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What is adult brain tumor?
Adult brain tumor is a disease in which cancer (malignant) cells begin
to grow in the tissues of the
brain. The brain controls memory and learning, senses (hearing, sight,
smell, taste, and touch), and
emotion. It also controls other parts of the body, including muscles,
organs, and blood vessels.
This PDQ summary covers tumors that start in the brain (primary brain
tumors). Often cancer
found in the brain has started somewhere else in the body and has spread
(metastasized) to the
brain. This is called brain metastasis (see the PDQ patient information
summary on brain
metastasis).
A doctor should be seen if the following symptoms appear: frequent headaches,
vomiting, or
difficulty walking or speaking.
If there are symptoms, a doctor may order a computed tomographic scan,
a special x-ray that
uses a computer to make a picture of the brain. A magnetic resonance
imaging scan, which uses
magnetic waves to make a picture of the brain, may also be done. Often
surgery is required to
determine if there is a brain tumor and to see what type of tumor it
is.
The chance of recovery (prognosis) and choice of treatment depend on
the type of brain tumor
and the patient's general state of health.
STAGE EXPLANATION
Types of adult brain tumor
Once adult brain tumor is found, more tests will be done to determine
the type of tumor. A doctor
will also need to know how different the tumor cells are from the cells
that are near it, which is
called the histologic grade of the tumor. To plan treatment, the doctor
needs to know the type and
grade of brain tumor. The following types are used to group adult brain
tumors.
Astrocytomas
Astrocytomas are tumors that start in brain cells called astrocytes.
There are different kinds of
astrocytomas, which are defined by how the cancer cells look under
a microscope.
Noninfiltrating astrocytoma
Noninfiltrating astrocytomas are tumors that grow slowly and usually
do not grow into the tissues
around them.
Well-differentiated mildly and moderately anaplastic astrocytoma
Well-differentiated mildly and moderately anaplastic astrocytomas are
slow growing, but grow
more quickly than noninfiltrating astrocytomas. They start to grow
into other tissues around them.
Anaplastic astrocytoma
Anaplastic astrocytomas have cells that look very different from normal
cells and that grow more
rapidly.
Glioblastoma multiforme
Glioblastoma multiformes are tumors that grow very quickly and have
cells that look very different
from normal cells. Glioblastoma multiforme is also called grade IV
astrocytoma.
Brain Stem Gliomas
Brain stem gliomas are tumors located in the bottom part of the brain
that connects to the spinal
cord (the brain stem).
Cerebellar Astrocytoma
Cerebellar astrocytoma occurs in the area of the brain called the cerebellum,
which is just above
the back of the neck. Cerebellar astrocytomas usually grow slowly and
do not usually spread
from where they began to other parts of the brain or body.
Ependymal Tumors
Ependymal tumors are tumors that begin in the ependyma, the cells that
line the passageways in
the brain where special fluid that protects the brain and spinal cord
(called cerebrospinal fluid) is
made and stored. There are different kinds of ependymal tumors, which
are defined by how the
cells look under a microscope.
Well-differentiated ependymoma
Well-differentiated ependymomas have cells that look very much like
normal cells and grow quite
slowly.
Anaplastic ependymoma
Anaplastic ependymomas are ependymal tumors that do not look like normal
cells and grow more
quickly than well-differentiated ependymal tumors.
Ependymoblastoma
Ependymoblastomas are rare cancers that usually occur in children. They may grow very quickly.
Oligodendroglial Tumors
Oligodendroglial tumors begin in the brain cells called oligodendrocytes,
which provide support
and nourishment for the cells that transmit nerve impulses. There are
different types of
oligodendroglial tumors, which are defined by how the cells look under
a microscope.
Well-differentiated oligodendroglioma
Well-differentiated oligodendrogliomas are slow-growing tumors that
look very much like normal
cells.
Anaplastic oligodendroglioma
Anaplastic oligodendrogliomas grow more quickly, and the cancer cells
look very different from
normal cells.
Other Brain Tumors
Mixed gliomas
Mixed gliomas are brain tumors that occur in more than one type of brain
cell, including cells of
astrocytes, ependymal cells, and/or oligodendrocytes.
Medulloblastoma
Medulloblastomas are brain tumors that begin in the lower part of the
brain. They are almost
always found in children or young adults. This type of cancer may spread
from the brain to the
spine.
