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What Are Brain and Spinal Cancers?

Brain tumors and spinal tumors are masses of abnormal cells that form in the brain or spinal cord. Together, the brain and spinal cord make up the central nervous system.  

Although they rarely spread outside the central nervous system, both benign (non-cancerous) and malignant (cancerous) brain and spinal cord tumors can be life threatening, since they can press against and destroy normal brain and spinal tissue, which can lead to serious and sometimes fatal damage.  

Brain and spinal cancers tend to be different in adults and children. They often form in different areas, develop from different types of cells, and may have different treatments and outlooks. Brain tumors and spinal cancers are the second most common cancers in children, after leukemia. They account for about 25% of all childhood cancer diagnoses.

According to the American Cancer Society, approximately 24,530 new cases of malignant tumors of the brain or spinal cord are diagnosed in the United States each year. Of those patients, about 4,000 are children and teenagers. Malignant brain and spine tumors result in approximately 18,600 deaths in the U.S. annually.

In Colorado, there are approximately 420 new cases of brain and spinal cancer diagnosed every year.

Brain and Spinal Cancer Prognosis and Survival Rates

Survival rates for brain and spinal tumors vary widely. The prognosis for a patient with brain or spine cancer depends on the type and location of the tumor and the age at which the patient is diagnosed.

According to the American Society of Clinical Oncology, the average five-year survival rate for patients with a malignant brain or spinal tumor is 36%. The 10-year survival rate is about 31%.

Why Come to CU Cancer Center for Brain and Spinal Cancers

As the only National Cancer Institute Designated Comprehensive Cancer Center in the state of Colorado and one of only four in the Rocky Mountain region, the University of Colorado Cancer Center has doctors who provide state-of-the-art, patient-centered brain and spine tumor care and researchers focused on diagnostic and treatment innovations.

The CU Cancer Center is home to the Neuro-Oncology multidisciplinary clinic on the Anschutz Medical Campus in Aurora, Colorado, focusing on primary and metastatic brain tumors in outpatient and inpatient settings, paraneoplastic disorders, and neurological complications of cancer in adult patients. Multidisciplinary clinics offer patients an “all in one” approach to clinical care, overseen by world-class neurologists, medical oncologists, neurosurgeons, radiation oncologists, radiologists, genetic counselors, nurse navigators, and others who collaborate on both primary treatment and aftercare.

The Neuro-Oncology Program at Children’s Hospital Colorado is a world-renowned clinical and research center caring for nearly all pediatric CNS tumor patients in the Rocky Mountain Region. The multi-disciplinary team includes neuro-oncologists, neurosurgeons, radiation oncologists, neuroradiologists, neuropathologists, and associated specialists. The program conducts cutting-edge basic and clinical research and provides care for patients from diagnosis to long-term survivorship.

→ Five CU Cancer Center Researchers Receive Grants to Study Brain Tumors

There are numerous brain and spinal cancer clinical trials being conducted by CU Cancer Center members all the time. These trials offer patients additional options to traditional cancer treatment and can result in increased life spans.

Our clinical partnership with UCHealth has produced survival rates higher than the state average for all stages of brain cancer.

Brain Cancer Graphic

Number of Patients Diagnosed – UCHealth 442 – State of Colorado 1,326
Number of Patients Surviving – UCHealth 262 – State of Colorado 402
*n<30, 5 Year Survival – (Date of diagnosis 1/1/2010–12/31/2014)

Types of Brain and Spinal Cancers

Different types of nervous system cells can become cancerous, and the type of cell affected determines the type of brain or spinal tumor. They are categorized by looking at the cells under a microscope. Doctors use this information to understand the expected growth pattern and speed, as well as which treatments may work best.

Tumors that begin in the brain or spine are called primary tumors, while tumors that begin in another part of the body and then spread to the brain or spine are called metastatic or secondary tumors. For adults, secondary brain and spine tumors are more common than primary tumors, and they are treated differently. This page pertains to primary tumors.

Brain tumors account for up to 90% of all primary central nervous system cancers.

Spinal tumors can be categorized as intradural tumors, which develop within the spinal cord or the covering of the spinal cord (dura), and vertebral tumors, which develop in the bones of the spine (vertebrae). Intradural tumors can be further classified as intramedullary tumors, which begin in the cells within the spinal cord, and extramedullary tumors, which form in the membrane surrounding the spinal cord or the nerve roots that branch out from the spinal cord.

Gliomas

Gliomas are brain and spine tumors that start in glial cells, the supporting cells of the brain. About 30% of all central nervous system (CNS) tumors are gliomas, and about 50% of CNS tumors in children are gliomas.

Astrocytomas are tumors that can form in the brain or spinal cord. They begin in glial cells called astrocytes. Astrocytomas may be slow-growing or aggressive. Astrocytomas in the brain can cause seizures, headaches, and nausea, and astrocytomas in the spinal cord can cause weakness and disability in the affected area. About 20% of all brain tumors are astrocytomas, and they are more common in children than adults. There are four grades of astrocytoma: non-infiltrating astrocytomas like pilocytic astrocytomas and subependymal giant cell astrocytomas (Grade 1), low-grade diffuse astrocytomas and pleomorphic xanthoastrocytomas (Grade 2), anaplastic astrocytomas (Grade 3), and glioblastomas (Grade 4), also known as glioblastoma multiforme.

Ependymomas develop in the glial ependymal cells of the brain or spinal cord. Ependymal cells line the passageways where cerebrospinal fluid flows. Ependymomas are most common in young children, where they cause headaches and seizures. In adults, ependymomas are most likely to form in the spinal cord and may cause weakness in the parts of the body controlled by the nerves affected by the tumors.

