Treatment Options For An Ependymoma

An ependymoma is a tumor that forms in the spinal cord or brain. The tumor begins in the ependymal cells of the nervous system. These cells line the passageways that allow cerebrospinal fluid to flow. Though an ependymoma can occur in patients of any age, most cases involve children. Patients might have seizures and headaches. The diagnosis of an ependymoma is done through a neurological exam, imaging tests, and a lumbar puncture. With a lumbar puncture, fluid is drawn from the spinal cord and tested for tumor cells. There are a few treatment options, with surgery generally being the first course of action. When tumors can't be removed completely, other treatment methods should also be used.

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Radiation Therapy

Radiation therapy is a process that uses high-energy beams, typically protons or x-rays, to kill a patient's cancer cells. A machine will direct beams to precise places throughout the brain. Radiation therapy might be recommended after a surgical operation to prevent tumors from recurring. It may also be recommended in cases where surgeons couldn't completely remove the tumor. Specialized techniques deliver radiation as accurately as possible to the cancer cells without harming the surrounding tissue. Radiation is a recommended treatment because it focuses only on the tumors, rather than flooding the entire body with radiation. When delivered in high doses, radiation slows the growth of cancer cells and kills them through damage to the DNA. The damaged cells then die because they can't reproduce, at which point the body naturally removes them. It takes several sessions before the cells become damaged enough to die.

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Stereotactic Radiosurgery

Stereotactic radiosurgery, despite the name, is a radiation treatment rather than a surgical operation. This treatment focuses multiple radiation beams on precise points throughout the nervous system. In most cases, normal radiation will be recommended first. However, stereotactic radiosurgery is an ideal option in cases where the tumor recurs following both radiation and surgery. The main difference between traditional radiation treatment and stereotactic radiosurgery is the time it takes to be effective. Rather than waiting weeks for results, stereotactic radiosurgery provides results in just a few treatments. Medical professionals will first ascertain the location of the tumor, then high-precision machines are used to damage the cancer cells with an accuracy of one to two millimeters. Image-guided therapy helps confirm the ependymoma's location before and during the treatment.

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Surgical Removal

Surgical removal is the first treatment option recommended for an ependymoma. A team of neurosurgeons will excise as much of the tumor as they can. The ultimate goal is complete removal of the tumor, but this isn't always possible. In some cases, the tumor is located near essential spinal or brain tissue, and removing it would risk damage to the nervous system. When surgeons are able to remove the entire tumor, a patient might not need follow-up treatment. If only part of the ependymoma is excised, the surgeon might recommend having another operation to attempt removing the rest. If the ependymoma cannot be removed or is aggressive enough that the chances of recurrence are high, alternative treatments are recommended.

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Chemotherapy

Though chemotherapy shows promise as a treatment for many cancers, it's not very effective at treating an ependymoma. This treatment is used on an experimental basis and hasn't shown many promising results. Because of this, it isn't a first-line treatment. It may be combined with radiosurgery in cases where both surgery and radiation have failed. There are also promising results when using chemotherapy in infants directly before radiotherapy. This helps decrease the disease, which makes effective radiotherapy sessions more likely. Chemotherapy might also be effective for children who have residual tumors after surgery, as long as it's paired with radiosurgery. Experts recommend managing chemotherapy protocols through a group trial.

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Medication For Symptom Management

While there isn't any medication that can treat an ependymoma itself, it is helpful to use medication for symptom management. Symptom management is also referred to as palliative or supportive care. In addition to medication, this kind of care may include emotional support, nutritional changes, and relaxation techniques. The most common symptoms include headaches, seizures, vomiting, weakness, confusion, blurry vision, and changes in bowel function. Doctors can prescribe medications to help with pain and nausea. There are also multiple anticonvulsant medications available to treat seizures. It's important to manage symptoms, as symptom management increases a patient's quality of life. Doctors should monitor the symptoms and progression of the patient to make sure they recommend the best therapies.

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