An estimated 700,000 Americans are living with a tumor
An estimated 86,970 people will receive a primary brain tumor diagnosis in 2019
The average survival rate for all malignant brain tumor patients is only 35%
An estimated 16,830 people will die from malignant brain tumors (brain cancer) in 2019
Brain and central nervous system (CNS) tumors are the most prevalent form of pediatric cancer in kids under 19
Pediatric brain tumors are the leading cause of cancer-related death among children and adolescents ages 0-19, surpassing leukemia.
More than any other cancer, brain tumors can have lasting and life-altering physical, cognitive, and psychological impacts on a patient’s life.
Even benign brain tumors can be deadly if they interfere with portions of the brain responsible for vital bodily functions.
There are more than 130 different types of brain tumors, many with their own multitude of subtypes.
Despite the amount of brain tumors, and their devastating prognosis, there have only been four (4) FDA approved drugs – and one device – to treat brain tumors in the past 30 years.
Between 1998 and 2014, there were 78 investigational brain tumor drugs that entered the clinical trial evaluation process. 75 failed. That is a 25:1 failure ratio in developing new brain tumor treatments over the past two decades.
Brain tumors have the highest per-patient initial cost of care for any cancer group, with an annualized mean net costs of care in 2010 US dollars at well over $100,000.
Doctors group brain tumors by grade. The grade of a tumor refers to the way the cells look under a microscope:
Cells from low-grade tumors (grades I and II) look more normal and generally grow more slowly than cells from high-grade tumors (grades III and IV).
Over time, a low-grade tumor may become a high-grade tumor. However, the change to a high-grade tumor happens more often among adults than children.
The median age at diagnosis for all primary brain tumors is 60 years
The cause of brain cancer is usually unknown. Most people diagnosed with a primary brain tumor do not have any known risk factors. However, certain risk factors and genetic conditions have been shown to increase a person’s chances of developing one, including:
The 5-year survival rate tells you what percent of people live at least 5 years after the tumor is found. Percent means how many out of 100. The 5-year survival rate for people with a cancerous brain or CNS tumor is approximately 34% for men and 36% for women. However, survival rates vary widely and depend on several factors, including the type of brain or spinal cord tumor.
Overall, the chance that a person will develop a malignant tumor of the brain or spinal cord in his or her lifetime is less than 1%.
On May 9, 2016, the World Health Organization (WHO) published an official reclassification of Tumor Types of the Central Nervous System, which has moved the greater neuro-oncology field toward a more precise and accurate system of brain tumor classification. Based on information from expert neuropathologists and neuro-oncologists, the result of the updated WHO classifications, which integrate molecular information with histology, is that doctors will be better able to more accurately diagnose, make prognoses, plan treatment, and predict therapeutic response for patients. A more precise diagnosis and treatment plan is a win for patients.
The most prevalent brain tumor types in adults:
The most prevalent brain tumor types in children (0-14):
Glioblastoma multiforme—also known as GBM—is the most lethal form of brain cancer in adults. This devastating brain cancer spreads into other parts of the brain very quickly and is usually not surgically curable. Typically, radiation and chemotherapy are given with the hopes of delaying tumor progression.
Medulloblastoma is a cancerous tumor—also called cerebellar primitive neuroectodermal tumor (PNET)—that starts in the region of the brain at the base of the skull, called the posterior fossa. These tumors tend to spread to other parts of the brain and to the spinal cord.
Survival rates in children with medulloblastoma depend on the patient’s age and how much the tumor spreads.
Diffuse intrinsic pontine gliomas (DIPG) are the most common brainstem tumors in children, representing approximately 75-80% of all pediatric brainstem tumors. The tumor is found in a part of the brainstem called the pons. The pons is responsible for a number of important bodily functions, like breathing, sleeping, bladder control, and balance. Because these functions are vital to survival, the pressure from the growing tumor is very dangerous.
