Brain and Spine Tumor Program

About Neurological Cancers

Approximately 400,000 people are diagnosed with a brain or spine tumor in the U.S. every year. Most of these tumors are cancers that have spread to the brain or spine from other parts of the body. The majority of neurological cancers are malignant, but some are benign tumors.

Signs and Symptoms

Brain tumors can increase the pressure within the skull, especially when the tumor is large and surrounded by an accumulation of fluid. This increase in pressure can cause several symptoms, including headache, blurred or double vision, vomiting and changes in mental state. Neurological problems can also be related to the specific location of a tumor. For instance, a person who has lost vision on the right side could have a tumor in the left temporal or occipital lobe of the brain. A right-handed person who is having difficulty speaking or understanding language could have a tumor in the left frontal lobe or left temporal lobe.

Tumors of the spine are usually accompanied by back pain. Less commonly, a person with a spinal tumor might experience impaired function of the arms or legs.

Metastatic Brain Tumors

Tumors that have spread to the brain from other cancer sites in the body are called metastatic brain tumors. As many as 200,000 people are diagnosed with metastatic brain cancer in the U.S. every year. All metastatic brain tumors are malignant abnormalities. Certain primary malignancies, such as lung cancer and breast cancer, are more likely to spread to the brain than other cancers.

Metastatic brain cancer that involves one tumor or one dominant tumor is often treated surgically. Focused radiation therapy (using technologies like Gamma Knife and TomoTherapy) can also be used. Patients with multiple brain metastases can be treated with whole brain radiation. Occasionally, patients with metastatic brain cancer also receive drug therapy.

Primary Brain Tumors

Brain tumors that originate in the brain are called primary brain tumors. Unlike metastatic brain cancers (which have spread through the bloodstream to the brain), primary brain tumors rarely spread to other parts of the body. A large percentage of primary brain tumors are benign.

The causes of primary brain tumors are largely unknown. Researchers have investigated possible links with diet, occupation, head trauma and many other factors, but none has ever been established as a risk factor for brain cancer. The only proven cause of brain tumor is exposure to very high doses of radiation (such as the radiation from an atomic bomb). In fact, the incidence of glioblastoma multiforme, the most common kind of primary malignant brain tumor, is consistent throughout the world — approximately 3 cases per 100,000 people. This suggests that differences in lifestyle, environment, etc., are not a factor in the development of primary brain tumors.

Primary benign tumors

The most common primary brain tumor is meningioma, a benign abnormality. A meningioma develops in the outer membrane that envelops the brain, and it pushes in on the brain as it grows. Treatment typically involves the surgical removal of the tumor with no further need for other therapies. In the U.S., approximately 30,000 people are diagnosed with meningioma every year.

Primary malignant tumors

About 18,000 primary malignant brain tumors are diagnosed in the U.S. annually. These tumors tend to occur in the substance of the brain (as opposed to the outer membrane). Glioblastoma multiforme (GBM) accounts for approximately half of all primary brain malignancies. Most malignant brain tumors are removed surgically, although complete surgical removal of all tumor cells is rarely possible. Commonly, radiation therapy is used to treat the tumor site following surgery. GBMs and certain other tumors are treated with a combination of radiation and simultaneous low-dose chemotherapy. When the tumor recurs, potential options include additional surgery, another course of radiation therapy (if enough time has elapsed) and a different chemotherapy drug.

Pituitary tumors

Abnormal growths in the pituitary gland account for 10 to 15 percent of all brain tumors. The large majority of pituitary tumors are benign. Problems arise when cancerous cells within the pituitary produce an excess of hormones such as growth hormones or prolactin, which can lead to multiple health problems. In addition, very large pituitary tumors (which often do not secrete hormones) can compress surrounding brain structures and nerve tissue, causing loss of peripheral vision and other neurological problems. Pituitary tumors require multidisciplinary care, and many can be managed with minimally invasive procedures.

Spinal Tumors

Approximately 80 percent of all spinal tumors are cancers growing within the bone of the spine. The remaining 20 percent are tumors growing in or near the spinal cord.

Among tumors of the bony spine, approximately four out of five are cancers that have spread to the spine from other parts of the body, often from lung cancer, prostate cancer or myeloma. These tumors can put pressure on the spinal cord and cause structural problems. Treatment typically consists of surgical removal of the tumor and spine reconstruction.

Spinal cord tumors are usually benign, but a significant percentage are malignant. Roughly two-thirds of these tumors abut the spinal cord, and about one-third grow within the tissue of the spinal cord itself. Treating these tumors requires extremely intricate microsurgery and intra-operative monitoring of spinal cord function.

Answers for New Patients

New patients and their families can find helpful information about many common concerns by reviewing some Frequently Asked Questions.