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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66023_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66023_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66023_"><span class="title" itemprop="name">Adult Central Nervous System Tumors Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: August 25, 2015.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062697__616">This PDQ cancer information summary has current information about the treatment of adult central nervous system tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062697__617">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062697__1"><h2 id="_CDR0000062697__1_">General Information About Adult Central Nervous System Tumors</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062697__2">An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__514">A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__476">The brain controls many important body functions.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__492">The spinal cord connects the brain to nerves in most parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__32">There are different types of brain and spinal cord tumors. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__14">Having certain genetic syndromes may increase the risk of a central nervous system tumor.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__581">The cause of most adult brain and spinal cord tumors is not known.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__16">The signs and symptoms of adult brain and spinal cord tumors are not the same in every person. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__20">Tests that examine the brain and spinal cord are used to
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diagnose adult brain and spinal cord tumors.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__203">A biopsy is also used to diagnose a brain tumor.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__25">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062697__2"><h3>An adult central nervous system tumor is a disease in which abnormal cells form in the tissues of the brain and/or spinal cord.</h3><p id="CDR0000062697__475">There are many types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. The tumors are formed by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> growth of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> and may begin in different parts of the brain or spinal cord. Together, the brain and spinal cord make up the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046481/" class="def">central nervous system</a> (CNS).</p><p id="CDR0000062697__4">The tumors may be either <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045614/" class="def">benign</a> (not <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> (cancer):</p><ul id="CDR0000062697__558"><li class="half_rhythm"><div>Benign brain and spinal cord tumors grow and press on nearby areas of the brain. They rarely spread into other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> and may <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recur</a> (come back). </div></li><li class="half_rhythm"><div>Malignant brain and spinal cord tumors are likely
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to grow quickly and spread into other brain tissue. </div></li></ul><p id="CDR0000062697__559">When a tumor grows into or presses on an area of the brain, it may stop that part of the brain from working the way it should. Both benign and malignant brain tumors cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and need treatment.</p><p id="CDR0000062697__411">Brain and spinal cord tumors can occur in both adults and children. However, treatment for
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children may be different than treatment for adults. (See the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summary
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on <a href="/books/n/pdqcis/CDR0000257997/">Childhood Brain and Spinal Cord Tumors Treatment Overview</a> for more information on the treatment of children.)</p><p id="CDR0000062697__522">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045368/" class="def">lymphoma</a> that begins in the brain, see the PDQ summary on <a href="/books/n/pdqcis/CDR0000258030/">Primary CNS Lymphoma Treatment</a>.</p></div><div id="CDR0000062697__514"><h3>A tumor that starts in another part of the body and spreads to the brain is called a metastatic brain tumor.</h3><p id="CDR0000062697__516">Tumors that start in the brain are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary</a> brain tumors.
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Primary brain tumors may spread to other parts of the brain or to the spine. They rarely spread to other parts of the body.</p><p id="CDR0000062697__580">Often, tumors found in the brain have started somewhere else in the body and spread to one or more parts of the brain. These are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> brain tumors (or brain metastases). Metastatic
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brain tumors are more common than primary brain tumors. </p><p id="CDR0000062697__600">Up to half of metastatic brain tumors are from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445043/" class="def">lung cancer</a>.
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Other types of cancer that commonly spread to the brain include:</p><ul id="CDR0000062697__601"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045135/" class="def">Melanoma</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">Breast cancer</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044237/" class="def">Colon cancer</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444995/" class="def">Kidney cancer</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000445072/" class="def">Nasopharyngeal cancer</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046134/" class="def">Cancer of unknown primary site</a>.</div></li></ul><p id="CDR0000062697__602">Cancer may spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386212/" class="def">leptomeninges</a> (the two innermost <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046294/" class="def">membranes</a> covering the brain and spinal cord). This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000747577/" class="def">leptomeningeal carcinomatosis</a>. The most common cancers that spread to the leptomeninges include:</p><ul id="CDR0000062697__603"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444971/" class="def">Breast cancer</a>.</div></li><li class="half_rhythm"><div>Lung cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045343/" class="def">Leukemia</a>.</div></li><li class="half_rhythm"><div> Lymphoma.</div></li></ul><p id="CDR0000062697__518">See the following for more information from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> about cancers that commonly spread to the brain or spinal cord:</p><ul id="CDR0000062697__519"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000257991/">Adult Hodgkin Lymphoma Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062958/">Adult Non-Hodgkin Lymphoma Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062955/">Breast Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062729/">Carcinoma of Unknown Primary Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062954/">Colon Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/leukemia" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Leukemia Home Page</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062713/">Melanoma Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062966/">Nasopharyngeal Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062956/">Non-Small Cell Lung Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000276462/">Renal Cell Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062947/">Small Cell Lung Cancer Treatment</a></div></li></ul></div><div id="CDR0000062697__476"><h3>The brain controls many important body functions.
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</h3><p id="CDR0000062697__478">The brain has three major parts:
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</p><ul id="CDR0000062697__479"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046484/" class="def">cerebrum</a> is the largest part of the brain. It is at the top of the head. The cerebrum controls thinking, learning, problem solving, emotions, speech, reading, writing, and voluntary movement.
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</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046714/" class="def">cerebellum</a> is in the lower back of the brain (near the middle of the back of the head). It controls movement, balance, and posture.