Choroid plexus carcinomas are rare, malignant brain tumors that occur primarily in children. They begin near the brain tissue that secretes cerebrospinal fluid and can affect the function of nearby structures in the brain. As they grow, these tumors can cause excess fluid in the brain (hydrocephalus), irritability, nausea or vomiting, and headaches.

Oligodendrogliomas are rare tumors that form in brain glial cells called oligodendrocytes. These cells are responsible for making myelin, the protein- and lipid-rich substance that surrounds nerves. They usually grow slowly, but they can become more aggressive over time. Extremely aggressive oligodendrogliomas are known as anaplastic oligodendrogliomas.

Embryonal Tumors 

Embryonal tumors are malignant tumors that develop in fetal (embryonic) nerve cells in the central nervous system, including both the brain and spinal cord. About 10–20% of all brain tumors in children are embryonal tumors. They are most common in babies and young children, and they are rare in adults. Embryonal tumors tend to grow quickly. In the past, some embryonal tumors were referred to as primitive neuroectodermal tumors.

Medulloblastomas are the most common type of embryonal tumors. They are fast-growing tumors that begin in the neuroectodermal cells of the cerebellum.

Atypical teratoid/rhabdoid tumors are rare tumors that form in the brains or spinal cords of infants and young children.

Embryonal tumors with multilayered rosettes are rare, aggressive, malignant tumors that usually develop in the largest part of the brain (the cerebrum) in infants and young children.

Pineoblastomas are rare, aggressive tumors that form in the cells of the pineal gland, which is located in the center of the brain and produces the hormone melatonin, which helps regulate the body’s sleep-wake cycle. Pineoblastomas can occur at any age, but they occur most often in young children. These tumors may cause headaches, sleepiness, and changes in the way the eyes move.

Other Brain and Spinal Tumors

Acoustic neuromas, also known as vestibular schwannomas or neurilemmomas, are benign and usually slow-growing tumors that develop on the vestibular nerve leading from the inner ear to the brain. Pressure from an acoustic neuroma can cause hearing loss, ringing in the ear, and unsteadiness.

Craniopharyngiomas are rare, benign brain tumors that develop near the pituitary gland. Craniopharyngiomas are usually slow-growing and occur most often in children and older adults. They may affect growth in children and can cause changes in vision, fatigue, excessive urination, and headaches.

Meningiomas are tumors that form in the meninges, the layers of tissue that surround the outer part of the brain and spinal cord. Meningiomas are usually benign and make up about a third of all primary brain and spinal tumors. They are the most common primary brain tumors diagnosed in adults and occur about twice as often in women as in men. People with a family history of neurofibromatosis type 2 may be more likely to develop meningiomas.

Gangliogliomas are slow-growing tumors that contain both neurons and glial cells. They are very rare in adults.

Pituitary tumors, also called pituitary adenomas, start in the pituitary gland. Although they are almost always benign, they can cause problems if they grow large enough to press on nearby brain structures or if they make too much of any kind of hormone. They are more common in teenagers than in children.

Germ cell tumors are rare tumors that develop from germ cells. During normal prenatal development, germ cells travel to the ovaries or testicles and develop into egg or sperm cells. But sometimes germ cells travel to abnormal locations, such as the brain, where they may develop into germ cell tumors. Germ cell tumors of the nervous system usually occur in children or teens and typically form in the pineal gland or near the pituitary gland.

Lymphomas begin in white blood cells called lymphocytes. Most lymphomas start in other parts of the body, but some form in the central nervous system. When this occurs, they are called primary CNS lymphomas. They are very rare in children and usually occur in adults with weakened immune systems.

Chordomas are rare tumors that start in the bone at the base of the skull or the lower end of the spine. Although they don’t technically start in the central nervous system, they can injure nearby brain structures or the spinal cord as they grow.

Risk Factors for Brain and Spinal Cancer

Brain and spinal cancers develop when cells begin to multiply rapidly, accumulating to form a lump or mass called a tumor. Although most brain and spinal tumors are not linked with known causes or risk factors, researchers have identified some hormonal, lifestyle, and environmental factors that may increase a person’s risk of developing a brain tumor or spine tumor.

Radiation exposure: The biggest environmental risk factor for brain and spine tumors is radiation exposure, usually from radiation therapy to treat another condition or type of cancer, such as leukemia.

Family history: Brain or spinal cancers usually do not run in families, but some rare familial cancer syndromes and genetic disorders are associated with increased risk. These include neurofibromatosis type 1, also known as von Recklinghausen disease; neurofibromatosis type 2; tuberous sclerosis; von Hippel-Lindau syndrome; Li-Fraumeni syndrome; Turcot syndrome, also known as brain tumor-polyposis syndrome; Gorlin syndrome, also known as basal cell nevus syndrome; Cowden syndrome, Lynch syndrome, and BRCA2 gene mutations.

Weakened immune system: People with weakened immune systems have a higher chance of developing lymphomas of the brain or spine.

Chemical exposure: Some studies have shown a possible link between exposure to vinyl chloride (a chemical used to manufacture plastics), petroleum products, and other industrial chemicals and an increased risk of brain tumors.

Age: Brain and spinal tumors are most common in older adults.

Gender: Men are generally more likely than women to develop brain or spinal cancer. However, some specific types of tumors, such as meningioma, are more common in women.

Viral infections: Infection with the Epstein-Barr virus (EBV), which is most widely recognized as the virus that causes mononucleosis or “mono,” increases the risk of primary CNS lymphoma. Other research has shown that high levels of a common virus called cytomegalovirus may also be associated with a higher risk for brain or spinal cancer.

Latest in Brain and Spinal Cancer from the CU Cancer Center

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Information reviewed by Adam Green, MD, in May 2022.