When a doctor tells you or your child that you have a cancer called "Ependymoma," it's normal to feel overwhelmed and anxious. As soon as you hear this word, questions come to mind. "What kind of disease is this? Why did it develop? What do I do now?" It's only natural that these kinds of things come to mind. So today, let's talk about this slowly, in a way that you can understand, and simply.
What is Ependymoma?
Simply put, an ependymoma is a cancerous tumor that can develop anywhere in your brain or spinal cord. They first develop in a special type of cell (ependymal cells) that lines the fluid-filled chambers (ventricles) inside your brain and the middle of your spinal cord.
The good news is that unlike other types of cancer, it doesn't usually spread to other parts of the body (like the liver or lungs). However, these tumors can spread to several places, including the brain and spinal cord. Especially in young children , this condition can cause a slight increase in the chance of recurrence after treatment.
Managing the stress and grief you feel when you learn about a disease like this is as important as the treatment. So talk to your family and friends about this. Their support will be a great strength to you at this time.
What are the symptoms of this?
Often, these tumors start out small and grow slowly over many years. So, there may be no symptoms at first. When symptoms do appear, they depend on where the tumor is located.
| Location of the tumor | Affecting symptoms |
|---|---|
| In the Brain |
|
| In the Spine |
If a baby has this condition, one of the first symptoms a mother may notice is that the baby's head is larger than normal .
What causes ependymoma?
Doctors don't know the exact cause of this, but if you have a genetic condition called neurofibromatosis type 2, you're at a slightly higher risk of developing these tumors.
This disease affects both men and women equally. Among adults, it is most common in people between the ages of 40 and 60. In children, 30% of reported cases of this disease are in children under the age of 3.
Are there types of this?
Yes, the doctor will tell you about the type of tumor. This is mainly classified according to "grades". Simply put, the higher the grade, the faster the tumor grows.
- Grade I: These are very slow-growing, low-risk types. They can develop near the ventricles of the brain or in the lower part of the spinal cord.
- Grade II: This is the most common type of ependymoma. It usually occurs in the brain.
- Grade III (Anaplastic Ependymoma): These are fast-growing, high-risk tumors. They most often develop in the brain or skull.
How to diagnose this disease exactly?
The doctor will do several tests to confirm whether you have Ependymoma.
| Test | What do you do with it? |
|---|---|
| Physical and neurological examination | The doctor will examine your body, ask about your health history, and test your brain and nervous system function (walking, balance). |
| MRI scan | This can take very clear pictures of the brain and spinal cord. Sometimes this is done by injecting a special liquid (dye). This makes the areas where the cancer cells are more clearly visible in the pictures. |
| Spinal Tap | You will be turned on your side and a small needle will be used to take a few drops of fluid from your spinal cord. This fluid will be tested to see if there are any cancer cells. |
| Biopsy | This is the only way to be 100% sure that a tumor is an Ependymoma. During surgery, a small piece of the tumor is taken and examined under a microscope. This is how the type and grade of the tumor are determined. |
What are the treatments?
When treating you, a team of doctors will make the best decisions. This may include an oncologist, a neurosurgeon, and a neurologist. Treatment decisions will take into account many factors, including your age, the location and type of tumor, and side effects.
- Observation: If the tumor is growing slowly and is asymptomatic, your doctor may not start treatment right away. Instead, they will monitor your condition and perform an MRI scan about once a year.
- Surgery: If the tumor is large or causing symptoms, surgery is the main treatment to remove as much of the tumor as possible. After surgery, an MRI is done to make sure the tumor is completely removed. Sometimes, another surgery may be needed to remove any remaining parts.
- Radiation or chemotherapy: These treatments are used to destroy any cancer cells that may remain after surgery. However, radiation therapy is a bit risky for children under 3 years of age because it can affect their growth and brain development. So, talk to your doctor about the best option for your little one.
- Targeted Drug Therapy: These are newer treatments. These drugs target cancer cells while minimizing damage to healthy cells.
What happens after treatment?
Some long-term side effects may occur after treatment. These include physical symptoms such as headaches and fatigue, as well as psychological problems such as depression. Children may experience learning disabilities or developmental delays.
However, the 5-year survival rate for those treated for Ependymoma is very high. This rate is slightly lower for children.
The important thing is that these tumors can grow back after treatment, especially in children. If they do, they often grow back in the same place they were before. Therefore, it is essential to see your doctor at the scheduled time and get tested to make sure the cancer has not returned.
Take-Home Message
- Ependymoma is a cancer that develops in the brain or spinal cord. It usually does not spread to other parts of the body.
- Symptoms depend on where the tumor is located. Symptoms may include headaches if it is in the brain, and back pain if it is in the spine.
- MRI and biopsy tests are essential to confirm the disease.
- The treatment method is decided by a team of doctors. Surgery is the main treatment. In addition, radiation and chemotherapy are also used.
- The emotional support of family and doctors is very important for you and your child during this journey.
- It is imperative to have follow-ups at the scheduled time, as this disease can recur.
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