Pineal parenchymal tumors
Pineal region tumors are tumors found in or around a tiny organ located
near the center of the
brain (the pineal gland). The tumors can be slow growing (pineocytomas)
or fast growing
(pineoblastomas). Astrocytomas may also start here.
Germ cell tumors
Germ cell tumors arise from the sex cells. There are different kinds
of germ cells, including
germinomas, embryonal carcinomas, choriocarcinomas, and teratomas.
Craniopharyngioma
Craniopharyngiomas are tumors that occur near the pituitary gland. The
pituitary gland is a small
organ about the size of a pea; this gland is located just above the
back of the nose and controls
many of the body's functions.
Meningioma
Meningiomas are tumors that occur in the membranes that cover and protect
the brain and spinal
cord (the meninges). Meningiomas usually grow slowly.
Malignant meningioma
Malignant meningioma is a rare tumor that grows more quickly than other
meningiomas.
Choroid Plexus Tumors
The choroid plexus is tissue located in the spaces inside the brain
called ventricles. The choroid
plexus makes the fluid that fills the ventricles and surrounds the
brain and spinal cord. Tumors of
the choroid plexus can grow slowly (choroid plexus papilloma) or grow
more rapidly (anaplastic
choroid plexus papilloma). The rapidly growing tumors are more likely
to spread to other places
in the brain and to the spinal cord.
Recurrent
Recurrent disease means that the cancer has come back (recurred) after
it has been treated. It
may come back in the brain or in another part of the body.
TREATMENT OPTION OVERVIEW
How adult brain tumors are treated
There are treatments for all patients with an adult brain tumor. Three kinds of treatment are used:
surgery
radiation therapy
chemotherapy
Surgery is the most common treatment of adult brain tumors. To take
out the cancer from the
brain, a doctor will cut a part of the bone from the skull to get to
the brain. This operation is called
a craniotomy. After the doctor removes the cancer, the bone will be
put back or a piece of metal
or fabric will be used to cover the opening in the skull.
Radiation therapy uses x-rays produced by a machine called a linear
accelerator or a cobalt
machine to kill cancer cells from the outside and shrink tumors (external-beam
radiation therapy).
Radiation therapy may also be used by putting materials that produce
radiation (radioisotopes)
through thin plastic tubes into the tumor to kill cancer cells from
the inside (internal radiation
therapy).
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken
by pill, or it may be
put into the body by a needle in the vein or muscle. Chemotherapy is
called a systemic treatment
because the drug enters the bloodstream, travels through the body,
and can kill cancer cells
throughout the body.
Biological therapy (using the body's immune system to fight cancer)
is also being studied in clinical
trials. Biological therapy tries to get the body to fight cancer. It
uses materials made by the body
or made in a laboratory to boost, direct, or restore the body's natural
defenses against disease.
Biological therapy is sometimes called biological response modifier
therapy or immunotherapy.
Treatment by type
Treatment of adult brain tumor depends on the type and stage of the
disease, and the patient's age
and overall health.
Standard treatment may be considered because of its effectiveness in
past studies, or participation
in a clinical trial may be considered. Not all patients are cured with
standard therapy, and some
standard treatments may have more side effects than are desired. For
these reasons, clinical trials
are designed to find better ways to treat cancer patients and are based
on the most up-to-date
information. Clinical trials are ongoing in most parts of the country
for most types of adult brain
tumor. To learn more about clinical trials, call the Cancer Information
Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
ADULT NONINFILTRATING ASTROCYTOMA
Treatment may be one of the following:
1. Surgery to remove the cancer.
2. Surgery followed by external-beam radiation therapy.
3. If anaplastic astrocytoma comes back (recurs)
after surgery, treatment may be radiation
therapy if it was not given before. If radiation
therapy was given before, clinical trials of
chemotherapy or biological therapy should
be considered.
ADULT WELL-DIFFERENTIATED MILDLY AND MODERATELY
ANAPLASTIC ASTROCYTOMA
Treatment may be one of the following:
1. Surgery followed by external-beam radiation therapy.
2. Surgery alone.
3. A clinical trial of surgery followed by
radiation therapy and chemotherapy.
