The National Cancer Institute estimates that in 2010, doctors will diagnose 22,020 people in the United States with a brain tumor 1. These brain tumors can be benign or malignant. If a patient has a cancerous brain tumor, the cancer receives a grade ranging from I to IV based on its malignancy.
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The American Association of Neurological Surgeons explains that the World Health Organization developed a brain tumor grading system with four grades: grade I and grade II tumors are considered low grade tumors, while grade III and grade IV are considered high-grade tumors 2. Grade IV or stage 4 brain cancer is the most malignant form of brain cancer. The doctor assigns the grade to the cancer after looking at a sample of the tumor taken during a biopsy.
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A grade IV brain tumor has certain characteristics that distinguishes it from other brain cancer stages. For example, the American Association of Neurological Surgeons notes that grade IV brain tumors grow rapidly and spread to affect other tissue 2. A doctor can note the rapid growth by observing mitosis in the biopsy sample, in which the cells divide and replicate. John W. Henson, MD, of the Brain Tumor Center from Massachusetts General Hospital and Harvard Medical School, adds that grade IV brain tumors outgrow their blood supply, called necrosis. A doctor may also notice new blood vessels growing in the sample of tissue.
- A grade IV brain tumor has certain characteristics that distinguishes it from other brain cancer stages.
- A doctor can note the rapid growth by observing mitosis in the biopsy sample, in which the cells divide and replicate.
Several types of brain cancers are classified as grade IV. An example includes an ependymoblastoma, a type of cancer found in infants and young children. Ependymoblastomas usually occur in the ventricles of the brain, which are areas of the brain that contain cerebrospinal fluid. The National Cancer Institute points out that glioblastoma multiforme makes up 12 percent to 15 percent of brain cancers 1. Glioblastoma multiforme occurs in the cerebral hemisphere and arises from astrocytes, a type of glial cell in the brain 3. Pineoblastomas occur in the pineal gland, while medulloblastomas, a type of brain cancer found in children, form in the cerebellum.
- Several types of brain cancers are classified as grade IV.
- Ependymoblastomas usually occur in the ventricles of the brain, which are areas of the brain that contain cerebrospinal fluid.
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Henson explains that doctors treat grade IV brain tumors with chemotherapy, surgery and radiation. After diagnosis, the doctor will start the treatment soon, as a grade IV brain cancer grows quickly. The treatment may begin with surgery, in which the surgeon opens the skull and removes as much of the tumor as possible without damaging nearby brain tissue. Within two to four weeks of the surgery, grade IV brain cancer patients receive radiation or chemotherapy. Radiation therapy uses ionized radiation targeted at the tumor, while chemotherapy uses one or more drugs that destroy the cancerous cells. The doctor will use an MRI scan to monitor the tumor and the progression of the treatment.
- Henson explains that doctors treat grade IV brain tumors with chemotherapy, surgery and radiation.
- The treatment may begin with surgery, in which the surgeon opens the skull and removes as much of the tumor as possible without damaging nearby brain tissue.
The prognosis for a grade IV brain tumor depends on the tumor. For example, the National Cancer Institute notes that 88 percent of pineoblastoma patients survive one year, 78 percent of patients survive three years and 58 percent of patients survive five years 1. In comparison, patients with an ependymoblastoma die within six to 12 months of their diagnosis. The five-year survival rate for a medulloblastoma ranges between 50 percent and 70 percent, according to the National Cancer Institute 1. With a glioblastoma multiforme, the National Cancer Institute explains that the average time patients live with the cancer is less than a year 1.
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- National Cancer Institute: Brain Tumor Home Page
- American Association of Neurological Surgeons: Brain Tumors
- Brain Tumor Center: Glioblastoma Multiforme and Anaplastic Gliomas: A Patient Guide
- National Institute of Neurological Disorders and Stroke. Brain and Spinal Cord Tumors: Hope Through Research. Updated December 31, 2019.
- American Cancer Society. Tests for Brain and Spinal Cord Tumors in Adults. Updated November 6, 2017.
- American Cancer Society. Types of Brain and Spinal Cord Tumors in Adults. Updated January 21, 2016.
- American Cancer Society. What Are Pituitary Tumors? Updated November 2, 2017.
- Le Rhun E, Taillibert S, Chamberlain MC. Carcinomatous meningitis: Leptomeningeal metastases in solid tumors. Surg Neurol Int. 2013;4(Suppl 4):S265–S288. doi:10.4103/2152-7806.111304
- American Society of Clinical Oncology. Brain Tumor: Grades and Prognostic Factors. Updated March 2019.
- Patel K, Clifford DB. Bacterial brain abscess. Neurohospitalist. 2014;4(4):196–204. doi:10.1177/1941874414540684
Lia Stannard has been writing about women’s health since 2006. She has her Bachelor of Science in neuroscience and is pursuing a doctorate in clinical health psychology.