What happens in your brain is what makes you, you. Your brain controls how you act, think, feel, learn, move, and remember. Your spinal cord relays messages between your brain and nerves throughout your body. 

Brain and spinal cord cancers are masses of abnormal cells, called tumors, that grow out of control. They can spread into the surrounding tissue. While most brain and spinal cord tumors are not cancerous, they can impinge on healthy neighboring tissues and lead to symptoms. 

When the tumor is cancerous, knowing how fast it grows is crucial. A very slow-growing brain tumor may only need careful checkups. The fastest tumors need an urgent treatment plan. Our neuroradiology and pathology experts are the critical first responders in creating a plan for you and your tumor.

At Carilion, we treat every kind of brain and spinal cord tumor, including those that are rare or more common in children.

Cancers that have spread to the brain or spinal cord

The most common cancers in the brain or spinal cord are ones that start somewhere else in the body. These are metastatic or secondary tumors.

Tumors that spread to the brain (also called brain metastases or "mets") are much more common than cancer that starts in the brain. Any cancer can spread to the brain, but breast, lung, and melanoma are the most likely.

Tumors that begin in the brain or spinal cord are primary tumors. These are rare in adults but more common in children. There are more than 120 different types, and many are not cancerous.

Gliomas

About 30% of all brain tumors are gliomas, including some of the most serious brain cancers. Gliomas start in the brain's supportive cells and can grow quickly or slowly.

Some types of gliomas are almost only found in children, like diffuse midline glioma (previously called DIPG). 

There are 3 main types:

• Astrocytomas: This group includes glioblastoma multiforme, the most aggressive brain cancer in adults. In children, pilocytic astrocytoma is a common slow-growing form that's often treatable with surgery.
• Ependymomas: These start in the fluid-filled spaces in the brain or spinal cord and develop in both kids and adults.
• Oligodendrogliomas: Usually slower-growing tumors, more common in adults.

Other types of brain tumors

Several other types of brain tumors can affect children and adults. Some are fast-growing and cancerous. Others are non-cancerous but still cause serious symptoms. 

Below are a few types our team treats:

• Medulloblastomas: This fast-growing tumor starts in the cerebellum (the lower back part of the brain). It's the most common cancerous brain tumor in children. It can spread through the spinal fluid and needs special treatment.
• Craniopharyngiomas: These non-cancerous tumors grow near the pituitary gland. They can press on nearby brain areas. They're more common in children and can affect vision, growth, and hormone levels.
• Atypical teratoid/rhabdoid tumors: These rare and aggressive tumors usually affect very young children. They grow quickly and often need a combination of treatments.
• Atypical and anaplastic meningiomas: Meningiomas grow from the tissue that covers the brain and spinal cord. They're the most common primary brain tumor in adults and are usually non-cancerous. They can be more aggressive (atypical or anaplastic) in rare cases.

Pituitary tumors and pituitary carcinomas

The pituitary gland, located at the base of the brain, controls many hormones in the body. Most tumors here are not cancer, but they can still cause problems by pressing on nearby areas or releasing extra hormones. Very rarely, a pituitary carcinoma can develop and spread.

Carilion has the most experienced surgeon in Virginia treating pituitary tumors.

How we treat these cancers depends on where they are and how treatment affects how your brain and spinal cord work.

Our team of neurosurgeons work alongside our cancer doctors to find the best course of action for your tumor. They may suggest we remove it surgically or attack it non-surgically.

Cancer surgery

Surgery is one of the main ways we treat most brain and spinal cord cancers. Our goal is to remove as much of the tumor as possible without affecting your brain or spinal cord function. 

Our neurosurgeons use a computer-guided system called stereotactic navigation. It links surgical tools to a 3-D map of your brain or spinal cord to pinpoint tumors for treatment. This accuracy reduces the risk of damage to surrounding tissue. 

They also specialize in brain mapping or awake brain surgery. You can't feel this surgery, but you're awake so that you can respond. Being awake helps us see how your brain functions during surgery.

Cancer surgery includes:

• Craniotomy: Also called brain tumor resection, this is the most common surgery to remove brain tumors. We make a surgical opening in your skull and remove as much of the tumor as possible. 
• Minimally invasive brain port surgery: We can reach many tumors that are deep inside the brain with a small tube the size of a dime or nickel. 
• Endonasal endoscopic surgery: We can remove many tumors at the base of the skull through the nasal cavity. We use a tube called an endoscope and don't make any cuts on the skin.
• Shunt surgery and endoscopic third ventriculostomy: These surgeries help relieve pressure inside the skull caused by tumors blocking the flow of cerebrospinal fluid. 
• Less invasive spinal cord surgery: We can use smaller incisions and special tools to remove tumors pressing on your spinal nerves. The surgery is quicker, and you recover faster than with traditional surgery.
• Laser interstitial thermal therapy: A less invasive treatment for certain brain cancers, including gliomas and metastatic tumors. It uses small incisions and a laser beam to kill the tumor cells. 
• Peripheral nerve surgery: This surgery removes peripheral nerve tumors.
• Spinal cord stimulation: This procedure uses a needle to deliver pulsed energy near your spinal cord to relieve pain from tumors. It's also called dorsal column stimulation.
• Spinal cord decompression and fusion: This surgery removes tumors pressing on your spinal cord. Decompression can sometimes weaken the nearby spinal bone. To strengthen it, we then fuse 2 nearby vertebrae.

Radiation therapy and radiosurgery

Radiation therapy uses high-energy rays to target and kill cancer cells. We aim the radiation at the cancer cells to stop their growth and shrink the tumor. Sophisticated machinery, scanners, and molding devices target cancer, not healthy cells.

For brain and spinal cord tumors that we can't remove with surgery, we may use radiation therapy. We may also use it after surgery, in combination with cancer medicines. 

At Carilion, we use the CyberKnife system to treat certain tumors in the brain and spine. It gives a strong, focused dose of radiation right to the tumor—without any cutting or surgery. Most people only need one treatment. 

Carilion was the first in Virginia to offer this advanced technology. You can get this innovative care close to home.

Cancer medicines

We create a plan tailored to each person when they get a brain and spinal cord cancer diagnosis. This plan may include cancer medicines.

As opposed to surgery, a cancer drug travels through the body seeking to kill or control the growth or spread of cancer cells. For brain and spinal cord cancer, we can give most of these drugs through an IV drip placed in your vein or by a pill you swallow.

Cancer medicines we may use include:

• Non-targeted therapy: Medicines like chemotherapy kill rapidly growing cells. Not everyone with brain and spinal cord cancer needs chemotherapy, and your cancer may respond well to other medicines. Chemotherapy pills are often used with radiation to fight brain tumors. 
• Targeted therapy: Some cancer cells have an "Achilles' heel" that we can use to kill the cancer cells and leave healthy cells relatively untouched. If your cancer has these targets, we may be able to use targeted therapies.

We may also give you cancer medicines over longer periods to stop cancer from coming back.

Tumor-treating fields therapy

At Carilion, we offer some of the latest options to help treat brain cancer. One is tumor-treating fields (TTF) therapy, which uses gentle electric fields to slow or stop tumor cells from growing.

Optune is a wearable device that delivers this therapy. While we don’t use it often, it may be an option for some people with glioblastoma. Our team will discuss whether it might be right for your care.

Clinical trials

Clinical trials are another way to fight cancer. We usually compare a new medicine or protocol to the current best therapy in a trial. Your care team may ask you to consider a trial when studying a new and exciting way to treat cancer.

These studies are voluntary; you will talk to your care team before enrolling. A trial can be a first treatment option or an option if your treatment stops working.