Penn Medicine Neuroscience Center: Neuro-oncology Program
 
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Brain and Spinal Cord Tumors


Diagnosis
The brain and spinal cord make up the central nervous system (CNS). The CNS controls all body functions such as breathing, blood pressure, movement, balance, coordination and thinking. Tumors that affect the CNS can be benign (non-cancerous) or malignant (cancerous). Benign CNS tumors are usually slow growing and rarely spread to other areas of the body. Surgery alone may be effective for some benign CNS tumors. However, even benign tumors may be life-threatening if they are growing in a vital area of the brain or spinal cord.

Malignant tumors of the brain or spinal cord are classified by grade. The grade of a tumor means the degree to which its cells are different from normal cells, their tendency to spread and their rate of growth. The grade of a tumor is determined by a neuropathologist, a doctor who specializes in the microscopic evaluation of diseases of the nervous system. For some tumors a genetic analysis of the tumor tissue is performed and this information can impact on the treatment recommendations.

Gliomas or glial tumors (also called astrocytomas or oligodendrogliomas) are the most common type of brain and spinal cord tumor. Astrocytomas that are grade I or II are known as low-grade astrocytomas. These tumors tend to grow slowly. Grade III astrocytomas are also called anaplastic astrocytomas. Their cells divide rapidly and invade nearby CNS tissue. The most malignant and aggressive astrocytomas are grade IV or glioblastoma multiforme. These tumors grow very quickly, their cells look abnormal under the microscope and they often spread widely in the brain. There are two types of oligodendrogliomas. Low-grade oligodendrogliomas tend to be slow growing and are often sensitive to chemotherapy while anaplastic oligodendrogliomas are faster growing and need more aggressive therapy.

Interdisciplinary Neuro-oncology Tumor Board
Precise diagnosis of the type and progression of the tumor is crucial to the successful treatment of nervous system tumors. The interdisciplinary neuro-oncology tumor board consists of all the doctors and health care professionals needed to accurately diagnose your particular condition and oversee your care. The entire team meets during a weekly conference. At that time, they review their findings from your clinic visit as well as any medical documents you have provided such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans, pathology slides and medical reports. Your lead doctor will then discuss with you the team’s conclusions and recommendations.

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Treatment Options
The goal of any cancer treatment is to eliminate the cancer and prevent or reduce the chance of tumor regrowth in the future. Surgery, radiation therapy, and chemotherapy are used alone or in various combinations, depending upon the type of cancer as well as other factors, such as the grade of tumor and your medical condition. Your doctor will recommend the best combination of treatments for your condition and will discuss experimental treatments (clinical trials). The neuro-oncology team will assist in making the choice that’s right for you.

Neurosurgery
Surgery is the treatment of choice for some nervous system tumors that can be removed without causing major neurological problems. The goals of this kind of surgery, also called neurosurgery, are to:

  • Remove as much of the tumor as possible
  • To relieve the pressure on your brain from the tumor
  • Provide tissue to establish a precise diagnosis
  • Determine the extent of the tumor
  • Provide access for other treatments, such as radiation implants

Radiation Therapy
Radiation therapy is another effective treatment for brain tumors and other central nervous system cancers. Radiation therapy uses X-rays or other high-energy rays to destroy cancer cells and shrink tumors. Radiation therapy can be used alone, or in combination with other treatments, such as chemotherapy.

Penn’s Radiation Oncology Department is a national leader in the development for advanced treatment approaches. Our radiation oncologists are experts in cancer treatment and research, and have contributed significant advances to the field.

Chemotherapy
Chemotherapy uses medications to eliminate cancer cells. Because drugs travel through the bloodstream, they can kill cancer cells throughout the body or in separate areas of the brain. Chemotherapy can be given orally or through a needle in the vein.

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