National Cancer Institute

What You Need 

To Know About TM

Brain

Tumors

U.S. DEPARTMENT OF 

HEALTH AND HUMAN SERVICES

National Institutes of Health
For more publications

This is only one of many free booklets for

people with cancer. 

Here’s how to get other National Cancer

Institute (NCI) booklets:

• Call the NCI Contact Center

at 1–800–4–CANCER (1–800–422–6237)

• Go to the NCI Web site at 

http://www.cancer.gov/publications

For materials in Spanish

Here’s how to get NCI materials in Spanish:

• Call the NCI Contact Center 

at 1–800–422–6237

• Go to the NCI Web site at 

http://www.cancer.gov/espanol
U.S. DEPARTMENT OF

HEALTH AND HUMAN SERVICES

National Institutes of Health

National Cancer Institute

Contents

About This Booklet 1

The Brain 2

Tumor Grades and Types 5

Risk Factors 8

Symptoms 9

Diagnosis 10

Treatment 13

Second Opinion 23

Nutrition 25

Supportive Care 25

Rehabilitation 26

Follow-up Care 27

Sources of Support 28

Taking Part in Cancer Research 30

Dictionary 31

National Cancer Institute Services 43

National Cancer Institute Publications 44
About This Booklet

This National Cancer Institute (NCI) booklet is

about tumors* that begin in the brain (primary brain

tumors). Each year in the United States, more than

35,000 people are told they have a tumor that started in

the brain.

This booklet tells about diagnosis, treatment, and

supportive care. Learning about medical care for brain

tumors can help you take an active part in making

choices about your care. 

1

*Words in italics are in the Dictionary on page 31. The Dictionary

explains these terms. It also shows how to pronounce them.

This booklet is only about primary brain

tumors. Cancer that spreads to the brain from

another part of the body is different from a

primary brain tumor. 

Lung cancer, breast cancer, kidney cancer,

melanoma, and other types of cancer commonly

spread to the brain. When this happens, the

tumors are called metastatic brain tumors. 

People with metastatic brain tumors have

different treatment options. Treatment depends

mainly on where the cancer started. Instead of

this booklet, you may want to read the NCI fact

sheet Metastatic Cancer. The NCI Contact Center

at 1–800–4–CANCER (1–800–422–6237) can

send you this fact sheet, as well as other

information about metastatic brain tumors.
This booklet has lists of questions that you may

want to ask your doctor. Many people find it helpful to

take a list of questions to a doctor visit. To help

remember what your doctor says, you can take notes or

ask whether you may use a tape recorder. You may also

want to have a family member or friend go with you

when you talk with the doctor—to take notes, ask

questions, or just listen. 

For the latest information about brain tumors,

please visit our Web site at http://www.cancer.gov/

cancertopics/types/brain. Also, the NCI Contact

Center can answer your questions about brain tumors.

We can also send you NCI booklets and fact sheets.

Call 1–800–4–CANCER (1–800–422–6237) or

instant message us through the LiveHelp service at

http://www.cancer.gov/help. 

The Brain

The brain is a soft, spongy mass of tissue. It is

protected by:

• The bones of the skull

• Three thin layers of tissue (meninges) 

• Watery fluid (cerebrospinal fluid) that flows

through spaces between the meninges and through

spaces (ventricles) within the brain 

2
The brain directs the things we choose to do (like

walking and talking) and the things our body does

without thinking (like breathing). The brain is also in

charge of our senses (sight, hearing, touch, taste, and

smell), memory, emotions, and personality.

A network of nerves carries messages back and forth

between the brain and the rest of the body. Some

nerves go directly from the brain to the eyes, ears, and

other parts of the head. Other nerves run through the

spinal cord to connect the brain with the other parts of

the body.

Within the brain and spinal cord, glial cells surround

nerve cells and hold them in place. 

3

Ventricles

(fluid filled)

Spinal cord

Brain

Meninges

Skull

Skull

Fluid between

the meninges

Brain

Fluid

This picture shows the brain and nearby structures.
The three major parts of the brain control different

activities:

• Cerebrum: The cerebrum uses information from our

senses to tell us what is going on around us and tells

our body how to respond. It controls reading,

thinking, learning, speech, and emotions.

