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• 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 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, headaches and a 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.

Brain and spinal cord tumours are abnormal growths 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.

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 legs, bladder and sexual dysfunction, and change in sensation in the legs. These symptoms get progressively worse as the tumour gets bigger in size. It is not something that comes and goes like most headaches sometimes do.

Diagnosis
A clinical evaluation is firstly needed if a brain and/or spinal column tumours is suspected. Special imaging techniques (computed tomography and magnetic resonance imaging) are also employed and needed to evaluate the extent of the tumour . 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 commonest cause of tumours in these areas is secondary (metastatic) spread from another primary tumour, such as breast or lung cancer.

Treatment
The three most commonly used treatments are surgery, radiation and chemotherapy. Doctors may prescribe steroids to reduce the swelling inside the CNS. The majority of primary brain tumours and metastatic tumours respond poorly to most forms of treatment and therefore treatment should be discussed with a team of doctors i.e. a neurosurgeon, an oncologist and a neurologist. The risks of these treatments must be weighed up, as they may worsen quality of life without conveying substantial benefit. The most significant intervention is usually excision of, or debulking the tumour after which other therapies may follow such as radiation or chemotherapy, or a combination of both. In general, radiotherapy will increase life expectancy and depending on the area being treated and the primary disease, it can be determined what eventual outcome can be expected. Stereotactic radiation can treat very small tumours very effectively without much damage to surrounding structures. Treatment of brain tumours is fraught with difficult decisions, and patients should seek as many expert opinions as they can before choosing a particular option.

Research
Researchers are actively studying new techniques for radiation and chemotherapy as well as other medications such as immune-therapy and heat therapy.

Reviewed by Dr C R Jacobs Clinical Oncologist

 

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