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The extreme risks of central nervous system malignancies

A diagnosis of malignant tumors in the brain or spinal cord is a terrible situation for Massachusetts residents and their families. When doctors miss the warning signs of brain and spinal tumors or opt to delay treatment, patients face worsening health, steep medical bills and disease spread. Furthermore, patients also may miss the window of opportunity for cutting-edge cancer therapies.

The National Cancer Institute notes that there are many varieties of central nervous system (CNS) tumors. Even benign tumors require treatment because they are liable to press on the spinal cord or brain and interfere with the essential processes of the CNS. Malignant tumors are graded on a scale of one to four depending upon the expected rates of growth and spread and the appearance of the cancer cells. Grade four tumors are the most severe, and recovery is unlikely. These tumors tend to spread rapidly, and cells from such tumors appear highly abnormal when viewed under a microscope.

The NCI points to several difficulties doctors may face in diagnosing CNS cancers. For example, symptoms may vary from person to person, and the causes of these tumors are unknown. Additionally, a biopsy is one common strategy to identify malignant brain tumors but is not a viable option in some cases.

Similarly, a 2015 study from the Proceedings of the National Academy of Sciences of the United States of America suggested several reasons that diagnosis and treatment of CNS cancers may be impeded. For example, among patients with tumors in the spinal cord or brain, invasive surgery to identify the cancer’s progression is considered high risk, and the accuracy of imaging technologies is limited. Moreover, circulating tumor DNA, which is detectable in the plasma of many cancer patients, is not a reliable indicator of malignant brain tumors.

Oncologists may opt to hold off on targeted treatment strategies until they spot clear imaging evidence of tumor development. Furthermore, patients are prevented from receiving both radiation and chemotherapy prior to and during recovery from the removal of problematic lesions. Both situations represent a span of time in which the disease may progress undetected and tumors may grow unchecked.

The PNAS study looked at the potential to use tumor DNA in the cerebrospinal fluid to manage malignancies in the CNS. However, the researchers acknowledged that patients with malignant tumors in the brain and spinal cord face dismal outcomes. Specifically, CNS cancer leads to death in the majority of the 25,000 cases diagnosed annually in the United States. Thus, diagnosis and treatment fail for more than half of all patients with spinal and brain cancers nationwide.



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