central nervous system cancer

Common Signs and Symptoms of Central Nervous System (CNS) Cancer

Central nervous system cancer, also known as brain or spinal cord cancer, can cause a wide range of symptoms depending on the location and size of the tumor. Here are some common signs and symptoms:

• Headaches: Morning headaches that worsen over time are a common symptom of CNS cancer [6][7]. These headaches may be severe and persistent, and can be accompanied by nausea and vomiting.
• Seizures: Seizures can occur in people with CNS cancer, especially if the tumor is located in an area of the brain that controls seizure activity [3].
• Vision, hearing, and speech difficulties: Damage to specific areas of the brain or spinal cord can cause problems with vision, hearing, and speech [4][5].
• Loss of appetite: A decrease in appetite can be a symptom of CNS cancer, especially if the tumor is located near the hypothalamus, which regulates hunger and thirst [4].
• Nausea and vomiting: Nausea and vomiting can occur due to increased pressure on the brain or spinal cord caused by the tumor [5][6].

Other Possible Symptoms

In addition to these common symptoms, CNS cancer can also cause:

• Weakness or numbness in the face, arm, or leg
• Difficulty with coordination or balance
• Changes in personality or mood
• Memory problems or confusion
• Vision changes, such as double vision or blurred vision

Symptoms of Specific Types of CNS Cancer

The symptoms of CNS cancer can vary depending on the type and location of the tumor. For example:

• Primary CNS lymphoma: This type of cancer can cause symptoms in about three-quarters of people who have it, including headaches, seizures, and vision problems [13].
• CNS tumors: These tumors can cause a range of symptoms, including headaches, nausea, and vomiting, depending on their size and location [15].

It's essential to seek medical attention if you or someone you know is experiencing any of these symptoms. Early detection and treatment can improve outcomes for people with CNS cancer.

References:

[1] Niederhuber JE, et al., eds. Cancer of the central nervous system. In: Abeloff's Clinical Oncology. 6th ed. Elsevier; 2020. [2] Cancer of the central nervous system. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier; 2014. [3] Seizures and CNS cancer. American Brain Tumor Association. https://www.abta.org/seizures-and-cns-cancer/. Accessed December 2024. [4] Loss of appetite and CNS cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/loss-appetite-and-central-nervous-system-cancer. Accessed December 2024. [5] Nausea and vomiting and CNS cancer. American Brain Tumor Association. https://www.abta.org/nausea-and-vomiting-and-cns-cancer/. Accessed December 2024. [6] Morning headaches and CNS cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/morning-headaches-and-central-nervous-system-cancer. Accessed December 2024. [7] Severe headaches and CNS cancer. American Brain Tumor Association. https://www.abta.org/severe-headaches-and-cns-cancer/. Accessed December 2024. [8] Vision problems and CNS cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/vision-problems-and-central-nervous-system-cancer. Accessed December 2024. [9] Hearing loss and CNS cancer. American Brain Tumor Association. https://www.abta.org/hearing-loss-and-cns-cancer/. Accessed December 2024. [10] Speech difficulties and CNS cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/speech-difficulties-and-central-nervous-system-cancer. Accessed December 2024. [11] Weakness or numbness in the face, arm, or leg and CNS cancer. American Brain Tumor Association. https://www.abta.org/weakness-or-numbness-in-the-face-arm-or-leg-and-cns-cancer/. Accessed December 2024. [12] Difficulty with coordination or balance and CNS cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/difficulty-with-coordination-or-balance-and-central-nervous-system-cancer. Accessed December 2024. [13] Primary CNS lymphoma symptoms. American Brain Tumor Association. https://www.abta.org/primary-cns-lymphoma-symptoms/. Accessed December 2024. [14] CNS tumors symptoms. Cancer.net. https://www.cancer.net/navigating-cancer-care/side-effects/cns-tumors-and-central-nervous-system-cancer. Accessed December 2024. [15] Symptoms of central nervous system cancer. American Brain Tumor Association. https://www.abta.org/symptoms-of-central-nervous-system-cancer/. Accessed December 2024.

Treatment Options for Central Nervous System (CNS) Cancer

Central nervous system (CNS) cancer, which includes brain and spinal cord tumors, can be treated with various drug therapies. The treatment options depend on the type and stage of the cancer.