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</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046491/" class="def">brain stem</a> connects the brain to the spinal cord. It is in the lowest part of the brain (just above the back of the neck). The brain stem controls breathing, heart rate, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a> and muscles used to see, hear, walk, talk, and eat.</div></li></ul><div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062697599" co-legend-rid="figlgndCDR0000062697599"><a href="/books/NBK66023.1/figure/CDR0000062697__599/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062697599" rid-ob="figobCDR0000062697599"><img class="small-thumb" src="/books/NBK66023.1/bin/CDR0000765034.gif" src-large="/books/NBK66023.1/bin/CDR0000765034.jpg" alt="Anatomy of the brain showing the cerebrum, ventricles (with cerebrospinal fluid shown in blue), cerebellum, brain stem (pons and medulla), and other parts of the brain" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062697599"><h4 id="CDR0000062697__599"><a href="/books/NBK66023.1/figure/CDR0000062697__599/?report=objectonly" target="object" rid-ob="figobCDR0000062697599">Figure</a></h4><p class="float-caption no_bottom_margin">Anatomy of the brain showing the cerebrum, ventricles (with cerebrospinal fluid shown in blue), cerebellum, brain stem (pons and medulla), and other parts of the brain. </p></div></div></div><div id="CDR0000062697__492"><h3>The spinal cord connects the brain to nerves in most parts of the body.</h3><p id="CDR0000062697__494">The spinal cord is a column of nerve tissue that runs from the brain stem down the center of the back. It is covered by three thin layers of tissue called membranes. These membranes are surrounded by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415916/" class="def">vertebrae</a> (back bones). Spinal cord nerves carry messages between the brain and the rest of the body, such as a message from the brain to cause muscles to move or a message from the skin to the brain to feel touch.</p></div><div id="CDR0000062697__32"><h3>There are different types of brain and spinal cord tumors. </h3><p id="CDR0000062697__210">Brain and spinal cord tumors are named based on the type of cell they formed in and where the tumor first formed in the CNS. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of a tumor may be used to tell the difference between slow-growing and fast-growing types of the tumor. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454794/" class="def">World Health Organization</a> (WHO) tumor grades are based on how abnormal the cancer cells look under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> and how quickly the tumor is likely to grow and spread.</p><h4><span class="title">WHO Tumor Grading System</span></h4><ul id="CDR0000062697__520"><li class="half_rhythm"><div>Grade I (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">low-grade</a>) — The tumor cells look more like normal cells under a microscope and grow and spread more slowly than grade II, III, and IV tumor cells. They rarely spread into nearby tissues. Grade I brain tumors may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cured</a> if they are completely removed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Grade II — The tumor cells grow and spread more slowly than grade III and IV tumor cells. They may spread into nearby tissue and may recur (come back). Some tumors may become a higher-grade tumor.</div></li><li class="half_rhythm"><div>Grade III — The tumor cells look very different from normal cells under a microscope and grow more quickly than grade I and II tumor cells. They are likely to spread into nearby tissue.</div></li><li class="half_rhythm"><div>Grade IV (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386205/" class="def">high-grade</a>) — The tumor cells do not look like normal cells under a microscope and grow and spread very quickly. There may be areas of dead cells in the tumor. Grade IV tumors usually cannot be cured.</div></li></ul><p id="CDR0000062697__585">The following types of primary tumors can form in the brain or spinal cord:</p><div id="CDR0000062697__495"><h4>Astrocytic Tumors</h4><p id="CDR0000062697__513">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytic tumor</a> begins in star-shaped brain cells called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269436/" class="def">astrocytes</a>, which help keep <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269443/" class="def">nerve cells</a> healthy. An astrocyte is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269440/" class="def">glial cell</a>. Glial cells sometimes form tumors called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045700/" class="def">gliomas</a>. Astrocytic tumors include the following:</p><ul id="CDR0000062697__500"><li class="half_rhythm"><div><b>Brain stem glioma (usually high grade)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045624/" class="def">brain stem glioma</a> forms in the brain stem, which is the part of the brain connected to the spinal cord. It is often a high-grade tumor, which spreads widely through the brain
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stem and is hard to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cure</a>. Brain stem gliomas are rare in adults. (See the PDQ summary on <a href="/books/n/pdqcis/CDR0000062962/">Childhood Brain Stem Glioma Treatment</a> for more information.)</div></li><li class="half_rhythm"><div><b>Pineal astrocytic tumor (any grade)</b>: A pineal astrocytic tumor
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forms in tissue around the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046226/" class="def">pineal gland</a> and may be any grade. The pineal gland is a tiny <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> in the brain that makes <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440118/" class="def">melatonin</a>, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormone</a> that helps control the sleeping and waking cycle. </div></li><li class="half_rhythm"><div><b>Pilocytic astrocytoma (grade I)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044341/" class="def">pilocytic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytoma</a> grows slowly in the brain or spinal cord. It may be in the form of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046461/" class="def">cyst</a> and
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rarely spreads into nearby tissues. Pilocytic astrocytomas can often be cured. </div></li><li class="half_rhythm"><div><b>Diffuse astrocytoma (grade II)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044508/" class="def">diffuse</a> astrocytoma grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells. In some cases, a diffuse astrocytoma can be cured. It is also called a low-grade diffuse astrocytoma. </div></li><li class="half_rhythm"><div><b>Anaplastic astrocytoma (grade III)</b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a> astrocytoma grows quickly and spreads into nearby tissues. The tumor cells look
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different from normal cells. This type of tumor usually cannot be cured. An anaplastic astrocytoma is also called a malignant astrocytoma or high-grade astrocytoma. </div></li><li class="half_rhythm"><div><b>Glioblastoma (grade IV)</b>: A glioblastoma grows and spreads very quickly. The tumor cells look very different from normal cells. This type of tumor usually cannot be cured. It is
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also called glioblastoma multiforme. </div></li></ul><p id="CDR0000062697__523">See the PDQ summary on <a href="/books/n/pdqcis/CDR0000574295/">Childhood Astrocytomas Treatment</a> for more information about astrocytomas in children.</p></div><div id="CDR0000062697__67"><h4>Oligodendroglial Tumors</h4><p id="CDR0000062697__69">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045808/" class="def">oligodendroglial tumor</a> begins in brain cells called
