disorders could play a role. Radiation and certain diseases such as neurofibromatosis also increase the risk of a tumor.

There are about a hundred types of central nervous system tumors. Gliomas, meningiomas and neuromas are the most common. Gliomas develop from the supporting tissue of the nervous system, which is responsible for supplying the nervous tissue with nutrients and ensuring its protection. Meningiomas are tumors of the membranes that surround the central nervous system; most often they are benign tumors. Neuromas are tumors of the sheath that surrounds nerve fibers. Finally, many brain and spinal cord tumors are metastases from tumors located elsewhere in the body. The prognosis varies greatly and depends on the type of tumor and the age of the patient.

What is their frequency and where do we find them?

Central nervous system tumors constitute 3-4% of all tumors; of these, 10% are spinal cord tumors and 90% are brain tumors. They are most often found in infancy and after the age of 65. According to the Belgian Cancer Registry, 800 new cases are registered each year.

Although very rare, childhood brain cancer is the second most common cancer, after leukemia.

How to recognize them?

Brain tumors

Among people with brain tumors, 30 to 50% develop epilepsy. An epileptic seizure without previous accident and in the absence of alcoholism is due to a tumor in one in five cases.

The person usually suffers from a headache, but this is rarely the only symptom. Headaches can have different causes. This complicates the diagnosis. With a brain tumor, the headache gradually gets worse, occurs when lying down, and can be so severe that the person wakes up. They are usually also accompanied by nausea and vomiting. The pain gets worse when the pressure in the brain increases, such as when the person coughs or sneezes.

Other symptoms depend on where the tumor is located. So a muscle weakness may occur in certain muscle groups, and one or more senses (eg, sight) may disappear in whole or in part. Bleeding into the tumor can cause symptoms typical ofStroke (eg paralysis of one half of the body). Finally, the character of the person can be disturbed, as well as the way of acting. It is mainly the entourage who realizes it. The person’s reactions may become slower, their attention may be diminished, they may have an absent attitude and difficulty concentrating. Sometimes her mood changes, and she becomes indifferent or listless or gets angry quickly.

Spinal cord tumors

Spinal cord tumors mainly cause motor or sensory deficits. Motor deficit is characterized by paralysis of the muscles. This means that some movements are difficult or even impossible. Sensitive deficit is an impairment of sensations (touch, heat and cold, pain, pressure …).

Metastases

If there is metastasis, the person also suffers from symptoms related to the tumor located elsewhere in the body. In most cases, it is a tumor of the lung or breast.

How is the diagnosis made?

At first, the diagnosis is not always obvious. The doctor will think of a tumor if the symptoms gradually worsen and do not improve with the treatment started. The questions put to the patient and theneurological examination highlight a series of anomalies. If a tumor is then suspected, the person will be referred to a neurologist. Additional examinations include an MRI and, in an emergency, a CT scan.

What can your doctor do?

The treatment always takes place in a specialized department in the hospital. It is often necessary to first reduce the pressure in the brain with strong diuretics and high doses of cortisone. If necessary, surgery is then performed to remove the tumor. The success of the procedure depends on the nature of the tumor, where it is, its size and how it grows, but also on the patient’s age and general condition.

Tumors located on the surface are easier to reach; the more centrally located the tumor, the harder it is to remove it completely. It is for this reason that sometimes other treatments, such as radiotherapy or chemotherapy, are also used. This is almost always the case with metastases. The localization of spinal cord tumors is generally favorable. We often manage to remove them.

If the prognosis is good, the person is sent for specialized rehabilitation to be accompanied by a physiotherapist and an occupational therapist. The occupational therapist helps people with disabilities in their daily activities. The tumor and the treatment are indeed often responsible for mobility problems, disturbed sensations and difficulty concentrating.

If the person was taking medication for epilepsy before the surgery, it is best to continue it after the tumor has been removed. After the treatment, the person is closely followed for several years, with regular checks carried out by the specialist in order to be able to quickly detect a recurrence. This is most often the case when new symptoms appear or when existing symptoms worsen.

Want to know more?

https://www.cancer.be/les-cancers/types-de-cancers/cancer-du-cerveau

Source

Foreign clinical practice guide ‘Brain and spinal cord tumors’ (2000), updated on 03.11.2015 and adapted to the Belgian context on 16.09.2019 – ebpracticenet

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