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Updated 19 May 2015

Brain and spinal cord tumours

These tumours are abnormal growths found inside the bony spinal column or skull.

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Summary

  • Brain and Spinal cord tumours are abnormal growths of tissue found inside the bony spinal column or the skull, which are the primary components of the central nervous system (CNS).  
  • Symptoms of brain and spinal cord tumours generally develop slowly and worsen over time unless they are treated. 
  • The commonest symptoms of brain tumours are seizures, weakness of one side of the body, headache and change in personality.
  • Spinal cord tumour symptoms include back pain, weakness in the legs and arms, change in bladder function, impotence and loss of feeling in the legs.

Description

Brain and spinal cord tumours are abnormal growths of tissue found inside the skull or the bony spinal column, which are the primary components of the central nervous system (CNS). Benign tumours are non-cancerous and malignant tumours are cancerous.

The CNS is housed within rigid, bony quarters (i.e. the skull and spinal column), so any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function.

Cause

Most primary tumours are caused by out-of-control growth among cells that surround and support neurons. In a small number of individuals, primary tumours may result from specific genetic disease (e.g. neurofibromatosis and tuberous sclerosis). The cause of most primary tumours remains a mystery. They are not contagious and, at this time, not preventable.

Symptoms

Symptoms of brain tumours include: seizures, headaches, weakness, visual disturbance, behavioural and cognitive problems and balance problems. Headache alone, without other symptoms, is a relatively uncommon form of presentation.

Spinal cord tumour symptoms include back pain, weakness of the legs, bladder and sexual dysfunction, and change in sensation in the legs.

Diagnosis

The first test to diagnose brain and spinal column tumours is a neurological examination. Special imaging techniques such as CT (computed tomography) and MRI (magnetic resonance imaging) scans are also employed. A biopsy, a surgical procedure in which a sample of tissue is taken from a suspected tumour, helps doctors diagnose the type of tumour. The most common tumours to the CNS are secondary or metastatic deposits that have spread from another primary tumour. The most common primary tumours to spread to the brain and spinal cord are from malignant melanoma, breast or lung cancer.

Treatment

The three most commonly used treatments are surgery, radiation and chemotherapy. Doctors also may prescribe steroids to reduce swelling inside the CNS. The majority of primary brain tumours and metastatic tumours respond poorly to all forms of treatment. The risk versus benefit of the various treatment options need to be discussed with the treating doctor and carefully weighed up by the patient and family. As for the most part treatment is palliative (trying to reduce symptoms), treatments that may worsen quality of life without conveying substantial benefit should be avoided. The most significant intervention is usually debulking the tumour, thereby relieving pressure, usually temporarily. The addition of radiotherapy with or without the use of concurrent chemotherapy has the potential to slow the regrowth of the remaining tumour. This may relieve some of the symptoms, reduce or delay the need for steroids and increase life expectancy, although often only by a few months. As the treatment of CNS tumours is fraught with difficult decisions, patients should seek as many expert opinions as they need, to be well informed before choosing a particular treatment option

Previously reviewed by Dr J. Carr, FCP(SA) Neurology, MSc(Med)

Reviewed by Dr David Eedes, Oncologist, March 2011

 
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