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000540447/" class="def">oligodendrocytes</a>, which help keep nerve cells healthy. An oligodendrocyte is a type of glial cell. Oligodendrocytes sometimes form tumors called oligodendrogliomas. Grades of oligodendroglial tumors include the following:</p><ul id="CDR0000062697__368"><li class="half_rhythm"><div><b>Oligodendroglioma (grade II)</b>: An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046257/" class="def">oligodendroglioma</a> grows slowly, but often spreads into nearby tissues. The tumor cells look something like normal cells. In some cases, an oligodendroglioma can be cured. </div></li><li class="half_rhythm"><div><b>Anaplastic oligodendroglioma (grade III)</b>: An anaplastic oligodendroglioma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually cannot be cured. </div></li></ul><p id="CDR0000062697__564"> See the PDQ summary on <a href="/books/n/pdqcis/CDR0000574295/">Childhood Astrocytomas Treatment</a> for more information about oligodendroglial tumors in children.</p></div><div id="CDR0000062697__76"><h4>Mixed Gliomas</h4><p id="CDR0000062697__78">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045344/" class="def">mixed glioma</a> is a brain tumor that has two types of tumor cells in it — oligodendrocytes and astrocytes. This type of mixed tumor is called an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321382/" class="def">oligoastrocytoma</a>.</p><ul id="CDR0000062697__369"><li class="half_rhythm"><div><b>Oligoastrocytoma (grade II)</b>: An oligoastrocytoma is a slow-growing tumor. The tumor cells look something like normal cells. In some cases, an oligoastrocytoma can be cured.</div></li><li class="half_rhythm"><div><b>Anaplastic oligoastrocytoma (grade III)</b>: An anaplastic oligoastrocytoma grows quickly and spreads into nearby tissues. The tumor cells look
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different from normal cells. This type of tumor has a worse <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> than oligoastrocytoma (grade II). </div></li></ul><p id="CDR0000062697__565"> See the PDQ summary on <a href="/books/n/pdqcis/CDR0000574295/">Childhood Astrocytomas Treatment</a> for more information about mixed gliomas in children.</p></div><div id="CDR0000062697__55"><h4>Ependymal Tumors</h4><p id="CDR0000062697__57">An <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045679/" class="def">ependymal tumor</a> usually begins in cells that line the
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a>-filled spaces in the brain and
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around the spinal cord. An ependymal tumor may also be called an ependymoma. Grades of ependymomas include the following:</p><ul id="CDR0000062697__370"><li class="half_rhythm"><div><b>Ependymoma (grade I or II)</b>: A grade I or II <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymoma</a> grows slowly and has cells
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that look something like normal cells. There are two types of grade I ependymoma — myxopapillary ependymoma and subependymoma. A grade II ependymoma grows in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045939/" class="def">ventricle</a> (fluid-filled space in the brain) and its connecting paths or in the spinal cord. In some cases, a grade I or II ependymoma can be cured.</div></li><li class="half_rhythm"><div><b>Anaplastic ependymoma (grade III)</b>: An anaplastic ependymoma grows quickly and spreads into nearby tissues. The tumor cells look different from normal cells. This type of tumor usually has a worse prognosis than a grade I or II ependymoma. </div></li></ul><p id="CDR0000062697__566"> See the PDQ summary on <a href="/books/n/pdqcis/CDR0000062971/">Childhood Ependymoma Treatment</a> for more information about ependymoma in children.</p></div><div id="CDR0000062697__79"><h4>Medulloblastomas</h4><p id="CDR0000062697__81">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045780/" class="def">medulloblastoma</a> is a type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000367442/" class="def">embryonal tumor</a>. Medulloblastomas are most common in children or young adults. </p><p id="CDR0000062697__332"> See the PDQ summary on <a href="/books/n/pdqcis/CDR0000552550/">Childhood Central Nervous System Embryonal Tumors Treatment</a> for more information about medulloblastomas in children.</p></div><div id="CDR0000062697__238"><h4>Pineal Parenchymal Tumors</h4><p id="CDR0000062697__240"> A pineal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044503/" class="def">parenchymal</a> tumor forms in parenchymal cells or pineocytes, which are the cells that make up most of the pineal gland. These tumors are different from pineal astrocytic tumors. Grades of pineal parenchymal
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tumors include the following:</p><ul id="CDR0000062697__371"><li class="half_rhythm"><div><b>Pineocytoma (grade II)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046228/" class="def">pineocytoma</a> is a slow-growing pineal tumor.</div></li><li class="half_rhythm"><div><b>Pineoblastoma (grade IV)</b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046227/" class="def">pineoblastoma</a> is a rare tumor that is very likely to spread. </div></li></ul><p id="CDR0000062697__567">See the PDQ summary on <a href="/books/n/pdqcis/CDR0000552550/">Childhood Central Nervous System Embryonal Tumors Treatment</a> for more information about pineal parenchymal tumors in children.</p></div><div id="CDR0000062697__88"><h4>Meningeal Tumors</h4><p id="CDR0000062697__90">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045781/" class="def">meningeal</a> tumor, also called a meningioma, forms in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046295/" class="def">meninges</a> (thin layers of tissue that cover the
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brain and spinal cord). It can form from different types of brain or spinal cord cells. Meningiomas are most common in adults. Types of meningeal tumors include the following:</p><ul id="CDR0000062697__372"><li class="half_rhythm"><div><b>Meningioma (grade I)</b>: A grade I meningioma is the most common type of meningeal tumor. A grade I meningioma is a slow-growing tumor. It forms most often in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000743301/" class="def">dura mater</a>. A grade I meningioma can be cured if it is completely removed by surgery.</div></li><li class="half_rhythm"><div><b>Meningioma (grade II and III)</b>: This is a rare meningeal tumor. It grows quickly
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and is likely
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to spread within the brain and spinal cord. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery. </div></li></ul><p id="CDR0000062697__503">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045707/" class="def">hemangiopericytoma</a> is not a meningeal tumor but is treated like a grade II or III meningioma. A hemangiopericytoma usually forms in the dura mater. The prognosis is worse than a grade I meningioma because the tumor usually cannot be completely removed by surgery. </p></div><div id="CDR0000062697__241"><h4>Germ Cell Tumors</h4><p id="CDR0000062697__243">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045695/" class="def">germ cell tumor</a> forms in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046382/" class="def">germ cells</a>, which are the cells that develop into <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257221/" class="def">sperm</a> in men or ova (eggs) in women. There are different types of germ cell tumors. These include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046383/" class="def">germinomas</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044248/" class="def">teratomas</a>, embryonal yolk sac <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045963/" class="def">carcinomas</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046753/" class="def">choriocarcinomas</a>. Germ cell tumors can be either benign or malignant. </p><p id="CDR0000062697__333">See the PDQ summary on <a href="/books/n/pdqcis/CDR0000719453/">Childhood Central Nervous System Germ Cell Tumors Treatment</a> for more information about childhood germ cell tumors in the brain.</p></div><div id="CDR0000062697__244"><h4>Craniopharyngioma (Grade I)</h4><p id="CDR0000062697__587">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046131/" class="def">craniopharyngioma</a> is a rare tumor that usually forms in the center of the brain just above the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046229/" class="def">pituitary gland</a> (a pea-sized organ at the bottom of the brain that controls other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glands</a>). Craniopharyngiomas can form from different types of brain or spinal cord cells. </p><p id="CDR0000062697__568">See the PDQ summary on <a href="/books/n/pdqcis/CDR0000574137/">Childhood Craniopharyngioma Treatment</a> for more information about craniopharyngioma in children.</p></div></div><div id="CDR0000062697__14"><h3>Having certain genetic syndromes may increase the risk of a central nervous system tumor.