The cerebrum is divided into the left and right

cerebral hemispheres. The right hemisphere controls

the muscles on the left side of the body. The left

hemisphere controls the muscles on the right side of

the body.

• Cerebellum: The cerebellum controls balance for

walking and standing, and other complex actions.

• Brain stem: The brain stem connects the brain with

the spinal cord. It controls breathing, body

temperature, blood pressure, and other basic body

functions.

4

Cerebrum

Cerebellum

Spinal cord

Brain stem

This picture shows the major parts of the brain.
Tumor Grades and Types

When most normal cells grow old or get damaged,

they die, and new cells take their place. Sometimes,

this process goes wrong. New cells form when the

body doesn’t need them, and old or damaged cells

don’t die as they should. The buildup of extra cells

often forms a mass of tissue called a growth or tumor. 

Primary brain tumors can be benign or malignant:

• Benign brain tumors do not contain cancer cells: 

—Usually, benign tumors can be removed, and they

seldom grow back. 

—Benign brain tumors usually have an obvious

border or edge. Cells from benign tumors rarely

invade tissues around them. They don’t spread to

other parts of the body. However, benign tumors

can press on sensitive areas of the brain and

cause serious health problems. 

—Unlike benign tumors in most other parts of the

body, benign brain tumors are sometimes life

threatening. 

—Benign brain tumors may become malignant.

• Malignant brain tumors (also called brain cancer)

contain cancer cells: 

—Malignant brain tumors are generally more

serious and often are a threat to life. 

—They are likely to grow rapidly and crowd or

invade the nearby healthy brain tissue. 

—Cancer cells may break away from malignant

brain tumors and spread to other parts of the

brain or to the spinal cord. They rarely spread to

other parts of the body. 

5
Tumor Grade

Doctors group brain tumors by grade. The grade of

a tumor refers to the way the cells look under a

microscope:

• Grade I: The tissue is benign. The cells look nearly

like normal brain cells, and they grow slowly.

• Grade II: The tissue is malignant. The cells look

less like normal cells than do the cells in a Grade I

tumor.

• Grade III: The malignant tissue has cells that look

very different from normal cells. The abnormal cells

are actively growing (anaplastic).

• Grade IV: The malignant tissue has cells that look

most abnormal and tend to grow quickly. 

Cells from low-grade tumors (grades I and II) look

more normal and generally grow more slowly than

cells from high-grade tumors (grades III and IV). 

Over time, a low-grade tumor may become a highgrade tumor. However, the change to a high-grade

tumor happens more often among adults than children.

You may want to read the NCI fact sheet Tumor

Grade.

Types of Primary Brain Tumors

There are many types of primary brain tumors.

Primary brain tumors are named according to the type

of cells or the part of the brain in which they begin.

For example, most primary brain tumors begin in glial

cells. This type of tumor is called a glioma. 

Among adults, the most common types are:

• Astrocytoma: The tumor arises from star-shaped

glial cells called astrocytes. It can be any grade. In

adults, an astrocytoma most often arises in the

cerebrum. 

6
—Grade I or II astrocytoma: It may be called a

low-grade glioma.

—Grade III astrocytoma: It’s sometimes called a

high-grade or an anaplastic astrocytoma. 

—Grade IV astrocytoma: It may be called a

glioblastoma or malignant astrocytic glioma.

• Meningioma: The tumor arises in the meninges. It

can be grade I, II, or III. It’s usually benign (grade I)

and grows slowly. 

• Oligodendroglioma: The tumor arises from cells

that make the fatty substance that covers and

protects nerves. It usually occurs in the cerebrum.

It’s most common in middle-aged adults. It can be

grade II or III.

Among children, the most common types are:

• Medulloblastoma: The tumor usually arises in the

cerebellum. It’s sometimes called a primitive

neuroectodermal tumor. It is grade IV.

• Grade I or II astrocytoma: In children, this lowgrade tumor occurs anywhere in the brain. The most

common astrocytoma among children is juvenile

pilocytic astrocytoma. It’s grade I.

• Ependymoma: The tumor arises from cells that line

the ventricles or the central canal of the spinal cord.

It’s most commonly found in children and young

adults. It can be grade I, II, or III.

