Health.com
May 21, 2008

*This story was first published in May, 2008 after Senator Kennedy was diagnosed with a brain tumor. Senator Kennedy, age 77, died of malignant glioma on August 25, 2009.

This week Senator Edward M. Kennedy’s doctors announced he has a glioma, a type of brain tumor. Kennedy, 76, had a seizure on Saturday.

Glioma is a catchall term that includes many different types of tumor, including astrocytomas, oligodendrogliomas, and ependymomas, according to the American Cancer Society.

An estimated 21,810 people will be diagnosed with malignant tumors of the brain or spinal cord this year in the United States—1.3% of all cancers, responsible for 2.2% of cancer-related deaths. Gliomas make up about 40% of all brain tumors and can be benign or malignant. Kennedy's, located in the left parietal lobe, is malignant. Gliomas are most likely to occur in those aged 75 to 84.

For insight into prognosis—and the significance of seizures and headaches in the diagnosis of brain turmors—I talked with Roshini Raj, MD, a Health magazine contributor and an assistant professor of medicine at the New York University Medical Center.

What is the significance of the glioma, and the malignancy?
About half of primary brain tumors [tumors that don’t spread from somewhere else in the body] are gliomas, and they can be very serious. Sometimes it's a slow-growing or a low-grade tumor, but if it’s called malignant it means it’s an aggressive from of brain tumor.

Where is the parietal lobe?
It’s kind of in the top and middle. There’s the frontal lobe, which is in front where the hairline is, and there is the occipital lobe, which is in the back, where you’d put your hand on the back of your head. I would say this is in between.

How can this type of tumor affect bodily functions?
Tumors of this type can cause effects both by directly invading brain tissue and therefore destroying brain tissue, or by exerting pressure on parts of the brain. In his particular location, the parietal lobe, it could certainly affect memory, it can affect movement so it causes weakness on the right side, it can cause speech difficulties, and then, of course, seizures, which he has already had.

Is a seizure often the first sign of a brain tumor?
If someone who’s never had seizures before all of a sudden develops seizures—especially in this age group—you have to be worried about a brain tumor. However, I would say brain tumors are relatively rare compared to other types of cancer, such as colon cancer or prostate cancer.

What other symptoms are a sign of brain tumor?
We mentioned seizures, but another one is headaches. Not to make people panic—most headaches are just headaches; they are not anything like this—but if there is an unusual headache that’s in a new location, that’s very frequent, and that's accompanied by things like vomiting or nausea or blurry vision, that could be a sign of something more serious, like a brain tumor.

It’s always important to see a doctor about a complaint like that. Maybe [the Senator’s diagnosis] can be a wake-up call for some people.

How will this be treated?
It really depends on the size and the stage of the tumor. You have to really look closely at the biopsy. Sometimes these are treated with surgery, but more often they are treated with radiation and chemotherapy.

Why are these so difficult to treat?
We know these types of tumors tend to be more aggressive, meaning they spread more easily, they grow more rapidly, and they are not as responsive to treatments such as radiation or chemotherapy. Brain tumors in general can be difficult to treat. Ideally you’d like to remove a tumor surgically, but you have to be very careful when you’re dealing with the brain in terms of how much can you remove and still preserve the functioning of the brain.

In addition, they have the ability to project and spread to other areas of the brain microscopically.

It's been reported that Senator Kennedy could have stage 3 or 4 tumor. What does this mean?
Basically once its stage 4, that means that you’re not trying to cure the tumor, it's not going to be possible to do that. You’re just trying to contain it and prevent any further complication, possibly shrink it, but you're not going to be able to get rid of it.

What sort of prognosis is associated with this type of tumor?
With these kind of tumors, it’s not very good, especially stage 4. About 1 in 5 people with the most aggressive type of glioma, glioblastoma multiforme, survive for more than two years, according to the Cancer Research UK.

For more information about brain tumors, read 3 Headaches That Require Emergency Attention, check out our Health A-Z Library, or visit these specific sites: Massachusetts General Hospital; National Cancer Institute.

By Theresa Tamkins

(PHOTO: NANCY OSTERTAG/GETTY IMAGES)

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