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</h3><p id="CDR0000062697__480">Anything that increases your chance of getting a disease is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. There are few known risk factors for brain tumors. The following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a> may increase the risk of certain types of brain tumors: </p><ul id="CDR0000062697__481"><li class="half_rhythm"><div>Being exposed to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046648/" class="def">vinyl chloride</a> may increase the risk of glioma.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">Infection</a> with the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045684/" class="def">Epstein-Barr virus</a>, having <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045950/" class="def">AIDS</a> (acquired immunodeficiency syndrome), or receiving an organ <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046631/" class="def">transplant</a> may increase the risk of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000468774/" class="def">primary CNS lymphoma</a>. (See the PDQ summary
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on <a href="/books/n/pdqcis/CDR0000258030/">Primary CNS Lymphoma</a> for more information.)</div></li><li class="half_rhythm"><div>Having certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045090/" class="def">syndromes</a> may increase the risk brain tumors:<dl id="CDR0000062697__521" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045096/" class="def">Neurofibromatosis type 1</a> (NF1) or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000256540/" class="def">2</a> (NF2).</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045563/" class="def">von Hippel-Lindau disease</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304692/" class="def">Tuberous sclerosis</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046322/" class="def">Li-Fraumeni syndrome</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin">Turcot syndrome type 1 or 2.</p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000442897/" class="def">Nevoid basal cell carcinoma syndrome</a>.</p></dd></dl>
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</div></li></ul></div><div id="CDR0000062697__581"><h3>The cause of most adult brain and spinal cord tumors is not known.</h3></div><div id="CDR0000062697__16"><h3>The signs and symptoms of adult brain and spinal cord tumors are not the same in every person. </h3><p id="CDR0000062697__597">Signs and symptoms depend on the following:</p><ul id="CDR0000062697__598"><li class="half_rhythm"><div>Where the tumor forms in the brain or spinal cord.</div></li><li class="half_rhythm"><div>What the affected part of the brain controls.</div></li><li class="half_rhythm"><div>The size of the tumor.</div></li></ul><p id="CDR0000062697__441">Signs and symptoms may be caused by CNS tumors or by other conditions, including cancer that has spread to the brain. Check with your doctor if you have any of the following:</p><h4><span class="title">Brain Tumor Symptoms</span></h4><ul id="CDR0000062697__19"><li class="half_rhythm"><div>Morning headache or headache that goes away after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390324/" class="def">vomiting</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045484/" class="def">Seizures</a>.</div></li><li class="half_rhythm"><div>Vision, hearing, and speech problems.</div></li><li class="half_rhythm"><div>Loss of appetite.</div></li><li class="half_rhythm"><div>Frequent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000390302/" class="def">nausea</a> and vomiting.
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</div></li><li class="half_rhythm"><div>Changes in personality, mood, ability to focus, or behavior.</div></li><li class="half_rhythm"><div>Loss of balance and trouble walking.</div></li><li class="half_rhythm"><div>Weakness.</div></li><li class="half_rhythm"><div>Unusual sleepiness or change in activity level.
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</div></li></ul><h4><span class="title">Spinal Cord Tumor Symptoms</span></h4><ul id="CDR0000062697__501"><li class="half_rhythm"><div>Back pain or pain that spreads from the back towards the arms or legs.</div></li><li class="half_rhythm"><div>A change in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046500/" class="def">bowel</a> habits or trouble <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urinating</a>.</div></li><li class="half_rhythm"><div>Weakness or numbness in the arms or legs.</div></li><li class="half_rhythm"><div>Trouble walking.</div></li></ul></div><div id="CDR0000062697__20"><h3>Tests that examine the brain and spinal cord are used to
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diagnose adult brain and spinal cord tumors.</h3><p id="CDR0000062697__23">The following tests and procedures may be used:</p><ul id="CDR0000062697__24"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000322871/" class="def">Neurological exam</a></b>: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
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</div></li><li class="half_rhythm"><div><b>Visual field exam</b>: An exam to check a person’s field of vision (the total area in which objects can be seen). This test measures both central vision (how much a person can see when looking straight ahead) and peripheral vision (how much a person can see in all other directions while staring straight ahead). Any loss of vision may be a sign of a tumor that has damaged or pressed on the parts of the brain that affect eyesight. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000732562/" class="def">Tumor marker test</a></b>: A procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a>. This test may be done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> a germ cell tumor.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046128/" class="def">Gene testing</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> in which a sample of blood or tissue is tested for changes in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosome</a> that has been linked with a certain type of brain tumor. This test may be done to diagnose an <a href="/books/n/pdqcis/glossary_gen/def-item/glossary_gen_CDR0000339343/" class="def">inherited syndrome</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b>: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging) with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000597153/" class="def">gadolinium</a></b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of the brain and spinal cord. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI). MRI is often used to diagnose tumors in the spinal cord. Sometimes a procedure called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269422/" class="def">magnetic resonance spectroscopy</a> (MRS) is done during the MRI <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046570/" class="def">scan</a>. An MRS is used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> tumors, based on their chemical make-up. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306534/" class="def">SPECT</a> scan (single photon emission computed tomography scan)</b>: A procedure that uses a special camera linked to a computer to make a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the brain. A very small amount of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance is injected into a vein or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044600/" class="def">inhaled</a> through the nose. As the substance travels through the blood, the camera rotates around the head and takes pictures of the brain. Blood flow and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046173/" class="def">metabolism</a> are higher than normal in areas where cancer cells are growing. These areas will show up brighter in the picture. This procedure may be done just before or after a CT scan.