• Brain stem glioma: The tumor occurs in the lowest

part of the brain. It can be a low-grade or high-grade

tumor. The most common type is diffuse intrinsic

pontine glioma.

You can find more information about types of brain

tumors at http://www.cancer.gov/cancertopics/

types/brain. Or, you can call the NCI Contact Center

at 1–800–4–CANCER (1–800–422–6237). 

7
Risk Factors

When you’re told that you have a brain tumor, it’s

natural to wonder what may have caused your disease.

But no one knows the exact causes of brain tumors.

Doctors seldom know why one person develops a brain

tumor and another doesn’t.

Researchers are studying whether people with

certain risk factors are more likely than others to

develop a brain tumor. A risk factor is something that

may increase the chance of getting a disease. 

Studies have found the following risk factors for

brain tumors:

• Ionizing radiation: Ionizing radiation from highdose x-rays (such as radiation therapy from a large

machine aimed at the head) and other sources can

cause cell damage that leads to a tumor. People

exposed to ionizing radiation may have an increased

risk of a brain tumor, such as meningioma or

glioma. 

• Family history: It is rare for brain tumors to run in

a family. Only a very small number of families have

several members with brain tumors. 

Researchers are studying whether using cell phones,

having had a head injury, or having been exposed to

certain chemicals at work or to magnetic fields are

important risk factors. Studies have not shown

consistent links between these possible risk factors and

brain tumors, but additional research is needed.

8
Symptoms

The symptoms of a brain tumor depend on tumor

size, type, and location. Symptoms may be caused

when a tumor presses on a nerve or harms a part of the

brain. Also, they may be caused when a tumor blocks

the fluid that flows through and around the brain, or

when the brain swells because of the buildup of fluid.

These are the most common symptoms of brain

tumors:

• Headaches (usually worse in the morning)

• Nausea and vomiting

• Changes in speech, vision, or hearing

• Problems balancing or walking

• Changes in mood, personality, or ability to

concentrate

• Problems with memory

• Muscle jerking or twitching (seizures or

convulsions)

• Numbness or tingling in the arms or legs

Most often, these symptoms are not due to a brain

tumor. Another health problem could cause them. If

you have any of these symptoms, you should tell your

doctor so that problems can be diagnosed and treated. 

9
Diagnosis

If you have symptoms that suggest a brain tumor,

your doctor will give you a physical exam and ask

about your personal and family health history. You may

have one or more of the following tests:

• Neurologic exam: Your doctor checks your vision,

hearing, alertness, muscle strength, coordination,

and reflexes. Your doctor also examines your eyes to

look for swelling caused by a tumor pressing on the

nerve that connects the eye and the brain.

• MRI: A large machine with a strong magnet linked

to a computer is used to make detailed pictures of

areas inside your head. Sometimes a special dye

(contrast material) is injected into a blood vessel in

your arm or hand to help show differences in the

tissues of the brain. The pictures can show abnormal

areas, such as a tumor.

• CT scan: An x-ray machine linked to a computer

takes a series of detailed pictures of your head. You

may receive contrast material by injection into a

blood vessel in your arm or hand. The contrast

material makes abnormal areas easier to see. 

Your doctor may ask for other tests:

• Angiogram: Dye injected into the bloodstream

makes blood vessels in the brain show up on an 

x-ray. If a tumor is present, the x-ray may show the

tumor or blood vessels that are feeding into the

tumor.

10
• Spinal tap: Your doctor may remove a sample of

cerebrospinal fluid (the fluid that fills the spaces in

and around the brain and spinal cord). This

procedure is performed with local anesthesia. The

doctor uses a long, thin needle to remove fluid from

the lower part of the spinal column. A spinal tap

takes about 30 minutes. You must lie flat for several

hours afterward to keep from getting a headache. A

laboratory checks the fluid for cancer cells or other

signs of problems.

• Biopsy: The removal of tissue to look for tumor

cells is called a biopsy. A pathologist looks at the

cells under a microscope to check for abnormal

cells. A biopsy can show cancer, tissue changes that

may lead to cancer, and other conditions. A biopsy is

the only sure way to diagnose a brain tumor, learn

what grade it is, and plan treatment. 

