Ependymoma cancer is a rare tumor found within the brain and spinal cord.
Ependymomas can grow but are more common in children in all age groups. It’s unclear the exact cause of those tumors.
In this article we look at the types, symptoms, diagnosis and ependymoma cancer treatment.
Important facts
- Ependymoma is a glial tumor of the cells that line the spinal cord and ventricles of the brain.
- It is a rare cancer. It is also uncommon for the cancer to spread.
- Ependymoma cancer is more common in children than adults.
- Grading of the tumor is in 3 stages of severity.
- Treatment involves surgical removal of the tumor followed by radiotherapy to remove any remaining cancer cells.
What is ependymoma cancer?
An ependymoma is a glial tumor of ependymal cells that line spinal cord center and brain ventricles.
Physically fragile ependymomas have a gray or red color and can contain mineral calcifications or cysts within them. A tumor can occur anywhere in the central nervous system where ependymal cells are present.
Ependymoma cancer are rare. It occurs in both adults and children, and in fairly equal numbers of men and women. Ependymomas, however, are more common in children compared with adults.
Types
There are several different types of cancers of ependymoma, classified by grade, too. How closely the cancer cells mimic normal cells decides the three grades used by ependymoma cancers. The lower the degree, the more the normal cells resemble the cancer cells. Within the spinal column or brain the different types of ependymomas occur in different locations.
Grade I tumors: Those include subependymomas and myxopapillary ependymomas, usually develop gradually. At the lower end of the spinal column myxopapillary ependymomas begin to develop. Subependymomas turn up in the brain around a ventricle. Such ventricles contribute to the production of cerebrospinal fluid.
Grade II tumors – These are called anaplastic ependymomas, and usually develop faster than the other classes. Anaplastic ependymomas typically occur in the base of the skull, brain, and brain stem. They never occur in the spinal cord.
Often, tumor cells may spread through the cerebrospinal fluid. When this happens, tumors can occur in multiple areas of the brain and spine. However, this form of cancer is rare for spreading to other parts of the body.
In children versus adults
Ependymomas occur in all ages, but are more common in children compared to adults.
Ependymomas can differ depending upon the age of an person. The tumor is most commonly located within the brain in children. This form of cancer is more likely to be found in adults along the spine.
Children with ependymoma can become irritable and have difficulty sleeping, and a child’s head can develop irregularly.
Children can also grow more slowly than expected, either physically or mentally.
Age can also have an impact on treatment methods. Younger children may not be able to undergo other types of treatment for cancer.
Symptoms
Ependymoma symptoms can vary from one case to another. Together with the tumor, many people experience significant symptoms, but others have little to no visible symptoms.
Symptoms of ependymoma may include:
- neck pain
- headaches
- vision changes, such as blurred vision or vision loss
- jerky eye movements
- nausea and vomiting
- difficulty with balance or walking
- seizures and convulsions
- tingling, numbness, or weakness in the limbs
Persistent symptoms should be reported to a physician for screening and treatment as soon as possible.
Diagnosis
Doctors can identify and treat ependymoma using several tests. Depending on the case, physicians can also perform tests to see whether tumors have spread to other areas of the body, or metastasised.
The tests prescribed by doctors can differ depending on the type of tumor that is suspected, the health of the person and any signs they display.
Many forms of tumors require a biopsy. It includes taking a small tissue sample from the area of the tumor for examination. If a biopsy can not be done or is too risky, doctors will also recommend other tests to help make their diagnosis.
Any type of imaging will be used as part of the diagnostic process. These tests allow doctors to examine and measure the tumor, taking pictures of the inside of the body. Usually, this is done on a CT scan or MRI.
A CT scan gives a more complete picture of the body’s inside, by creating a series of X-ray images from different angles. An MRI generates a similar image, using magnetic fields rather than X-rays. Often to get a clearer image a special dye or other contrast medium is injected into the patient.
In cases of ependymoma a lumbar puncture, or spinal tap, may also be required. A doctor inserts a needle from the lower back to take a small sample of cerebral spinal fluid to inspect it for tumor cells.
Numerous cases of ependymomas require a neurological examination. Doctors will ask a series of questions and perform tests designed to examine the brain and the nerve function of a individual.
It can take time to diagnose ependymoma but every move is significant. A thorough diagnosis helps doctors find the best possible way to treat this cancer.
Treatment
In cases where the tumor is very small and causes no immediate danger, doctors can recommend that you wait and watch for progression. Otherwise, removing as much of the tumor as possible is usually the first step in active care.
In certain cases, the entire tumor may be removed, while others may be in more delicate areas that require removal of only a portion of it.
Doctors usually recommend radiation therapy after surgery to help get rid of any lingering tumor cells. Chemotherapy use can also help with other forms of ependymoma although its effectiveness can vary.
During treatment, people should be closely watched to detect any changes that might occur, so that care modifications can be made, if appropriate.
New clinical trials are underway to improve various methods of treatment for ependymomas, and doctors may recommend one of these if they think it may help. It is important to note that it is still up to the patient to decide to participate in clinical trials.
Doctors may prescribe medication or recommend other therapies to help relieve both tumor and cancer treatment symptoms, the latter of which may have adverse side effects.
Long-term effects
In certain cases, long-term or late side effects can arise from ependymoma or surgery. After surgery these side effects can grow months or years and can occur anywhere in the body.
Long-term physical consequences may include heart problems, respiratory disorders and secondary cancers. Some long-term symptoms may include memory or cognitive disorders, anxiety, depression or difficulty learning.
Doctors may want to regularly track a person to test for any lasting effects. Additional tests or examinations may be necessary to detect some problems.
Many people may require different types of rehabilitation, such as physical therapy, hearing aid, or cognitive therapy. Children can also experience developmental disorders and hormones irregularities.
An individual who has been treated for ependymoma cancer can find it beneficial to keep a personal health record to notice any new symptoms. This can then be reported to a doctor to help recommend any additional treatments.
The ependymoma outlook depends on a number of individual factors. The tumor type, grade, and location may influence how easily it is removed.
Individual perceptions often depend on the age and health of the person being treated, and whether any cancer cells remain after surgery. Often, recurring tumors may have a different outlook than tumors which do not return.
The average 5-year relative survival rate for cases of ependymoma is 83.4 percent, according to statistics given by the Central Brain Tumor Registry of the United States (CBTRUS).