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SPECT is used to tell the difference between a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a> and a tumor that has spread to the brain from somewhere else in the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find malignant tumor cells in the body. A small amount of radioactive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. PET is used to tell the difference between a primary tumor and a tumor that has spread to the brain from somewhere else in the body.</div></li></ul></div><div id="CDR0000062697__203"><h3>A biopsy is also used to diagnose a brain tumor.</h3><p id="CDR0000062697__529">If <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a> show there may be a brain tumor, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">biopsy</a> is usually done. One of the following types of biopsies may be used:
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</p><ul id="CDR0000062697__533"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044299/" class="def">Stereotactic biopsy</a></b>: When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incision</a> is made in the scalp and a small hole is drilled through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a>. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335492/" class="def">Open biopsy</a></b>: When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046457/" class="def">craniotomy</a>. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain. <div class="iconblock whole_rhythm clearfix ten_col fig" id="figCDR0000062697588" co-legend-rid="figlgndCDR0000062697588"><a href="/books/NBK66023.1/figure/CDR0000062697__588/?report=objectonly" target="object" title="Figure" class="img_link icnblk_img figpopup" rid-figpopup="figCDR0000062697588" rid-ob="figobCDR0000062697588"><img class="small-thumb" src="/books/NBK66023.1/bin/CDR0000680519.gif" src-large="/books/NBK66023.1/bin/CDR0000680519.jpg" alt="Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain" /></a><div class="icnblk_cntnt" id="figlgndCDR0000062697588"><h4 id="CDR0000062697__588"><a href="/books/NBK66023.1/figure/CDR0000062697__588/?report=objectonly" target="object" rid-ob="figobCDR0000062697588">Figure</a></h4><p class="float-caption no_bottom_margin">Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain. </p></div></div></div></li></ul><p id="CDR0000062697__532">The pathologist checks the biopsy sample to find out the type and <a href="/books/NBK66023.1/#CDR0000062697__520">grade</a> of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.
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</p><p id="CDR0000062697__483">The following tests may be done on the tumor tissue that is removed:</p><ul id="CDR0000062697__484"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000653117/" class="def">Immunohistochemistry</a></b>: A test that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> to check for certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046086/" class="def">antigens</a> in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044052/" class="def">Light</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044025/" class="def">electron microscopy</a></b>: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270737/" class="def">Cytogenetic analysis</a></b>: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046470/" class="def">chromosomes</a>.
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</div></li></ul><div id="CDR0000062697__551"><h4>Sometimes a biopsy or surgery cannot be done.</h4><p id="CDR0000062697__553">For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.</p><p id="CDR0000062697__561">Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done.</p></div></div><div id="CDR0000062697__25"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000062697__217">The prognosis (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) and treatment options for <i>primary</i> brain and spinal cord tumors depend on the following:</p><ul id="CDR0000062697__215"><li class="half_rhythm"><div>The type and grade of the tumor.</div></li><li class="half_rhythm"><div> Where the tumor is in the brain or spinal cord.</div></li><li class="half_rhythm"><div>Whether the tumor can be removed by surgery.</div></li><li class="half_rhythm"><div>Whether cancer cells remain after surgery.</div></li><li class="half_rhythm"><div>Whether there are certain changes in the chromosomes.</div></li><li class="half_rhythm"><div>Whether the cancer has just been diagnosed or has recurred (come back).</div></li><li class="half_rhythm"><div>The patient's general health.</div></li></ul><p id="CDR0000062697__412">The prognosis and treatment options for <i>metastatic</i> brain and spinal cord tumors depend on the following:</p><ul id="CDR0000062697__413"><li class="half_rhythm"><div>Whether there are more than two tumors in the brain or spinal cord.</div></li><li class="half_rhythm"><div>Where the tumor is in the brain or spinal cord.</div></li><li class="half_rhythm"><div>How well the tumor responds to treatment.</div></li><li class="half_rhythm"><div>Whether the primary tumor continues to grow or spread.</div></li></ul></div></div><div id="CDR0000062697__28"><h2 id="_CDR0000062697__28_">Stages of Adult Central Nervous System Tumors</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062697__220">There is no standard staging system for adult brain and spinal cord tumors.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__485">Imaging tests may be repeated after surgery to help plan more treatment.</a></div></li></ul></div><div id="CDR0000062697__220"><h3>There is no standard staging system for adult brain and spinal cord tumors.</h3><p id="CDR0000062697__219">The extent or spread of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> is usually described as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a>. There is no standard <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689095/" class="def">staging system</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. Brain tumors that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. Treatment of primary brain and spinal cord tumors is based on the following:</p><ul id="CDR0000062697__583"><li class="half_rhythm"><div>The type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cell</a> in which the tumor began.</div></li><li class="half_rhythm"><div>Where the tumor formed in the brain or spinal cord.</div></li><li class="half_rhythm"><div>The amount of cancer left after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of the tumor.</div></li></ul><p id="CDR0000062697__584">Treatment of tumors that have spread to the brain from other parts of the body is based on the number of tumors in the brain.</p></div><div id="CDR0000062697__485"><h3>Imaging tests may be repeated after surgery to help plan more treatment.</h3><p id="CDR0000062697__487">Some of the <a href="#CDR0000062697__20">tests and procedures</a> used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> a brain or spinal cord tumor may be repeated after treatment to find out how much tumor is left. </p></div></div><div id="CDR0000062697__606"><h2 id="_CDR0000062697__606_">Recurrent Adult Central Nervous System Tumors</h2><p id="CDR0000062697__607">A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000427310/" class="def">central nervous system (CNS) tumor</a> is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> that has recurred (come back)
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after it has been treated. CNS tumors often recur, sometimes many years
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after the first tumor. The tumor may recur at the same place as the first tumor or in other parts of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046481/" class="def">central nervous system</a>.</p></div><div id="CDR0000062697__102"><h2 id="_CDR0000062697__102_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062697__103">There are different types of treatment for patients with adult
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brain and spinal cord tumors. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__107">Five types of standard treatment are used:</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__615">Supportive care is given to lessen the problems caused by the disease or its treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__119">New types of treatment are being tested in clinical trials.
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__466">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__468">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062697__470">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062697__103"><h3>There are different types of treatment for patients with adult
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brain and spinal cord tumors. </h3><p id="CDR0000062697__105">Different types of treatment are available for patients with adult
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000387264/" class="def">brain</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and
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some are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical
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trials</a>. A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help improve current treatments or obtain information on new
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treatments for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new
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treatment is better than the standard
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treatment, the new treatment may become the standard treatment.