ADULT ANAPLASTIC ASTROCYTOMA
Treatment may be one of the following:
1. Surgery followed by external-beam radiation therapy.
2. Surgery followed by external-beam radiation therapy and chemotherapy.
3. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
4. A clinical trial of chemotherapy or biological therapy following radiation therapy.
5. A clinical trial of chemotherapy drugs,
which are placed in the body during surgery.
ADULT GLIOBLASTOMA MULTIFORME
Treatment may be one of the following:
1. Surgery followed by external-beam radiation therapy and chemotherapy.
2. Surgery followed by external-beam radiation therapy.
3. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
4. A clinical trial of chemotherapy or biological therapy following radiation therapy.
5. A clinical trial of chemotherapy drugs,
which are placed in the body during surgery.
ADULT BRAIN STEM GLIOMA
Treatment may be one of the following:
1. External-beam radiation therapy.
2. A clinical trial of chemotherapy or biological
therapy.
ADULT WELL-DIFFERENTIATED EPENDYMOMA
Treatment may be one of the following:
1. Surgery to remove the cancer.
2. Surgery to remove the cancer followed by external-beam radiation therapy.
3. A clinical trial of chemotherapy or biological
therapy.
ADULT MALIGNANT EPENDYMOMA
Treatment may be one of the following:
1. Surgery to remove the cancer followed by external-beam radiation therapy.
2. A clinical trial of external-beam radiation therapy with chemotherapy.
3. A clinical trial of chemotherapy or biological
therapy.
ADULT WELL-DIFFERENTIATED OLIGODENDROGLIOMA
Treatment may be one of the following:
1. Surgery to remove the cancer followed by external-beam radiation therapy.
2. Surgery to remove the cancer.
3. A clinical trial of radiation therapy plus
chemotherapy.
ADULT ANAPLASTIC OLIGODENDROGLIOMA
Treatment may be one of the following:
1. Surgery to remove the cancer followed by external-beam radiation therapy.
2. Surgery followed by external-beam radiation therapy and chemotherapy.
3. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
4. A clinical trial of chemotherapy or biological
therapy following radiation therapy.
MIXED GLIOMAS
Treatment may be one of the following:
1. Surgery followed by external-beam radiation therapy.
2. Surgery followed by external-beam radiation therapy and chemotherapy.
3. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
4. A clinical trial of chemotherapy or biological
therapy following radiation therapy.
ADULT MEDULLOBLASTOMA
Treatment may be one of the following:
1. Surgery to remove the cancer plus external-beam radiation therapy.
2. A clinical trial of surgery plus external-beam radiation therapy and chemotherapy.
(See the PDQ patient information summary on childhood brain tumor for
more information).
ADULT PINEAL PARENCHYMAL TUMOR
Treatment may be one of the following:
1. Surgery plus external-beam radiation therapy.
2. Surgery plus external-beam radiation therapy plus chemotherapy.
3. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
4. A clinical trial of chemotherapy or biological
therapy following radiation therapy.
ADULT CENTRAL NERVOUS SYSTEM GERM CELL TUMOR
Treatment depends on whether the cancer can be removed in an operation,
the kind of cells, the
location of the tumor, and other factors.
ADULT CRANIOPHARYNGIOMA
Treatment may be one of the following:
1. Surgery to remove the cancer.
2. Surgery to remove the cancer followed by
radiation therapy.
ADULT MENINGIOMA
Treatment usually consists of surgery to remove the tumor. If all of
the tumor cannot be removed
in an operation, a patient may also receive external-beam radiation
therapy after surgery.
ADULT MALIGNANT MENINGIOMA
Treatment may be one of the following:
1. Surgery followed by external-beam radiation therapy.
2. A clinical trial of new forms of radiation
therapy, such as internal radiation, radiation
given during surgery, or radiation given with
drugs to make the cancer cells more sensitive
to radiation.
3. A clinical trial of chemotherapy or biological
therapy following radiation therapy.
RECURRENT ADULT BRAIN TUMOR
Treatment may be one of the following:
1. Surgery alone.
2. Surgery followed by chemotherapy.
3. External-beam radiation therapy alone, if
not used during previous treatment, with or
without chemotherapy.
4. Internal radiation therapy.
5. A clinical trial of chemotherapy.
6. A clinical trial of chemotherapy drugs,
which are placed in the body during surgery
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