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CNI Center for Brain & Spinal Tumors
Education & Information
FAQ
What is a brain tumor?
A brain tumor is an abnormal growth, or neoplasm, growing in the brain.
What causes brain tumors?
Usually there is no known cause. Occasionally we can attribute a brain tumor to previous exposure to radiation or a hereditary predisposition. Sometimes a brain tumor is the result of the spread of another kind of cancer to the brain.
What kinds of brain tumors are there?
We classify brain tumors as primary (those that originate in the brain) or metastatic (those that have spread to the brain from other parts of the body).
What cancers are most likely to spread (metastasize) to the brain?
- Lung cancer
- Kidney cancer
- Breast cancer
- Leukemia
- Melanoma
- Lymphoma
What are the types of primary brain tumors?
We classify primary brain tumors by the type of cells that are in the tumor and by its grade of malignancy. The brain is composed mostly of two main cell types: Glial cells and neurons.
Most tumors are composed of glial cells that have become cancerous. Different kinds of glial cells include astrocytes (star-shaped), oligodendrocytes and ependymal cells. Tumors composed of these cells are called astrocytomas, oligodendrogliomas and ependymomas respectively. Sometimes tumors contain more than one of these types of cells.
The basic types of brain tumors include:
- Glioblastoma multiforme (astrocytoma Grade IV) - the most common primary brain tumor in adults
- Anaplastic astrocytoma (astrocytoma Grade III)
- Astrocytoma (Grades I and II)
- Oligodendroglioma (low grade or high grade)
- Mixed glioma (low grade or high grade)
- Gliosarcoma
- Meningiomas (may be typical, atypical, or malignant)
- Nerve sheath tumors (include acoustic neuromas)
- Ependymomas (most common in spinal cord)
- Primitive neural actodermal tumor (PNAT)
- Pituitary tumors
- Craniopharyngiomas
- Neurofibromas
- Lymphomas
What is the difference between low grade and high grade?
The neuropathologist determines whether a tumor is low grade or high grade by the tumor’s appearance under the microscope. The major finding that separates low grade from high grade is the absence (low grade) or presence (high grade) and the frequency of dividing tumor cells (mitosis).
We grade astrocytomas I to IV, with Grade I being the least aggressive and Grade IV being the most aggressive. We commonly call a Grade III astrocytoma an anaplastic astrocytoma and a Grade IV astrocytoma a glioblastoma multiforme (GBM), which is the most common primary brain tumor in adults. Typical characteristics of the lowest and highest grade tumors are as follows:
Low-grade tumors:
- Slower growing and less invasive.
- Potentially curable by surgery.
- Less likely to spread within the brain.
- More likely to be associated with long term survival.
High-grade tumors:
- Faster growing and more invasive.
- Essentially never curable by surgery alone.
- More likely to spread to other parts of the brain.
- Less likely to be associated with long-term survival.
What is the goal of surgery for brain tumors?
Whenever possible, the goal of neurosurgery in the CNI Center for Brain & Spinal Tumors is to remove most or all of a brain tumor. Studies over the years have shown that optimum surgery is crucial, but must be combined with a high degree of concern for the preservation of brain function since severe neurological deficit is a negative prognostic factor.
What is radiation therapy and what does it achieve?
Radiation therapy is a proven form of treatment for all brain tumors, although its value is most evident in high-grade tumors. Radiation is a way of delivering subatomic particles to a tumor in an effort to damage or kill cancer cells. Our program incorporates modern, sophisticated techniques to optimize the benefit of this treatment for patients.
What is chemotherapy?
Chemotherapy is the use of chemicals or drugs to damage or kill cancer cells or cause the cancer cells to activate an internal process that causes cell death (apoptosis). Chemotherapy has the advantage over surgery and radiation therapy of circulating throughout the body to wherever cancer cells may be. This can also be a disadvantage if there is not adequate blood supply to get the drugs to the cancer cells.
Since we know that high-grade tumors invade microscopically into the brain beyond the surgical margin in virtually every case, we believe that effective chemotherapy must be a part of any strategy that seeks to cure this disease. We therefore offer chemotherapy to all patients whom we believe can benefit from it.
What is biological therapy?
Biological therapy, or biotherapy, is the newest and most exciting approach to cancer treatment. Based upon the rapidly growing knowledge of the molecular basis of cancer, biotherapy seeks to treat cancer not by destroying or removing cancer cells, which is the case with surgery, radiation therapy and chemotherapy, but by modifying the abnormal chemical processes that allow the cells to grow relentlessly--a feature shared by all malignancies.
How do brain tumors affect emotions, intellect and personality?
Brain tumors affect people in many different ways, depending on a variety of factors that include tumor type, location, size and other factors. CNI's Center for Brain & Spinal Tumors Team includes neuropsychologists; they are involved in a patient's treatment to assess and monitor the impact of the tumor on a patient's cognitive and motor functions as well as emotions. A neuropsychologist is often involved during surgeries, particularly awake craniotomies. Neuropsychological evaluations are also part of CNI's offering to patients. In addition, neuropsychologists can help patients and their families cope with changes that result from the brain tumor or treatment.
What does CNI’s program offer that is unique?
CNI offers a number of modern approaches to treatment that are state-of-the-art, and, in some cases, not available at most other centers. However, the most unique feature of our Center is that we have put together a multi-disciplinary team of professionals that is committed to providing patients with the best and most comprehensive care anywhere. This is done in a private setting where each patient, from diagnosis through treatment and follow-up, knows who his or her advocate is in order to ensure the best possible outcome and to address all needs and concerns throughout their care. Ultimately, the goal for all patients is cure.
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