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Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.</p></div><div id="CDR0000062697__107"><h3>Five types of standard treatment are used:</h3><div id="CDR0000062697__608"><h4>Active surveillance</h4><p id="CDR0000062697__610">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a> is closely watching a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>, which can cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> or other problems. During active surveillance, certain exams and tests are done on a regular schedule. Active surveillance may be used for very slow-growing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that do not cause <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>.</p></div><div id="CDR0000062697__109"><h4>Surgery </h4><p id="CDR0000062697__111">Surgery may be used to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> and treat adult brain and spinal cord tumors. Removing tumor tissue helps decrease pressure of the tumor on nearby parts of the brain.See the <a href="#CDR0000062697__203">General Information</a> section of this summary.</p><p id="CDR0000062697__443">Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> or radiation therapy after surgery to kill any cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000062697__112"><h4>Radiation therapy</h4><p id="CDR0000062697__199">Radiation therapy is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> and where it is in the brain or spinal cord. </p><p id="CDR0000062697__534">The following ways of giving radiation therapy to the tumor cause less damage to the healthy tissue around the tumor:</p><ul id="CDR0000062697__535"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270731/" class="def">3-dimensional conformal radiation therapy</a>:
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A procedure that uses a computer to create a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the brain or spinal cord tumor. This allows doctors to give the highest possible <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044664/" class="def">dose</a> of radiation to the tumor, with as little damage to normal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> as possible. This type of radiation therapy is also called 3-dimensional radiation therapy and 3D-CRT.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000335073/" class="def">Intensity-modulated radiation therapy</a> (IMRT): A type of 3-D radiation therapy that uses a computer to make pictures of the size and shape of the brain or spinal cord tumor. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. This type of radiation therapy causes less damage to healthy tissue near the tumor.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">Stereotactic radiosurgery</a>: A type of radiation therapy that uses a head frame attached to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000763008/" class="def">skull</a> to aim a single large dose of radiation directly to a brain tumor. This causes less damage to nearby healthy tissue. Stereotactic radiosurgery is also called stereotaxic radiosurgery and radiosurgery. This procedure does not involve surgery.</div></li></ul></div><div id="CDR0000062697__115"><h4>Chemotherapy</h4><p id="CDR0000062697__200">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a>, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> is treatment using more than one anticancer drug. To treat brain tumors, a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306512/" class="def">wafer</a> that dissolves may be used to deliver an anticancer drug directly to the brain tumor site after the tumor has been removed by surgery. The way the chemotherapy is given depends on the type and grade of tumor and where it is in the brain.</p><p id="CDR0000062697__589">Anticancer drugs given by mouth or vein to treat brain and spinal cord tumors cannot cross the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046504/" class="def">blood-brain barrier</a> and enter the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> that surrounds the brain and spinal cord. Instead, an anticancer drug is injected into the fluid-filled space to kill cancer cells there. This is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046681/" class="def">intrathecal chemotherapy</a>.</p><p id="CDR0000062697__528">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/brain" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Brain Tumors</a> for more information.</p></div><div id="CDR0000062697__590"><h4>Targeted therapy</h4><p id="CDR0000062697__592"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.</p><p id="CDR0000062697__593"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046066/" class="def">Monoclonal antibody</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044737/" class="def">therapy</a> is a type of targeted therapy that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044918/" class="def">antibodies</a> made in the laboratory from a single type of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045738/" class="def">infusion</a>. They may be used alone or to carry drugs, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046622/" class="def">toxins</a>, or radioactive material directly to cancer cells.</p><p id="CDR0000062697__594"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046115/" class="def">Bevacizumab</a> is a monoclonal antibody that binds to a protein called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044222/" class="def">vascular endothelial growth factor</a> (VEGF) and may prevent the growth of new <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> that tumors need to grow. Bevacizumab is used in the treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045698/" class="def">glioblastoma</a>.</p><p id="CDR0000062697__596">Other types of targeted therapies are being studied for adult brain tumors, including <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044833/" class="def">tyrosine kinase inhibitors</a> and new VEGF inhibitors.</p><p id="CDR0000062697__595">See <a href="http://www.cancer.gov/about-cancer/treatment/drugs/brain" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Brain Tumors</a> for more information.</p></div></div><div id="CDR0000062697__615"><h3>Supportive care is given to lessen the problems caused by the disease or its treatment.</h3><p id="CDR0000062697__614">This therapy controls problems or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by the disease or its treatment and improves <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>. For brain tumors, supportive care includes drugs to control <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045484/" class="def">seizures</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044669/" class="def">fluid</a> buildup or swelling in the brain. </p></div><div id="CDR0000062697__119"><h3>New types of treatment are being tested in clinical trials.
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</h3><p id="CDR0000062697__465">This summary section refers to new treatments being studied in clinical trials, but it may not mention every new treatment being studied. Information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p><div id="CDR0000062697__539"><h4>Proton beam radiation therapy</h4><p id="CDR0000062697__541"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270726/" class="def">Proton beam radiation therapy</a> is a type of high-energy, external radiation therapy that uses streams of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044715/" class="def">protons</a> (small, positively-charged pieces of matter) to make radiation. This type of radiation kills tumor cells with little damage to nearby tissues. It is used to treat cancers of the head, neck, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a> and organs such as the brain, eye, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>. Proton beam radiation is different from x-ray radiation.
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</p></div><div id="CDR0000062697__129"><h4>Biologic therapy</h4><p id="CDR0000062697__131">
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">Biologic therapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.</p><p id="CDR0000062697__578">Biologic therapy is being studied for the treatment of some types of brain tumors. Treatments may include the following:</p><ul id="CDR0000062697__579"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044949/" class="def">Dendritic cell vaccine</a> therapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045353/" class="def">Gene therapy</a>.</div></li></ul></div></div><div id="CDR0000062697__466"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062697__466_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062697__466_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062697__466_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062697__468"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062697__468_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062697__468_30">Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044267/" class="def">NCI's</a> listing of clinical trials. </p></div><div id="CDR0000062697__470"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062697__470_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062697__470_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000062697__562">The following tests and procedures may be used to check whether a brain tumor has come back after treatment:</p><ul id="CDR0000062697__563"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306534/" class="def">SPECT</a> scan (single photon emission computed tomography scan)</b>: A procedure that uses a special camera linked to a computer to make a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045582/" class="def">3-dimensional</a> (3-D) picture of the brain. A very small amount of a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance is injected into a vein or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044600/" class="def">inhaled</a> through the nose. As the substance travels through the blood, the camera rotates around the head and takes pictures of the brain. Blood flow and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046173/" class="def">metabolism</a> are higher than normal in areas where cancer cells are growing. These areas will show up brighter in the picture. This procedure may be done just before or after a CT scan.
