Tumors that originate in the brain are a relatively rare form of cancer, with only about 18,500 new cases diagnosed in the United States each year. The outlook for these patients is not good because most types of brain tumors are malignant and difficult to fully remove. Brain tumors account for only 1.4% of all cancers, but 2.4% of all cancer-related deaths. The American Cancer Society estimates that about 12,760 people will die this year from malignant brain tumors. Tumors that start in other organs such as the lung or breast and then spread to the brain are called metastatic brain cancers. Fortunately, not all brain tumors are cancerous. Benign (noncancerous) tumors do not metastasize and, with very rare exceptions, are not life-threatening.

The brain consists of different kinds of tissues and cells. Treatment is determined by the "grade" or level of aggressiveness of the tumor and by the type of cells from which it grew. Common types of brain tumors include:

• Meningioma: Tumors beginning in the layer of tissue that surrounds the brain
• Glioma: Types of tumors from glial cells, including:
• Astrocytomas: Developing from astrocytes (a type of brain cell)
• Oligodendrogliomas: Tarting in brain cells called oligodendrocytes
• Ependymomas: Arising from the ependymal cells lining the ventricles

Diagnosis

Brain tumors are most often discovered because of symptoms that the patient has developed - symptoms caused by the degeneration of function in the area of the brain that the tumor is forming. MR and CT scans of the brain are used to look at the brain when an abnormality is suspected. These give exquisite detail of the structure and anatomy of brain tumors, but provide only part of the picture. The level of aggressiveness is also important. Although tissue samples may indicate the grade of a tumor, PET scanning has been shown to be a more accurate predictor of patient outcome.

A PET scan can show how fast the tumor cells are growing, which helps your doctor determine the best course of treatment.

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Treatment

Many brain tumors have a risk of recurrence. If the cancer does return, it is important that additional treatment begin immediately. This is also where PET can help.

Follow-Up

MR images show changes in the structure of the brain...but these changes may be side effects from previous treatments, such as surgery or radiation. Because PET shows the activity levels of cells, it is the most accurate way of determining whether the cancer has returned. PET scans may also be very helpful in assessing the response of the brain tumor to treatment.

More Information

Brain tumors are devastating to both the patient and caregiver. Several organizations provide information and support to patients and their families, including:

Online Resources:

• American Brain Tumor Association
• American Cancer Society
• Brain Tumor Society
• National Brain Tumor Foundation
• National Cancer Institute
• CTI: Real Life Answers
• PETNet Pharmaceuticals

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