11
Surgeons can obtain tissue to look for tumor cells in

two ways:

—Biopsy at the same time as treatment: The

surgeon takes a tissue sample when you have

surgery to remove part or all of the tumor. See the

Surgery section on page 16.

—Stereotactic biopsy: You may get local or general

anesthesia and wear a rigid head frame for this

procedure. The surgeon makes a small incision in

the scalp and drills a small hole (a burr hole) into

the skull. CT or MRI is used to guide the needle

through the burr hole to the location of the tumor.

The surgeon withdraws a sample of tissue with

the needle. A needle biopsy may be used when a

tumor is deep inside the brain or in a part of the

brain that can’t be operated on. 

However, if the tumor is in the brain stem or certain

other areas, the surgeon may not be able to remove

tissue from the tumor without harming normal brain

tissue. In this case, the doctor uses MRI, CT, or

other imaging tests to learn as much as possible

about the brain tumor.

12
Treatment

People with brain tumors have several treatment

options. The options are surgery, radiation therapy,

and chemotherapy. Many people get a combination of

treatments.

The choice of treatment depends mainly on the

following:

• The type and grade of brain tumor 

• Its location in the brain

• Its size

• Your age and general health

For some types of brain cancer, the doctor also

needs to know whether cancer cells were found in the

cerebrospinal fluid.

13

A person who needs a biopsy may want to ask

the doctor the following questions:

• Why do I need a biopsy? How will the biopsy

results affect my treatment plan?

• What kind of biopsy will I have?

• How long will it take? Will I be awake? Will it

hurt?

• What are the chances of infection or bleeding

after the biopsy? Are there any other risks?

• How soon will I know the results? 

• If I do have a brain tumor, who will talk with

me about treatment? When?
Your doctor can describe your treatment choices, the

expected results, and the possible side effects. Because

cancer therapy often damages healthy cells and tissues,

side effects are common. Before treatment starts, ask

your health care team about possible side effects and

how treatment may change your normal activities. You

and your health care team can work together to

develop a treatment plan that meets your medical and

personal needs. 

You may want to talk with your doctor about taking

part in a clinical trial, a research study of new

treatment methods. See the Taking Part in Cancer

Research section on page 30.

Your doctor may refer you to a specialist, or you

may ask for a referral. Specialists who treat brain

tumors include neurologists, neurosurgeons, neurooncologists, medical oncologists, radiation oncologists,

and neuroradiologists. 

Your health care team may also include an oncology

nurse, a registered dietitian, a mental health counselor,

a social worker, a physical therapist, an occupational

therapist, a speech therapist, and a physical medicine

specialist. Also, children may need tutors to help with

schoolwork. (The Rehabilitation section on page 26

has more information about therapists and tutors.)

14
15

You may want to ask your doctor these

questions before you begin treatment:

• What type of brain tumor do I have?

• Is it benign or malignant?

• What is the grade of the tumor?

• What are my treatment choices? Which do you

recommend for me? Why?

• What are the expected benefits of each kind of

treatment?

• What can I do to prepare for treatment?

• Will I need to stay in the hospital? If so, for

how long?

• What are the risks and possible side effects of

each treatment? How can side effects be

managed?

• What is the treatment likely to cost? Will my

insurance cover it?

• How will treatment affect my normal

activities? What is the chance that I will have

to learn how to walk, speak, read, or write after

treatment? 

• Would a research study (clinical trial) be

appropriate for me? 

• Can you recommend other doctors who could

give me a second opinion about my treatment

options?

• How often should I have checkups?
Surgery

Surgery is the usual first treatment for most brain

tumors. Before surgery begins, you may be given

general anesthesia, and your scalp is shaved. You

probably won’t need your entire head shaved.

Surgery to open the skull is called a craniotomy.

The surgeon makes an incision in your scalp and uses a

special type of saw to remove a piece of bone from the

skull. 

You may be awake when the surgeon removes part

or all of the brain tumor. The surgeon removes as much

tumor as possible. You may be asked to move a leg,

count, say the alphabet, or tell a story. Your ability to

follow these commands helps the surgeon protect

important parts of the brain.

After the tumor is removed, the surgeon covers the

opening in the skull with the piece of bone or with a

piece of metal or fabric. The surgeon then closes the

incision in the scalp.