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</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> tumor cells in the body. A small amount of radioactive <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044033/" class="def">glucose</a> (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the brain. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.</div></li></ul></div></div><div id="CDR0000062697__134"><h2 id="_CDR0000062697__134_">Treatment Options by Type of Primary Adult Brain Tumor </h2><div id="CDR0000062697__512"><h3>Astrocytic Tumors</h3><div id="CDR0000062697__257"><h4>Brain Stem Gliomas</h4><p id="CDR0000062697__542">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045624/" class="def">brain stem gliomas</a> may include the following:</p><ul id="CDR0000062697__543"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_257_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38825&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult brain stem glioma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__255"><h4>Pineal Astrocytic Tumors</h4><p id="CDR0000062697__320">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046226/" class="def">pineal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269436/" class="def">astrocytic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may include the
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following:</p><ul id="CDR0000062697__397"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>. For high-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> tumors, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> may also be given.</div></li></ul><p id="CDR0000062697__TrialSearch_255_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=561966&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult pineal gland astrocytoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__247"><h4>Pilocytic Astrocytomas</h4><p id="CDR0000062697__544">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044341/" class="def">pilocytic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytomas</a> may include the following:</p><ul id="CDR0000062697__545"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may also be given if tumor remains after surgery.</div></li></ul><p id="CDR0000062697__TrialSearch_247_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41741&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult pilocytic astrocytoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__249"><h4>Diffuse Astrocytomas</h4><p id="CDR0000062697__140">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044508/" class="def">diffuse</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytomas</a> may include the following:</p><ul id="CDR0000062697__394"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li><li class="half_rhythm"><div>Surgery followed by radiation therapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_249_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41743&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult diffuse astrocytoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__251"><h4>Anaplastic Astrocytomas</h4><p id="CDR0000062697__144">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045602/" class="def">astrocytomas</a> may include the
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following:</p><ul id="CDR0000062697__395"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> may also be given.</div></li><li class="half_rhythm"><div>Surgery and chemotherapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy placed into the brain during surgery.</div></li><li class="half_rhythm"><div>A clinical trial of a new treatment added to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_251_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40858&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult anaplastic astrocytoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__253"><h4>Glioblastomas</h4><p id="CDR0000062697__148">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045698/" class="def">glioblastomas</a> may include the
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following: </p><ul id="CDR0000062697__396"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> given at the same time, followed by chemotherapy alone. </div></li><li class="half_rhythm"><div>Surgery followed by radiation therapy.</div></li><li class="half_rhythm"><div>Chemotherapy placed into the brain during surgery.</div></li><li class="half_rhythm"><div>Radiation therapy and chemotherapy given at the same time.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment added to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_253_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38830&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult glioblastoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062697__259"><h3>Oligodendroglial Tumors</h3><p id="CDR0000062697__163">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046257/" class="def">oligodendrogliomas</a> may
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include the following:</p><ul id="CDR0000062697__399"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> may be given after radiation therapy.</div></li></ul><p id="CDR0000062697__167"> Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a> oligodendroglioma may include the
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following:</p><ul id="CDR0000062697__586"><li class="half_rhythm"><div>Surgery followed by radiation therapy with or without chemotherapy.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment added to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_259_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=430660&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult oligodendroglial tumors</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__261"><h3>Mixed Gliomas</h3><p id="CDR0000062697__171">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045344/" class="def">mixed gliomas</a> may include the following:</p><ul id="CDR0000062697__401"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>. Sometimes
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> is also given. </div></li></ul><p id="CDR0000062697__TrialSearch_261_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41195&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult mixed glioma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__263"><h3>Ependymal Tumors</h3><p id="CDR0000062697__156">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> I and grade II <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046432/" class="def">ependymomas</a> may include the following:</p><ul id="CDR0000062697__556"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may also be given if tumor remains after surgery.</div></li></ul><p id="CDR0000062697__159">Treatment of grade III <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045591/" class="def">anaplastic</a> ependymoma may include the
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following:</p><ul id="CDR0000062697__402"><li class="half_rhythm"><div>Surgery and radiation therapy.</div></li></ul><p id="CDR0000062697__TrialSearch_263_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=430659&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult ependymal tumors</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__267"><h3>Medulloblastomas</h3><p id="CDR0000062697__175">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045780/" class="def">medulloblastomas</a> may include the
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following:</p><ul id="CDR0000062697__404"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the brain and
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> added to surgery and radiation therapy to the brain and
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spine</div></li></ul><p id="CDR0000062697__TrialSearch_267_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38828&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult medulloblastoma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__265"><h3>Pineal Parenchymal Tumors</h3><p id="CDR0000062697__180">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046226/" class="def">pineal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044503/" class="def">parenchymal</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may include the
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following:</p><ul id="CDR0000062697__403"><li class="half_rhythm"><div>For <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046228/" class="def">pineocytomas</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>. </div></li><li class="half_rhythm"><div>For pineoblastomas, surgery, radiation therapy, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_265_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41196&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult pineal parenchymal tumor</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__269"><h3>Meningeal Tumors</h3><p id="CDR0000062697__189">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> I <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045783/" class="def">meningiomas</a> may include the following:</p><ul id="CDR0000062697__405"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Active surveillance</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> with no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the tumor. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> may also be given if tumor remains after surgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">Stereotactic radiosurgery</a> for tumors smaller than 3 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>.</div></li><li class="half_rhythm"><div>Radiation therapy for tumors that cannot be
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removed by surgery. </div></li></ul><p id="CDR0000062697__192"> Treatment of grade II and III meningiomas and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045707/" class="def">hemangiopericytoma</a>s may include the
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following:</p><ul id="CDR0000062697__406"><li class="half_rhythm"><div>Surgery and radiation therapy. </div></li></ul><p id="CDR0000062697__TrialSearch_269_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=377472&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult meningeal tumor</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__271"><h3>Germ Cell Tumors</h3><p id="CDR0000062697__184"> There is no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045695/" class="def">germ cell tumors</a> (germinoma, embryonal <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045963/" class="def">carcinoma</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046753/" class="def">choriocarcinoma</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044248/" class="def">teratoma</a>). Treatment depends on what the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> look like under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a>, where the tumor is in the brain, and whether it can be removed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</p><p id="CDR0000062697__TrialSearch_271_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=41197&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult central nervous system germ cell tumor</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__273"><h3>Craniopharyngiomas</h3><p id="CDR0000062697__186"> Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046131/" class="def">craniopharyngiomas</a> may include the following:</p><ul id="CDR0000062697__407"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to completely remove the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>.</div></li><li class="half_rhythm"><div>Surgery to remove as much of the tumor as possible, followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_273_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38827&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">adult craniopharyngioma</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div></div><div id="CDR0000062697__572"><h2 id="_CDR0000062697__572_">Treatment Options for Primary Adult Spinal Cord Tumors</h2><p id="CDR0000062697__573">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000340937/" class="def">spinal cord</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> may include the following:</p><ul id="CDR0000062697__574"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> to remove the tumor.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul></div><div id="CDR0000062697__195"><h2 id="_CDR0000062697__195_">Treatment Options for Recurrent Adult Central Nervous System Tumors</h2><p id="CDR0000062697__275">There is no <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000427310/" class="def">central nervous system (CNS) tumors</a>. Treatment depends on the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a>, the expected <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of the treatment, where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> is in the CNS, and whether the tumor can be removed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>. Treatment may include the
