Ependymomas are a special type of tumour that forms in the brain or spinal cord and stays within the central nervous system. They cannot spread outside of the CNS, nor can they spread to the CNS from another part of the body. However, they can spread within the brain and spinal cord because they travel with cerebrospinal fluid. Ependymomas are named for the ependymal cells that they typically form inside.
Ependymoma tumours can happen to anyone regardless of their age or physical condition. Medical experts are not sure what causes them to form, only that people with neurofibromatosis Type 2 are at higher risk than others. There are different types of ependymomas, but they all cause similar symptoms and require a similar treatment. Additionally, the signs and symptoms of ependymomas will vary from person to person depending on their age, the size of the tumour, and its location.
Regardless of what type of ependymoma you have, the process of diagnosing and treating it will be similar.
Currently, surgery is the most common and successful way to treat ependymomas, regardless of what type it is or where it is located. Surgery can be performed for several reasons. The first one is to shrink the tumour in the event that it is putting pressure on certain parts of the brain. Pressure and fluid buildup are the main reasons for many of the unwanted signs and symptoms of an ependymoma.
A biopsy or lumbar puncture is another surgical treatment used if it is confirmed that you have an ependymoma. A biopsy or lumbar puncture is where your surgeon retrieves a sample of the tumour to determine if it is cancerous or benign. From there, your doctor can come up with a more concrete treatment plan.
Finally, your doctor can perform surgery to extract the tumour. While the goal is always to remove the entire tumour, this is not always possible, depending on its location. In these cases, the surgeon will remove as much of the tumour as possible and use additional treatments to remove the rest of it.
Aside from surgery, chemotherapy is the most common treatment used in people with ependymomas. Chemotherapy consists of medications that attack healthy and cancerous cells in the brain or spinal cord and destroy them. While chemotherapy treatments are more targeted than they used to be and have come a long way, they still cause unwanted side effects, such as nausea, vomiting, diarrhoea, hair loss, and more.
Chemotherapy is often used before surgery to shrink the tumour or after it to remove any cancer that surgery missed. It is often accompanied by other treatments, such as radiation, immunotherapy, and targeted therapy.
Radiation therapy, which consists of high-powered beams of radiation energy, is often used alongside chemotherapy. It is often administered before surgery to shrink tumours or afterward, as an insurance policy to ensure that no cancer is left behind.
In addition to treatments used to fight cancer from the outside, your doctor may also use immunotherapy to fight it from the inside. Immunotherapy is where your doctor prescribes medications to strengthen your immune system and give it the ability to break down and destroy cancer cells.
Targeted therapy is one of the newer ways to treat ependymomas. Targeted therapy is similar to chemotherapy in that it uses medications to destroy cancer cells. However, it is much more targeted than traditional chemotherapy because it only targets unhealthy cancer cells and leaves healthy cells alone. Therefore, it has fewer unwanted side effects than chemo.
While ependymomas can be frightening and painful, they are very treatable since they do not spread outside of the brain and spinal cord. Whether your ependymoma is malignant or benign, it is important to have it diagnosed and monitored so that you know if treatment is necessary. If the tumour is cancerous or is putting unwanted pressure on the brain, it will need to be removed with surgery and other treatments.