Sometimes surgery isn’t possible. If the tumor is in

the brain stem or certain other areas, the surgeon may

not be able to remove the tumor without harming

normal brain tissue. People who can’t have surgery

may receive radiation therapy or other treatment.

You may have a headache or be uncomfortable for

the first few days after surgery. However, medicine can

usually control pain. Before surgery, you should

discuss the plan for pain relief with your health care

team. After surgery, your team can adjust the plan if

you need more relief. 

16
You may also feel tired or weak. The time it takes to

heal after surgery is different for everyone. You will

probably spend a few days in the hospital.

Other, less common problems may occur after

surgery for a brain tumor. The brain may swell or fluid

may build up within the skull. The health care team

will monitor you for signs of swelling or fluid buildup.

You may receive steroids to help relieve swelling. A

second surgery may be needed to drain the fluid. The

surgeon may place a long, thin tube (shunt) in a

ventricle of the brain. (For some people, the shunt is

placed before performing surgery on the brain tumor.)

The tube is threaded under the skin to another part 

of the body, usually the abdomen. Excess fluid is

carried from the brain and drained into the abdomen.

Sometimes the fluid is drained into the heart instead. 

Infection is another problem that may develop after

surgery. If this happens, the health care team will give

you an antibiotic.

Brain surgery may harm normal tissue. Brain

damage can be a serious problem. It can cause

problems with thinking, seeing, or speaking. It can also

cause personality changes or seizures. Most of these

problems lessen or disappear with time. But sometimes

damage to the brain is permanent. You may need

physical therapy, speech therapy, or occupational

therapy. See the Rehabilitation section on page 26.

17
Radiation Therapy

Radiation therapy kills brain tumor cells with highenergy x-rays, gamma rays, or protons. 

Radiation therapy usually follows surgery. The

radiation kills tumor cells that may remain in the area.

Sometimes, people who can’t have surgery have

radiation therapy instead.

Doctors use external and internal types of radiation

therapy to treat brain tumors:

• External radiation therapy: You’ll go to a hospital

or clinic for treatment. A large machine outside the

body aims beams of radiation at the head. Because

cancer cells may invade normal tissue around a

tumor, the radiation may be aimed at the tumor and

nearby brain tissue, or at the entire brain. Some

people need radiation aimed at the spinal cord also.

18

You may want to ask your doctor these

questions about surgery:

• Do you suggest surgery for me?

• How will I feel after the operation?

• What will you do for me if I have pain?

• How long will I be in the hospital?

• Will I have any long-term effects? Will my hair

grow back? Are there any side effects from

using metal or fabric to replace the bone in the

skull?

• When can I get back to my normal activities?

• What is my chance of a full recovery?
19

The treatment schedule depends on your age, and the

type and size of the tumor. Fractionated external

beam therapy is the most common method of

radiation therapy used for people with brain tumors.

Giving the total dose of radiation over several weeks

helps to protect healthy tissue in the area of the

tumor. Treatments are usually 5 days a week for

several weeks. A typical visit lasts less than an hour,

and each treatment takes only a few minutes. 

Some treatment centers are studying other ways of

delivering external beam radiation therapy:

—Intensity-modulated radiation therapy or 

3-dimensional conformal radiation therapy:

These types of treatment use computers to more

closely target the brain tumor to lessen the

damage to healthy tissue. 

—Proton beam radiation therapy: The source of

radiation is protons rather than x-rays. The doctor

aims the proton beam at the tumor. The dose of

radiation to normal tissue from a proton beam is

less than the dose from an x-ray beam.

—Stereotactic radiation therapy: Narrow beams of

x-rays or gamma rays are directed at the tumor

from different angles. For this procedure, you

wear a rigid head frame. The therapy may be

given during a single visit (stereotactic

radiosurgery) or over several visits. 

• Internal radiation therapy (implant radiation

therapy or brachytherapy): Internal radiation isn’t

commonly used for treating brain tumors and is

under study. The radiation comes from radioactive

material usually contained in very small implants

called seeds. The seeds are placed inside the brain

and give off radiation for months. They don’t need to

be removed once the radiation is gone. 
Some people have no or few side effects after

treatment. Rarely, people may have nausea for several

hours after external radiation therapy. The health care

team can suggest ways to help you cope with this

problem. Radiation therapy also may cause you to

become very tired with each radiation treatment.

