Neurological Cancer

If you’ve been recently diagnosed with brain or spinal cancer, you and your family might be overwhelmed with questions and concerns. Your first decision is where to get treatment.

You want a place where you can get the most advanced treatment options available. A place where you are supported by a team of compassionate experts. A place where you are treated as a whole person.

MultiCare Regional Cancer Center is that place. We have the region’s best health care providers in the field of oncology. Our world-class treatment facility offers cutting-edge technology in a welcoming and positive healing environment.

Learn about our cancer care team or more about neurological cancer in the tabs below.

Neurological Cancer Facts

There are many types of brain and spinal cord tumors. The tumors are formed by the abnormal growth of cells and may begin in different parts of the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system (CNS).

Benign (not cancer) tumors grow and press on nearby areas of the brain. They rarely spread into other tissues.

Malignant (cancer) tumors grow quickly and spread into other brain tissue. A metastatic tumor starts in another part of the body and spreads to the brain. Tumors that start in the brain are called primary brain tumors. Metastatic brain tumors are more common than primary brain tumors.
Cancers that commonly spread to the brain and spinal cord:

• Adult Hodgkin Lymphoma
• Adult Non-Hodgkin Lymphoma
• Breast Cancer
• Carcinoma of Unknown Primary
• Colon Cancer 
• Melanoma 
• Non-Small Cell Lung Cancer
• Small Cell Lung Cancer

Symptoms

When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Symptoms vary depending on the location of the tumor and are not the same for every person.

Brain tumor symptoms include:

• Morning headache or headache that goes away after vomiting
• Frequent nausea and vomiting
• Vision, hearing and speech problems
• Loss of balance and trouble walking
• Weakness on one side of the body
• Unusual sleepiness or change in activity level
• Unusual changes in personality or behavior
• Seizures

Spinal cord tumor symptoms include:

• Back pain or pain that spreads from the back towards the arms or legs
• A change in bowel habits or trouble urinating
• Weakness in the legs
• Trouble walking

Prevention

Causes and Risk Factors

The cause of most adult brain tumors is unknown. There are few known risk factors for brain tumors. The following conditions may increase the risk of developing certain types of brain tumors:

• Being exposed to vinyl chloride may increase the risk of glioma
• Past treatment with radiation therapy to the scalp or brain may increase the risk of meningioma
• Infection with the Epstein-Barr virus, having AIDS (acquired immunodeficiency syndrome) or receiving an organ transplant may increase the risk of primary CNS lymphoma

Having certain genetic syndromes may increase the risk of developing the following types of brain tumors:

• Neurofibromatosis type 1 or 2
• von Hippel-Lindau disease
• Tuberous sclerosis
• Li-Fraumeni syndrome
• Turcot syndrome type 1 and type 2
• Klinefelter syndrome
• Nevoid basal cell carcinoma syndrome

Diagnosis

The following tests and procedures may be used to assess the type and grade of brain tumors:

• Physical exam and history
• Neurological exam
• Visual field exam
• Tumor marker test
• Gene testing
• Lumbar puncture
• CT scan
• MRI (magnetic resonance imaging) with gadolinium
• SPECT scan (single photon emission computed tomography scan)
• PET scan (positron emission tomography scan)
• Angiogram

If doctors think there may be a brain tumor, a biopsy may be done to remove a sample of tissue. The biopsy is done by removing part of the skull and using a needle to remove the tissue sample.

A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are found, the doctor may remove as much tumor as safely possible during the same surgery.
After the surgery, a pathologist checks the cancer cells to find out the type and grade of brain tumor. The grade of the tumor is based on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. A CT scan or MRI may be used to find out if any cancer cells remain after surgery.

Sometimes a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed based on the results of imaging tests and other procedures.

The extent or spread of cancer is usually described as stages. There is no standard staging system for brain tumors. Brain tumors that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. 

Treatments

Treatment of brain tumors is based on the type of cell in which the tumor began, where the tumor formed in the central nervous system, the amount of cancer left after surgery and the grade of the tumor.

Surgery

Surgery is the most common treatment for tumors that can be reached surgically. After surgery, some patients may be given chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. 

External radiation therapy uses a machine outside the body to send radiation toward the cancer. One type of external radiation therapy is hyperfractionated radiation therapy, in which the total dose of radiation is divided into small doses given more than once a day.

Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of tumor and where it is in the brain.

MultiCare offers image-guided, stereotactic radiosurgery on the Varian® Trilogy System for treating cancer. Stereotactic radiosurgery is a form of radiation therapy that uses 3-D computer imaging to attack tumors and lesions with an extremely precise dose of radiation. Learn more about this treatment option.

Intensity Modulated Radiation Therapy (IMRT) is the most advanced form of radiotherapy. IMRT employs a powerful, advanced computer program that plans a precise dose of radiation in three dimensions based on individual tumor size, shape and location. Remarkably, it allows for radiation doses up to 40 percent higher than traditional radiotherapy methods, while sparing close to 70 percent more of the surrounding healthy tissue.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).

When chemotherapy is placed directly into the cerebrospinal fluid, an organ or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

To treat brain tumors, a dissolving wafer may be used to deliver an anticancer drug directly to the brain tumor site after the tumor has been removed by surgery. The way the chemotherapy is given depends on the type of tumor and where it is in the brain.