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• Chemotherapy, while effective at treating tumors, often harms healthy cells as well, leading to severe side effects especially in young children.

Brain and Spinal Cord Tumors

Brain and spinal cord tumors are abnormal growths of tissue found inside the skull or the bony spinal column. The word tumor is used to describe both abnormal growths that are new (neoplasms) and those present at birth (congenital tumors). No matter where they are located in the body, tumors are usually classed as benign (or non-cancerous) if the cells that make up the growth are similar to other normal cells, grow relatively slowly, and are confined to one location. Tumors are called malignant (or cancerous) when the cells are very different from normal cells, grow relatively quickly, and can spread easily to other locations.

In most parts of the body, benign tumors are not particularly harmful. This is not necessarily true in the brain and spinal cord, which are the primary components of the central nervous system (CNS). Because the CNS is housed within rigid, bony quarters (that is, the skull and spinal column), any abnormal growth can place pressure on sensitive tissues and impair function. Also, any tumor located near vital brain structures or sensitive spinal cord nerves can seriously threaten health. A benign tumor growing next to an important blood vessel in the brain does not have to grow very large before it can block blood flow. Or, if a benign tumor is found deep inside the brain, surgery to remove it may be very risky because of the chances of damaging vital brain centers. On the other hand, a tumor located near the brain's surface can often be removed surgically.

An important difference between malignant tumors in the CNS and those elsewhere in the body lies with their potential to spread. While malignant cells elsewhere in the body can easily seed tumors inside the brain and spinal cord, malignant CNS tumors rarely spread out to other body parts. Brain and spinal cord tumors cause many diverse symptoms, which can make detection tricky. Whatever specific symptoms a patient has, the symptoms generally develop slowly and worsen over time.

Brain Tumors

Brain tumors can cause a bewildering array of symptoms depending on their size, type, and location. Certain symptoms are quite specific because they result from damage to particular brain areas. Other, more general symptoms are triggered by increased pressure within the skull as the growing tumor encroaches on the brain's limited space or blocks the flow of cerebrospinal fluid (fluid that bathes the brain and spinal cord).

Some of the more common symptoms of a brain tumor include:

Headaches More than half of people with brain tumors experience headaches. Because the skull cannot expand, the growing mass places pressure on pain-sensitive areas. The headaches recur, often at irregular periods, and can last several minutes or hours. They may worsen when coughing, changing posture, or straining. As the tumor grows, headaches often last longer, become more frequent, and grow more severe.

Seizures The abnormal tissue found in a brain tumor can disrupt the normal flow of electricity through which brain cells communicate. The resulting bursts of electrical activity cause seizures with a variety of symptoms, such as convulsions, loss of consciousness, or loss of bladder control. Seizures that first start in adulthood (in a patient who has not been in an accident or had an illness that causes seizures) are a key warning sign of brain tumors. Sometimes, seizures are the only sign of a slowly growing brain tumor.

Nausea and Vomiting Increased pressure within the skull can cause nausea and vomiting. These symptoms sometimes accompany headaches.

Vision or Hearing Problems. Increased intracranial pressure can also decrease blood flow in the eye and trigger swelling of the optic nerve, which in turn causes blurred vision, double vision, or partial visual loss. Tumors growing on or near sensory nerves often trigger visual or hearing disturbances, such as ringing or buzzing sounds, abnormal eye movements or crossed eyes, and partial or total loss of vision or hearing. Tumors that grow in the brain's occipital lobe, which interprets visual images, may also cause partial vision loss.

Behavioral and Cognitive Symptoms Because they strike at the core of the individual's identity, changes in behavior and personality can be the most frightening and devastating symptoms of a brain tumor. These symptoms usually occur when the tumor is located in the brain's cerebral hemispheres, which are responsible, in part, for personality, communication, thinking, behavior, and other vital functions. Examples include problems with speech, language, thinking, and memory, or psychotic episodes and changes in personality.

Motor Problems When tumors affect brain areas responsible for command of body movement, they can cause motor symptoms, including weakness or paralysis, lack of coordination, or trouble with walking. Often, muscle weakness or paralysis affects only one side of the body.

Balance Problems Brain tumors that disrupt the normal control of equilibrium can cause dizziness or difficulty with balance.

Spinal Cord Tumors

The spinal cord is, in part, like a living telephone cable. Lying protected the bony spine, it contains bundles of nerves that carry messages between the brain and the body's nerves, such as instructions from the brain to move an arm or information from the skin that signals pain. A tumor that forms on or near the spinal cord can disrupt this communication. Often, these tumors exert pressure on the spinal cord or the nerves that exit from it; sometimes, they restrict the cord's supply of blood.

Common symptoms that result from this include:

Pain Normally, the spinal cord carries important warnings about pain from the body's nerves to the brain. By putting pressure on the spinal cord, a tumor can trigger these circuits and cause pain that feels as if it is coming from various parts of the body. This pain is often constant, sometimes severe, and can have a burning or aching quality. Sensory changes. Many people with spinal cord tumors suffer a loss of sensation. This usually takes the form of numbness and decreased skin sensitivity to temperature.

Motor Problems Since the nerves control the muscles, tumors that affect nerve communication can trigger a number of muscle-related symptoms. Early symptoms include muscle weakness; spasticity in which the muscles stay stiffly contracted; and impaired bladder and/or bowel control. If untreated, symptoms may worsen to include muscle wasting and paralysis. In addition, some people develop an abnormal walking rhythm known as ataxia. The parts of the body affected by these symptoms vary with tumor location along the spinal cord. In general, symptoms strike body areas at the same level or at a level below that of the tumor. For example, a tumor midway along the spinal cord (in the thoracic spine) can cause pain that spreads over the chest in a girdle-shaped pattern and gets worse when the individual coughs, sneezes, or lies down. A tumor that grows in the top fourth of the spinal column (or cervical spine) can cause pain that seems to come from the neck or arms. And a tumor that grows in the lower spine (or lumbar spine) can trigger back or leg pain.