Brain Cancer Overview
Lesion, tumor or cancer?
A lesion is an abnormality – anything from a spot on your skin to a shadow on a chest X-ray. Lesions can be scar tissue, infections, benign cysts or malignant tumors. Usually, a lesion is something your physician isn’t sure about and further tests are recommended.
A tumor is an overgrowth of cells causing an abnormal mass or lump in the body. Some tumors are very slow-growing, do not invade local structures (like bone) and do not spread (metastasize). These are referred to as benign tumors.
A cancer is a type of tumor that can grow quickly, invade local structures or metastasize. Sometimes it can do all of these things. These are referred to as malignant or high-grade tumors.
Benign vs. Non-malignant
When discussing tumors of the brain and spinal cord, we typically use the term “non-malignant” rather than "begnin" to describe a non-cancerous growth.
Even a slow growing, non-invasive and non-metastatic cancer located in an area which is difficult for the neurosurgeon to get to safely, or near critical brain or spine structures, can cause symptoms which are certainly not “benign” for the patient.
“Brain tumor” or “brain cancer” often refers to either a non-malignant or malignant tumor located within the central nervous system (also known as CNS). The CNS includes both the brain and spinal cord.
In adults, tumors that affect the spinal cord are much less common than tumors affecting the brain. As a result, the term “brain tumor” may be used to refer to the whole group of various central nervous system tumors, even if they aren’t located within the actual brain.
There are many different specialists involved in the treatment of brain or spine tumors including neurosurgeons, radiation oncologists and/or neuro-oncologists. Often tumors of the brain or spine are the same type or histology. Although tumors of the spine often cause different symptoms from those found in the brain, they are often treated with similar approaches.
In this section:
Types of brain and spine tumors
The large group of brain and spine tumors can be divided into primary and metastatic tumors.
Metastatic cancers of the brain and spinal cord are much more common than primary tumors. Metastatic cancers begin outside of the brain and spinal cord. These cancers shed small clusters of tumor cells that can spread to other locations in the body, including the brain and spine, where they begin to grow.
A primary tumor is one which begins in the brain or spinal cord. They often do not spread or metastasize, even if they grow quickly. The few brain and spine tumors that do metastasize usually spread only within the brain and spinal cord spaces and not to the rest of the body.
There are more than 100 types of primary brain tumors, all of which are rare, some extremely so. Each has its own behavior and treatment. Additionally, in recent years a number of markers have emerged as important in predicting aggressiveness and responsiveness to treatment – which further subdivides tumor categories.
Learn more about types of primary brain tumors.
Expert care: The neuro-oncologist
A neuro-oncologist (also central nervous system oncologist or brain and spine oncologist) is a cancer doctor who specializes in the treatment of patients with brain and spine cancer, primary or metastatic. This type of doctor also helps manage the neurologic complications of cancer (such as seizures) and manages the neurologic complications of treatment.
These specialists can have neuro-oncology fellowship training and spend all or most of their practice time treating patients with brain and spine tumors.
While general medical oncologists typically provide excellent care for brain and spine tumor patients, a neuro-oncologist provides additional perspective on treatment and symptom management options for these rare and complex conditions. A neuro-oncologist will often provide primary cancer care for their patients but, alternatively, can serve in a consulting role. This can allow more options for patients while they receive care closer to home.
Both because of the relative rarity of patients with brain tumors and the small number of formally trained neuro-oncologists, brain tumor programs are most often found at larger hospitals. This allows for the support of specialists like neuropathologists, neuroradiologists, specialty trained neurosurgeons as well as neuro-oncologists. It also allows for the availability of advanced technologies like functional MRI brain mapping or stereotactic radiosurgery and opportunities for clinical trials which make novel therapies possible.
Learn more about the neuro-oncologist's role in your care.
What is a tumor board meeting?
At The University of Kansas Cancer Center, we recognize that the care of patients with brain and spine cancers can be complicated. Getting the best outcomes requires a team approach. The entire brain tumor team, including the neuroradiologists, our neuropathologist, the neurosurgeons, our neuro-oncologists and radiation oncologists, meet on a regular basis and review the treatment history, MRI studies, pathology results and the current clinical situation of our patients.
These discussions generate multiple options and opinions and serve to create a comprehensive set of treatment recommendations that are subsequently discussed with the patient and family in an effort to determine the best options going forward.