Resting is important, but doctors usually advise people

to try to stay as active as they can. 

Also, external radiation therapy commonly causes

hair loss from the part of the head that was treated.

Hair usually grows back within a few months.

Radiation therapy also may make the skin on the scalp

and ears red, dry, and tender. The health care team can

suggest ways to relieve these problems.

Sometimes radiation therapy causes brain tissue to

swell. You may get a headache or feel pressure. The

health care team watches for signs of this problem.

They can provide medicine to reduce the discomfort.

Radiation sometimes kills healthy brain tissue.

Although rare, this side effect can cause headaches,

seizures, or even death. 

Radiation may harm the pituitary gland and other

areas of the brain. For children, this damage could

cause learning problems or slow down growth and

development. In addition, radiation increases the risk

of secondary tumors later in life. 

You may find it helpful to read the NCI booklet

Radiation Therapy and You. 

20
Chemotherapy

Chemotherapy, the use of drugs to kill cancer cells,

is sometimes used to treat brain tumors. Drugs may be

given in the following ways: 

• By mouth or vein (intravenous): Chemotherapy

may be given during and after radiation therapy. The

drugs enter the bloodstream and travel throughout

the body. They may be given in an outpatient part of

the hospital, at the doctor’s office, or at home.

Rarely, you may need to stay in the hospital. 

The side effects of chemotherapy depend mainly on

which drugs are given and how much. Common

side effects include nausea and vomiting, loss of

appetite, headache, fever and chills, and weakness.

If the drugs lower the levels of healthy blood cells,

you’re more likely to get infections, bruise or bleed

easily, and feel very weak and tired. Your health

care team will check for low levels of blood cells.

Some side effects may be relieved with medicine.

21

You may want to ask your doctor these

questions about radiation therapy:

• Why do I need this treatment?

• When will the treatments begin? When will

they end?

• How will I feel during therapy? Are there side

effects?

• What can I do to take care of myself during

therapy?

• How will we know if the radiation is working?

• Will I be able to continue my normal activities

during treatment?
• In wafers that are put into the brain: For some

adults with high-grade glioma, the surgeon implants

several wafers into the brain. Each wafer is about

the size of a dime. Over several weeks, the wafers

dissolve, releasing the drug into the brain. The drug

kills cancer cells. It may help prevent the tumor

from returning in the brain after surgery to remove

the tumor. 

People who receive an implant (a wafer) that

contains a drug are monitored by the health care

team for signs of infection after surgery. An

infection can be treated with an antibiotic.

You may wish to read the NCI booklet

Chemotherapy and You. 

22

You may want to ask your doctor these

questions about chemotherapy:

• Why do I need this treatment?

• What will it do?

• Will I have side effects? What can I do about

them?

• When will treatment start? When will it end?

• How will treatment affect my normal

activities?
Second Opinion

Before starting treatment, you might want a second

opinion about your diagnosis and treatment plan. Some

people worry that the doctor will be offended if they

ask for a second opinion. Usually the opposite is true.

Most doctors welcome a second opinion. And many

health insurance companies will pay for a second

opinion if you or your doctor requests it. Some

companies require a second opinion.

If you get a second opinion, the doctor may agree

with your first doctor’s diagnosis and treatment plan.

Or the second doctor may suggest another approach.

Either way, you’ll have more information and perhaps

a greater sense of control. You can feel more confident

about the decisions you make, knowing that you’ve

looked at your options. 

23
It may take some time and effort to gather your

medical records and see another doctor. In many cases,

it’s not a problem to take several weeks to get a second

opinion. The delay in starting treatment usually won’t

make treatment less effective. To make sure, you

should discuss this delay with your doctor. Some

people with a brain tumor need treatment right away.

There are many ways to find a doctor for a second

opinion. You can ask your doctor, a local or state

medical society, a nearby hospital, or a medical school

for names of specialists. 

Also, you can request a consultation with specialists

at the National Institutes of Health Clinical Center in

Bethesda, Maryland.

• Adults and children with a brain tumor:

Specialists in the NCI Neuro-Oncology Branch

provide consultations. The telephone number is

301–594–6767 or 866–251–9686.

