Central nervous system (CNS) tumours are abnormal growths of tissue in the brain and spine. This type of cancer occurs when the growth of cells gets out of control, developing a lump known as a ‘tumour’.
Cancerous tumours that start in the brain and spine do not often spread to other parts of the body, but can increase in size and take over surrounding tissue.
The brain and central nervous system
The brain is the control centre of your body: responsible for everything you think, feel or do. It is part of your central nervous system, along with your spinal cord. Different areas of your brain control different parts of your body, as well as your thoughts, memories and feelings. Brain tumours can develop anywhere in your brain.
There are more than 200 different types of brain tumours. They are often named after the type of cell or the region of the brain where they begin. Most brain tumours start in the glial cells that bind the nerve cells of the brain together. These are tumours are called ‘gliomas’. There are a number of different sub-types of gliomas.
The ones that are most common in young people are astrocytomas and ependymomas. Medulloblastomas are tumours that develop in the cerebellum at the back of the brain but may spread to other parts of the brain and, occasionally to other parts of the body.
There are also a number of rarer types of brain tumours. Talk to your specialist for more information about your particular diagnosis.
You also may have been told about your tumour’s ‘grade'. This refers to how fast the tumour is growing. Those classified with a higher grade generally grow faster than those classified with a lower grade.
People can get brain tumours at any age.
The first symptoms of a central nervous system tumour may be headaches and sickness that are usually worse in the morning. Depending on where the tumour is located, other symptoms could include loss of vision or hearing, irritability, changes in your behaviour and fits, unsteadiness when walking, weakness in your arms or legs, and difficulty going to the toilet.
Central nervous system tumours are diagnosed using a number of tests. Specialists use MRI scans and CT scans to let them look inside the brain and identify where your tumour is located. They will also examine your eyes for any increased pressure in your brain, take blood tests, and possibly also test your hearing and reflexes. Doing these tests and getting the results may take some time, but it is important for your specialist to identify the particular type of tumour you have so that they can determine the best form of treatment.
Your treatment plan will depend on the type of tumour you have, and its size and location.
Surgery is the most common treatment for central nervous system tumours. The surgeons will aim to remove the tumour, or as much of it as possible. However, sometimes surgery is not a treatment option because the tumour has no clear edges and is located next to or within a delicate part of the brain.
Radiotherapy may be used in addition to surgery if it is has not been possible to remove the entire tumour surgically, or if surgery is not possible because of the location of the tumour. Radiotherapy will also usually be given to those affected by high grade tumours, whether or not these have been removed by surgery.
Proton Beam Therapy
If you are under 16 and have a particular type brain tumour, your specialist may recommend that you travel abroad to have a specialised form of radiotherapy called proton beam therapy. See our Proton Beam Therapy section for more information.
Chemotherapy can also be used, especially when treating high grade gliomas and medulloblastoma. Steroid drugs are given to reduce the swelling around brain tumours. They don’t treat the tumour itself but help relieve some of the symptoms that the tumour causes. You may also be given drugs to prevent fits.
If you are undergoing chemotherapy, you may experience side-effects such as tiredness, sickness, diarrhoea and temporary hair loss. You will also be at greater risk of infections.
Radiotherapy can also make you feel tired and sick. You might experience skin irritation similar to sun burn and hair loss in the area that is being treated. The use of steroids can produce temporary side-effects, including a rounded-looking face, weight gain and mood swings. For more information, see our side-effects section.
After your treatment is complete you will still need to be seen regularly at an outpatient clinic. At this clinic, your specialist will be looking for any signs that your cancer has returned (this is known as a relapse). They will also check that your major organs, such as your heart and lungs, are still functioning correctly and haven’t been affected by your cancer treatment.
Long-term follow up
Once your risk of relapse has reduced, the focus of on-going follow up changes to looking out for potential long-term side-effects of treatment. The risk of long-term side-effects depends on the type of cancer you had and the treatment you received. A personalised surveillance plan is usually created that outlines the specific long term follow up and on-going investigations that you require.
Many people are at low risk of future health problems but some will have significant on-going health needs. Talk to your specialist about the potential long-term side-effects of your treatment.
The long-term side-effects that you experience following on from your brain cancer treatment will depend on where your cancer was originally located, the treatment you received, your age when you received the treatment and a number of other factors.
You may continue to have shaking or fits, weakness on one side or in one part of your body, or difficulty in walking, speaking or understanding. These side-effects may be overcome through therapy (for example speech therapy or physiotherapy). Talk to your specialist about the options available to you.
Updated December 2014, next review planned 2017.