A primary brain tumor originates in the central nervous system, while metastatic brain tumors spread to the brain from other parts of the body. Meningiomas account for about 27 percent of primary brain tumors, making them the most common of that type.
A meningioma develops from the meninges, the membrane that surrounds the brain and spinal cord. Most meningiomas (90 percent) are categorized as benign tumors, with the remaining 10 percent being atypical or malignant. However, the word benign can be misleading in this case, as when benign tumors grow and constrict and affect the brain, they can cause disability and even be life threatening.
The symptoms of a brain tumor depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or harms a part of the brain. Also, they may be caused when a tumor blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid. These are the most common symptoms of brain tumors:
Most often, these symptoms are not due to a brain tumor.
Sophisticated imaging techniques can pinpoint brain tumors. Diagnostic tools include computed tomography (CT or CAT scan) and magnetic resonance imaging (MRI). Other MRI sequences can help the surgeon plan the resection of the tumor based on the location of the normal nerve pathways of the brain. Intraoperative MRI also is used during surgery to guide tissue biopsies and tumor removal. Magnetic resonance spectroscopy (MRS) is used to examine the tumor's chemical profile and determine the nature of the lesions seen on the MRI. Positron emission tomography (PET scan) can help detect recurring brain tumors.
Sometimes the only way to make a definitive diagnosis of a brain tumor is through a biopsy. The neurosurgeon performs the biopsy and the pathologist makes the final diagnosis, determining whether the tumor appears benign or malignant, and grading it accordingly.
Brain Tumor Treatment
Brain tumors (whether primary or metastatic, benign or malignant) usually are treated with surgery, radiation, and/or chemotherapy — alone or in various combinations. While it is true that radiation and chemotherapy are used more often for malignant, residual or recurrent tumors, decisions as to what treatment to use are made on a case-by-case basis and depend on a number of factors. There are risks and side effects associated with each type of therapy.
Brain Tumor Surgery
It is generally accepted that complete or nearly complete surgical removal of a brain tumor is beneficial for a patient. The neurosurgeon's challenge is to remove as much tumor as possible, without injuring brain tissue important to the patient's neurological function (such as the ability to speak, walk, etc.). Traditionally, neurosurgeons open the skull through a craniotomy to insure they can access the tumor and remove as much of it as possible. A drain (EVD) may be left in the brain fluid cavities at the time of surgery to drain the normal brain fluid as the brain recovers from the surgery.
Another procedure that is commonly performed, sometimes before a craniotomy, is called a stereotactic biopsy. This smaller operation allows doctors to obtain tissue in order to make an accurate diagnosis.
Radiation therapy uses high-energy X-rays to kill cancer cells and abnormal brain cells and to shrink tumors. Radiation therapy may be an option if the tumor cannot be treated effectively through surgery.
American Association of Neurological Surgeons
Chemotherapy generally is considered to be effective for specific pediatric tumors, lymphomasand some oligodendrogliomas. While it has been proven that chemotherapy improves overall survival in patients with the most malignant primary brain tumors, it does so in only in about 20 percent of all patients, and physicians cannot readily predict which patients will benefit before treatment. As such, some physicians choose not to use chemotherapy because of the potential side effects (lung scarring, suppression of the immune system, nausea, etc.).
Chemotherapy works by inflicting cell damage that is better repaired by normal tissue than tumor tissue. Resistance to chemotherapy might involve survival of tumor tissue that cannot respond to the drug, or the inability of the drug to pass from the bloodstream into the brain. A special barrier exists between the bloodstream and the brain tissue called the blood-brain barrier. Some investigators have tried to improve the effect of chemotherapy by disrupting this barrier or by injecting the drug into the tumor or brain.
Coping and Support
A diagnosis of a brain tumor can be overwhelming and frightening. It can make you feel like you have little control over your health. But you can take steps to cope with the shock and grief that may come after your diagnosis. Consider trying to:
Ask your doctor about support groups in your area. Or check your phone book, library or a cancer organization, such as the National Cancer Institute or the American Cancer Society.