Treatment of Spinal Cord and Brain

Tumors
By Krisha McCoy, MS | Medically reviewed by Lindsey Marcellin, MD, MPH

Treatment depends on many factors, including the tumor type, its speed of
growth, its location, and the patient's overall health.

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Since no tumor is exactly alike, treatment for spinal cord and brain tumors often differs
from patient to patient. To begin, treatment "depends on what type of tumor you are dealing
with," says Elizabeth Gerstner, MD, neuro-oncologist at the Stephen E. and Catherine Pappas
Center for Neuro-oncology and assistant professor of neurology at Massachusetts General
Hospital.
There are many different types of spinal cord and brain tumors, some highly curable by
surgery and others very hard to cure. Doctors put tumors into categories. These categories are
determined by how quickly the tumor grows, and how likely it is to spread. So your tumor's
category, or grade, will help determine your treatment options. Tumor grades range from I to
IV, with grade I being slower-growing and less likely to spread, and grade IV being fastergrowing and likely to spread.The spinal cord and brain are very complex, and the location of
your tumor often dictates whether a neurosurgeon will be able to remove it without causing
severe damage. Some types of spinal cord or brain tumor treatments are only recommended
for people who have good overall health.
Spinal Cord and Brain Tumors: Treatment Options
There are many ways to treat a spinal cord or brain tumor. Treatment may include:
Watchful waiting. "In rare cases we'll not do anything and just follow patients with MRI
[magnetic resonance imaging] scans," says Dr. Gerstner. Watchful waiting, or observing the
tumor until it needs treatment, is sometimes recommended for smaller tumors that are not
causing major problems.

Surgery. Most spinal cord and brain tumors are treated surgically. Surgery can be very
effective in removing all or part of your tumor and relieving your symptoms. It will take
several weeks or months to recover from brain or spinal cord surgery, and risks of surgery
include infection, bleeding, blood clots, unstable blood pressure, cognitive damage, coma, and
death.
Radiation therapy. Radiation therapy is often used along with surgery to treat spinal cord
and brain tumors, usually to help kill any remaining tumor cells after surgery. A session of
radiation therapy generally takes 30 minutes to two hours. Common side effects include
fatigue, hair loss, skin changes and swelling at the radiation entry site, and sometimes
difficulties with mental tasks, like focused thinking.
Chemotherapy. Although not usually used to treat spinal cord tumors, chemotherapy can be
beneficial in treating certain types of malignant (cancerous) brain tumors. Chemotherapy can
be given through a vein to circulate throughout the entire body, or it can be surgically placed
directly in the brain. The length of time you need to be on chemotherapy depends on your
tumor and response to treatment. Since chemotherapy kills healthy cells as well as cancerous
ones, common side effects include mouth sores, gastrointestinal problems, and hair loss.
Steroids. If you have a brain tumor that is causing significant swelling in your brain, your
doctor may prescribe corticosteroid medications to reduce swelling and temporarily relieve
some of your symptoms. Steroids can be used at any point during your treatment. Your dose
may need to be increased over time, and your doctor will need to be informed of adverse
effects such as weight gain, infection, mood swings, or high blood sugar levels.

Work with your treatment team to carefully weigh the benefits and risks of each treatment
option when devising a plan that is right for you.