Brain and Spinal Tumors Health Article

Clinical trials

Persons with recurrent tumors or tumors resistant to treatment are often offered participation in an experimental protocol or clinical trial. Experimental treatments include gene therapy that introduces substances into the brain tumor, changing the genetic makeup of the tumor cells. Another experimental therapy involves new forms of brachytherapy, where radioactive pellets are implanted directly into the tumor.

The scientific community continually conducts clinical trials in the effort to find new drugs and treatments that are effective against cancer, including those types most often occurring in the brain and spinal cord. As of mid-2004, the National Institutes of Health (NIH) and related agencies were sponsoring more than 200 ongoing studies and trials specific for the treatment of brain and spinal cord tumors. Updated information on these and other trials can be found at the NIH website for clinical trials at <http://www.clinicaltrials.gov>.

Prognosis

Symptoms of malignant brain and spinal cord tumors are usually progressive over time. Symptoms become more pronounced and troublesome as tumors invade or otherwise obstruct healthy tissue. Benign tumors can also cause severe dysfunction by placing pressure on surrounding vital structures, but with treatment, they have a more favorable prognosis.

The slowest growing and least serious of these tumor types, grade II astrocytomas (a "low grade" tumor) can still infiltrate surrounding tissue and thus hold a potential for malignancy. Grade III anaplastic astrocytomas are more malignant than type II tumors. This increase in malignancy translates into lower long-term survival rates. Many persons with grade III anaplastic astrocytomas die within two to three years, while may people with the grade II astrocytoma show long-term survival beyond five years.

Patients with the most severe form of astrocytoma (glioblastoma multiforme, or GBH) usually show survival times of less than two years. Patients with oligodendrogliomas and oligoastrocytomas have generally better prognoses than the diffuse astrocytomas. Brainstem gliomas (a form of pediatric diffuse, fibrillary astrocytoma) have a tendency toward malignancy, and survival beyond two years is unusual. Because PXA tumors are usually slow growing and superficial, they are therefore more likely to be successfully treated by surgical removal.

Primary tumors of the spinal cord are often benign, and surgical removal results in a favorable prognosis. With metastatic spinal tumors, prognosis depends on the type of primary cancer.

BOOKS

Goetz C. G., et al. Textbook of Clinical Neurology. Philadelphia: W.B. Saunders Company, 1999.

Guyton & Hall. Textbook of Medical Physiology, 10th ed. Philadelphia: W.B. Saunders Company, 2000.

Roloff, Tricia Ann. Navigating through a Strange Land: A Book for Brain Tumor Patients and Their Families. Minneapolis, MN: Fairview Press, 2001.

Shiminski-Maher, Tania. Childhood Brain & Spinal Cord Tumors: A Guide for Families, Friends & Caregivers. Sebastopol, CA: O'Reilly & Associates, 2001.

Stark-Vance, Virginia. 100 Q & A about Brain Tumors. Sudbury, MA: Jones & Bartlett, 2003.

OTHER

"Brain and Spinal Cord Tumors—Hope through Research." National Institute of Neurological Disorders and Stroke. May 2, 2004 (May 22, 2004). <http://www.ninds.nih.gov/health_and_medical/pubs/brain_tumor_hope_through_research.htm#What_Research_is_Being_Done>.

"Facts About Brain Tumors." National Brain Tumor Foundation. May 2, 2004 (May 22, 2004). <http://www.braintumor.org/newsroom/quick_facts/index.html>.

Francavilla, Thomas L. "Intramedullary Spinal Cord Tumors." eMedicine May 2, 2004 (May 22, 2004). <http://www.emedicine.com/med/topic2995.htm>.

"Living with a Brain Tumor: A Guide for Brain Tumor Patients." American Brain Tumor Association. May 2, 2004 (May 22, 2004). <http://www.abta.org/Livingwi.pdf>.

"NINDS Brain and Spinal Tumors Information Page." National Institute of Neurological Disorders and Stroke. May 4, 2004 (May 22, 2004). <http://www.ninds.nih.gov/health_and_medical/disorders/brainandspinaltumors.htm>.

"What You Need To Know about Brain Tumors." National Cancer Institute. May 2, 2004 (May 22, 2004). <http://www.cancer.gov/cancerinfo/wyntk/brain>.

ORGANIZATIONS

American Brain Tumor Association (ABTA). 2720 River Road, Des Plaines, IL 60018-4110. (847) 827-9910; Fax: (847) 827-9918. info@abta.org. <http://www.abta.org>.

National Cancer Institute (NCI), National Institutes of Health. Bldg. 31, Rm. 10A31, Bethesda, MD 20892-2580. (301) 435-3848 or (800) 4CANCER (422-6237); Fax: (847) 827-9918. cancermail@icicc.nci.nih.gov. <http://cancernet.nci.nih.gov>.

Paul Arthur