Second cancer: CNS tumours

What is a brain tumor as a second form of cancer?

This page belongs to Second form of cancer. We recommend reading that information first.

The brain, together with the spinal cord, forms the central nervous system. This system controls almost all processes in the body, such as feeling, seeing, hearing, smelling, tasting, moving, and thinking.

Sometimes brain cells behave abnormally and form a tumor. This is called a brain tumor. This can be a benign or malignant tumor. Even a benign tumor can cause problems.

The most common are:

• Meningioma: the tumor develops in the meninges. Meningiomas are usually benign.

• Glioma: the tumor develops from support cells (glial cells). A glioma is almost always malignant.

The chance of developing a brain tumor after childhood cancer is very small.

Do I have an increased risk of a brain tumor?

Everyone, including people who have not had cancer, can develop a brain tumor. However, some cancer treatments can increase the risk.

The following treatments can increase the risk of a brain tumor:

• Radiation to the head, brain, or spinal cord, or to an area where these are located

You can see in your treatment summary whether you have received this treatment. If you do not have a summary, you can contact the LATER clinic or the hospital where you were treated. A brain tumor does not always have to be caused by treatment. There may also be other causes.

What are the symptoms and signs of a brain tumor?

Certain symptoms and signs may indicate a brain tumor. Even if you do not have these symptoms now, it is important to recognize them in case you ever develop them.

The following symptoms and signs may indicate a brain tumor:

• Persistent headache

• Vomiting without nausea, especially in the morning

• Epileptic seizure

• Paralysis on one side of the body

• Difficulty speaking and/or seeing

• Difficulty walking and/or with balance

The following symptoms and signs may indicate a spinal cord tumor:

• Back pain that radiates to other parts of the body

• Loss of strength in arms and legs

• Back pain that worsens at night

• Inability to urinate or constipation

• Loss of urine or stool (incontinence)

Often these symptoms have a different cause. However, rapid diagnosis and treatment of a brain tumor are very important. Therefore, contact your general practitioner immediately if you recognize any of these symptoms.

I have an increased risk of a brain tumor. What tests are necessary and when?

If you have an increased risk of a brain tumor, the recommendation is to visit the LATER clinic at least once every 5 years. Your LATER physician:

• Asks about any symptoms or signs of a brain tumor

• Performs a neurological examination

• Discusses whether regular MRI scans are necessary

What happens if I (might) have a brain tumor?

If you (might) have a brain tumor, your general practitioner or LATER physician will refer you to an oncology team. This team consists of:

• Neurologist (physician specialized in brain and spinal cord)

• Neuro-oncologist (physician specialized in cancer in the central nervous system)

• Neurosurgeon (surgeon specialized in brain and spinal cord surgery)

• Radiation oncologist

The oncology team will conduct further tests and discuss treatment options with you if necessary.

What else can I do?

Living with an (increased risk of) brain tumor can be difficult. Talking with friends and family can help. Contact with people in a similar situation can also provide support, for example through a patient association such as VOX, part of the Dutch Childhood Cancer Association.

Above all, take good care of yourself. Although it is not certain that it reduces the risk of a brain tumor, a healthy lifestyle is important. Also take care of your mental wellbeing. Small changes can already have a positive impact on your physical and mental health.

It is important that you know you have an increased risk of a brain tumor and that you recognize the symptoms and signs. If you have questions or are concerned, contact your general practitioner or LATER physician.

Where can I find more information?

This LATER website also contains information about:

• Healthy lifestyle

• Mental health

• Second form of cancer

In the PanCare Plain Language Summaries you will find links to reliable information in English.

You can search for information about brain tumors online, but keep in mind that it is not always up-to-date and accurate.

Disclaimer

This information is based on the plain language summary of the guideline below, created by the PanCare Plain Information Group, and has been adapted to the Dutch LATER guideline where necessary. If you experience symptoms and signs, do not rely solely on this information, but consult your general practitioner, LATER physician, or specialist.

```