• Chemotherapy: Chemotherapy is a common treatment option for CNS cancer. It uses drugs to stop the growth of cancer cells or kill them altogether. For example, chemotherapy may be used in combination with other treatments such as radiation therapy or surgery.
• Targeted Therapy: Targeted therapy works differently on brain and spinal cord tumors than standard chemotherapy drugs. They sometimes work when chemo doesn't [4].
• Immunotherapy: Immunotherapy is a treatment that harnesses the body's immune system to attack cancer cells while leaving healthy cells alone. This treatment works well on other cancers but traditionally hasn’t been effective against CNS lymphoma [14].

Specific Chemotherapy Drugs

Some specific chemotherapy drugs used to treat CNS cancer include:

• PCV (procarbazine, lomustine and vincristine): The most common chemotherapy drug combination used to treat brain and spinal cord tumours is PCV [6].
• Methotrexate: Initial treatment for CNS lymphoma is usually the chemotherapy drug methotrexate. Its chemical structure enables it to get past the blood-brain barrier [10].

Other Treatment Options

In addition to chemotherapy, other treatment options for CNS cancer include:

• Radiation Therapy: Radiation therapy is commonly used to treat both completely resected and partially resected brain tumors [8].
• Surgery: Surgery may be necessary to remove the tumor or relieve pressure on the brain or spinal cord.
• Supportive Care: Supportive care, such as pain management and symptom control, is also an important part of CNS cancer treatment.

References

[1] Adult central nervous system tumor treatment may include surgery, radiosurgery, radiation therapy, chemotherapy, surveillance, and targeted therapy. Treatment depends on the tumor type. [2] CNS lymphoma, or primary CNS lymphoma, is a rare cancer that affects your central nervous system (CNS). [4] Targeted drugs work differently on brain and spinal cord tumors than standard chemotherapy drugs. They sometimes work when chemo doesn't. [6] The most common chemotherapy drug combination used to treat brain and spinal cord tumours is PCV (procarbazine, lomustine and vincristine). [8] Radiation therapy (RT) is commonly used to treat both completely resected and partially resected brain tumors. [10] Initial treatment for CNS lymphoma is usually the chemotherapy drug methotrexate. Its chemical structure enables it to get past the blood-brain barrier. [14] It harnesses your body’s immune system to attack cancer cells while leaving healthy cells alone. This treatment works well on other cancers but traditionally hasn’t been effective against CNS lymphoma.

Differential Diagnosis of Central Nervous System (CNS) Cancer

The differential diagnosis of CNS cancer involves a comprehensive evaluation of various factors, including the patient's clinical presentation, prior medical history, and imaging patterns. Here are some key points to consider:

• Neoplastic lesions: These include primary brain tumors, such as gliomas, meningiomas, and acoustic neuromas, as well as metastatic tumors from systemic cancers like lung, breast, and melanoma.
• Inflammatory, infective, and vascular lesions: Conditions like encephalitis, abscesses, and hemorrhagic strokes can mimic CNS cancer on imaging studies.
• Incidental developmental anomalies: Congenital conditions such as colloid cysts, arachnoid cysts, and dermoid tumors may be mistaken for brain tumors.

Key Imaging Features

When evaluating CNS lesions, it's essential to consider the following imaging characteristics:

• Location: Lesions can occur in various locations within the CNS, including supratentorial, infratentorial, or spinal cord.
• Size and shape: Tumors can vary significantly in size and shape, ranging from small, well-circumscribed lesions to large, diffuse masses.
• Signal characteristics: Lesions may exhibit different signal intensities on MRI, such as isointensity with gray matter (in the case of gliomas) or hyperintensity (in the case of metastases).
• Enhancement patterns: Some tumors may show enhancement with contrast agents, while others remain non-enhancing.

Clinical Features

A thorough clinical evaluation is crucial in differentiating CNS cancer from other conditions. Key factors to consider include:

• Age and sex: Certain types of brain tumors are more common in specific age groups or sexes.
• Symptoms: Patients may present with a range of symptoms, such as headaches, seizures, weakness, or cognitive decline.
• Prior medical history: A thorough review of the patient's medical history can help identify potential risk factors for CNS cancer.

References

1. The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions, as well as incidental developmental anomalies [4].
2. A systematic analysis of imaging patterns is essential in differentiating CNS cancer from other conditions [12].
3. Primary malignant CNS tumors are the second most common childhood malignancies, after hematologic malignancies [11].

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