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following:</p><ul id="CDR0000062697__550"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> placed into the brain during surgery.</div></li><li class="half_rhythm"><div>Chemotherapy with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> not used to treat the original tumor.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> for recurrent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045698/" class="def">glioblastoma</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a>.</div></li><li class="half_rhythm"><div>Surgery to remove the tumor.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000062697__TrialSearch_195_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=38719&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">recurrent adult brain tumor</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__430"><h2 id="_CDR0000062697__430_">Treatment Options for Metastatic Adult Brain Tumors</h2><p id="CDR0000062697__431">Treatment of one to four <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a> that have spread to the brain from another part of the body may include the following:</p><ul id="CDR0000062697__433"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> to the whole brain with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</div></li><li class="half_rhythm"><div>Radiation therapy to the whole brain with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046701/" class="def">stereotactic radiosurgery</a>.</div></li><li class="half_rhythm"><div>Stereotactic radiosurgery.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>, if the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a> is one that <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044085/" class="def">responds</a> to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000639945/" class="def">anticancer</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>. It may be combined with radiation therapy. </div></li></ul><p id="CDR0000062697__611">Treatment of tumors that have spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386212/" class="def">leptomeninges</a> may include the following:</p><ul id="CDR0000062697__612"><li class="half_rhythm"><div>Chemotherapy (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic</a> and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046681/" class="def">intrathecal</a>). Radiation therapy may also be given.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046609/" class="def">Supportive care</a>.</div></li></ul><p id="CDR0000062697__TrialSearch_430_10">Check the list of NCI-supported cancer clinical trials that are now accepting patients with <a href="http://www.cancer.gov/search/ClinicalTrialsLink.aspx?Diagnosis=40825&tt=1&format=1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">tumors metastatic to brain</a>. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062697__472"><h2 id="_CDR0000062697__472_">To Learn More About Adult Central Nervous System Tumors</h2><p id="CDR0000062697__473">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about adult central nervous system tumors, see the following:</p><ul id="CDR0000062697__474"><li class="half_rhythm"><div><a href="http://www.cancer.gov/types/brain" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Brain Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/wyntk-brain-tumors" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What You Need to Know About™ Brain Tumors</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/treatment/drugs/brain" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Brain Tumors</a></div></li></ul><p id="CDR0000062697__472_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062697__472_41"><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/diagnosis-staging/staging/staging-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="http://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="http://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062697__AboutThis_1"><h2 id="_CDR0000062697__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062697__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062697__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="http://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062697__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062697__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062697__AboutThis_6">This PDQ cancer information summary has current information about the treatment of adult central nervous system tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062697__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062697__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
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</p><p id="CDR0000062697__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062697__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062697__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062697__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="http://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062697__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062697__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062697__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062697__AboutThis_21">National Cancer Institute: PDQ® Adult Central Nervous System Tumors Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: <a href="http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq</a>. Accessed <MM/DD/YYYY>.</p><p id="CDR0000062697__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="http://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
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</p></div><div id="CDR0000062697__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062697__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="http://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062697__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062697__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="http://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="http://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66023.1/?report=reader">PubReader</a></li><li><a href="/books/NBK66023.1/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK66023" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK66023" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Adult Central Nervous System Tumors Treatment (PDQ®): Patient Version. 2015 Aug 25. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK66023.18/">NBK66023.18</a></span> January 5, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66023.17/">NBK66023.17</a></span> September 7, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK66023.16/">NBK66023.16</a></span> August 6, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK66023.15/">NBK66023.15</a></span> May 7, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66023.14/">NBK66023.14</a></span> March 11, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66023.13/">NBK66023.13</a></span> March 6, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66023.12/">NBK66023.12</a></span> October 11, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66023.11/">NBK66023.11</a></span> August 20, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66023.10/">NBK66023.10</a></span> September 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66023.9/">NBK66023.9</a></span> July 5, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66023.8/">NBK66023.8</a></span> March 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66023.7/">NBK66023.7</a></span> March 13, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66023.6/">NBK66023.6</a></span> January 12, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66023.5/">NBK66023.5</a></span> August 26, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66023.4/">NBK66023.4</a></span> August 10, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66023.3/">NBK66023.3</a></span> May 6, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66023.2/">NBK66023.2</a></span> April 27, 2016</li><li><span class="bk_col_itm">NBK66023.1</span> August 25, 2015 (Displayed Version)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062697__1" ref="log$=inpage&link_id=inpage">General Information About Adult Central Nervous System Tumors</a></li><li><a href="#CDR0000062697__28" ref="log$=inpage&link_id=inpage">Stages of Adult Central Nervous System Tumors</a></li><li><a href="#CDR0000062697__606" ref="log$=inpage&link_id=inpage">Recurrent Adult Central Nervous System Tumors</a></li><li><a href="#CDR0000062697__102" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062697__134" ref="log$=inpage&link_id=inpage">Treatment Options by Type of Primary Adult Brain Tumor </a></li><li><a href="#CDR0000062697__572" ref="log$=inpage&link_id=inpage">Treatment Options for Primary Adult Spinal Cord Tumors</a></li><li><a href="#CDR0000062697__195" ref="log$=inpage&link_id=inpage">Treatment Options for Recurrent Adult Central Nervous System Tumors</a></li><li><a href="#CDR0000062697__430" ref="log$=inpage&link_id=inpage">Treatment Options for Metastatic Adult Brain Tumors</a></li><li><a href="#CDR0000062697__472" ref="log$=inpage&link_id=inpage">To Learn More About Adult Central Nervous System Tumors</a></li><li><a href="#CDR0000062697__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65982/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389369" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pituitary Tumors Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pituitary Tumors Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389363" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Ovarian Germ Cell Tumors Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Ovarian Germ Cell Tumors Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389213" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Extragonadal Germ Cell Tumors Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Extragonadal Germ Cell Tumors Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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