Central Nervous System Carcin... Health Article

Treatment team

A CNS carcinoma requires attention from several different types of physician specialists. A neurologist, a physician specializing in the nervous system, does the initial assessment. A radiologist interprets x rays, CT and MRI images. A hematologist or oncologist evaluates the results of blood tests. A pathologist studies the tissue from a biopsy. The surgery team that removes the tumor typically includes a neurosurgeon and an orthopedic surgeon. The orthopedic surgeon takes part because it is necessary to cut through bone to reach the brain and maneuver around vertebrae to reach the spinal cord. At premier cancer centers teams of physicians work collaboratively with one person, usually an oncologist, taking the lead. Physical and occupational therapists who help with rehabilitation following treatment and surgery, and registered nurses who administer chemotherapy, are also part of the team.

Clinical staging, treatments, and prognosis

By studying tissue from the tumor and surrounding cells the oncologist determines whether the tumor is growing and, if so, how fast. There is an elaborate system for assigning grades to the tumors that depends on things such as which part of the brain was served by the glial cell(s) in which the tumor began.

A plan for treatment is based on the location, size, and rate of growth of the tumor. Surgical removal of the tumor, radiation, and chemotherapy are all used. Method of treatment depends on the type of CNS carcinoma. In some cases the treatment is strictly palliative (provides comfort) and is not expected to halt the course of the cancer. Drugs, such as steroids, are often given to reduce swelling and, correspondingly, reduce pain and other symptoms.

About three-quarters of all individuals diagnosed with CNS carcinoma die before attaining a five-year survival rate.

Alternative and complementary therapies

Relaxation techniques may help to relieve pain from swelling.

Coping with cancer treatment

Being an active participant in the treatment team, something that specialized cancer centers encourage, is one way to cope. Joining a support group also may help.

Clinical trials

The National Cancer Institute at the National Institutes of Health operates an information service that provides the most up-to-date information about clinical trials. The number is (800) 4-CANCER ([800] 422-6237).

Prevention

Limiting exposure to cosmic radiation and chemicals might lower the risk. However, experts have no specific recommendations for prevention.

Special concerns

Psychological changes as simple as mood swings and as severe as major changes in personality are possible. Sensory impairment is also possible. Advance directives, or written instructions for the care a person wants at each juncture of treatment, should be prepared and legalized as early in the therapeutic process as possible. Such directives make the patient's choices clear should he or she become unable to express them as the cancer progresses. Doing so relieves loved ones of the responsibility for making those decisions, which can become extremely difficult.

See Also Brain and central nervous system tumors

Resources

BOOKS

Schold, S. Clifford Jr. et al. Primary Tumors of the Brain and Spinal Cord. Boston: Butterworth-Heinemann, 1997.

PERIODICALS

Ballard, T. et al. "Cancer Incidence and Mortality Among Flight Personnel: A Meta-Analysis" Aviation, Space, and Environmental Medicine. 71 (March 2000): 216-24.

Black, P. M. "Brain Tumors" (part two) New England Journal of Medicine 324 (May 31, 1991): 1555-1564.

Huncharek, M. et al. "Chemotherapy Response Rates in Recurrent/Progressive Pediatric Glioma; Results of a Systematic Review" Anticancer Research 19 (July-Aug. 1999): 3569-74.

ORGANIZATIONS

American Brain Tumor Association. 2720 River Road, DesPlaines, IL 60018 (800) 886-2282 <http://www.abta.org>

The Brain Tumor Society. 124 Watertown Street, Suite 3-H, Watertown, MA 02472. (617) 924-9997 <http://www.tbts.org>

OTHER

"Year 2000 Standard Report" Central Brain Tumor Registry of the United States 28 March 2001 6 July 2001 <http://www.cbtrus.org/2000/y2kstats_report.htm>

"Facts and Statistics from the American Brain Tumor Association" CancerWise.org 28 March 2001. 6 July 2001 <http://www.cancerwise.org/archive/august/facts_figures/ff_brain.html>

Diane M. Calabrese

Biopsy

—Tissue sample taken from body for microscopic examination.

Carcinoma

—A cancer that originates in cells that developed from epithelial tissue, a tissue that forms layers and often specializes to cover and protect organs.

Computed tomography (CT)

—X rays aimed at sections of the body (by rotating equipment) and images appear as slices. Results are assembled with a computer to give a three-dimensional image.

Homeostasis

—Self-regulating mechanisms are working, body is in equilibrium, no uncontrolled cell growth.

Magnetic resonance imaging (MRI)

—Magnetic fields and radio frequency waves are used to make images of the inside of the body.

Meninges

—The three layers of tissue that cover the brain and spinal cord.

Pineal

—A very small gland in the center of the brain that is sensitive to light.

Pituitary

—A gland at the base of the brain that produces hormones.