• Children with a brain tumor: Specialists in the

NCI Pediatric Neuro-Oncology Section of the

Pediatric Oncology Branch provide consultations.

The telephone number is 301–496–8009 or

877–624–4878.

The NCI Contact Center at 1–800–4–CANCER

(1–800–422–6237) can tell you about nearby

treatment centers. Other sources can be found in NCI’s

fact sheet How To Find a Doctor or Treatment Facility

If You Have Cancer.

Nonprofit groups with an interest in brain tumors

may be of help. Many such groups are listed in the

NCI fact sheet National Organizations That Offer

Services to People With Cancer and Their Families.

24
Nutrition

It’s important for you to take care of yourself by

eating well. You need the right amount of calories to

maintain a good weight. You also need enough protein

to keep up your strength. Eating well may help you

feel better and have more energy.

Sometimes, especially during or soon after

treatment, you may not feel like eating. You may be

uncomfortable or tired. You may find that foods don’t

taste as good as they used to. In addition, the side

effects of treatment (such as poor appetite, nausea,

vomiting, or mouth blisters) can make it hard to eat

well. Your doctor, a registered dietitian, or another

health care provider can suggest ways to deal with

these problems. Also, the NCI booklet Eating Hints has

many useful ideas and recipes. 

Supportive Care

A brain tumor and its treatment can lead to other

health problems. You may receive supportive care to

prevent or control these problems. 

You can have supportive care before, during, and

after cancer treatment. It can improve your comfort and

quality of life during treatment.

Your health care team can help you with the

following problems:

• Swelling of the brain: Many people with brain

tumors need steroids to help relieve swelling of the

brain. 

• Seizures: Brain tumors can cause seizures

(convulsions). Certain drugs can help prevent or

control seizures. 

25
• Fluid buildup in the skull: If fluid builds up in the

skull, the surgeon may place a shunt to drain the

fluid. Information about shunts is in the Surgery part

of the Treatment section (page 17).

• Sadness and other feelings: It’s normal to feel sad,

anxious, or confused after a diagnosis of a serious

illness. Some people find it helpful to talk about

their feelings. See the Sources of Support section on

page 28 for more information.

Many people with brain tumors receive supportive

care along with treatments intended to slow the

progress of the disease. Some decide not to have

antitumor treatment and receive only supportive care to

manage their symptoms. 

You can get information about supportive care at

http://www.cancer.gov/cancerinfo/coping on the NCI

Web site and from the NCI Contact Center at

1–800–4–CANCER (1–800–422–6237) or LiveHelp

(http://www.cancer.gov/help).

Rehabilitation

Rehabilitation can be a very important part of the

treatment plan. The goals of rehabilitation depend on

your needs and how the tumor has affected your ability

to carry out daily activities. 

Some people may never regain all the abilities they

had before the brain tumor and its treatment. But your

health care team makes every effort to help you return

to normal activities as soon as possible.

26
Several types of therapists can help: 

• Physical therapists: Brain tumors and their

treatment may cause paralysis. They may also cause

weakness and problems with balance. Physical

therapists help people regain strength and balance. 

• Speech therapists: Speech therapists help people

who have trouble speaking, expressing thoughts, or

swallowing.

• Occupational therapists: Occupational therapists

help people learn to manage activities of daily

living, such as eating, using the toilet, bathing, and

dressing.

• Physical medicine specialists: Medical doctors with

special training help people with brain tumors stay

as active as possible. They can help people recover

lost abilities and return to daily activities. 

Children with brain tumors may have special needs.

Sometimes children have tutors in the hospital or at

home. Children who have problems learning or

remembering what they learn may need tutors or

special classes when they return to school.

Follow-up Care

You’ll need regular checkups after treatment for a

brain tumor. For example, for certain types of brain

tumors, checkups may be every 3 months. Checkups

help ensure that any changes in your health are noted

and treated if needed. If you have any health problems

between checkups, you should contact your doctor. 

27
Your doctor will check for return of the tumor. Also,

checkups help detect health problems that can result

from cancer treatment. 

Checkups may include careful physical and

neurologic exams, as well as MRI or CT scans. If you

have a shunt, your doctor checks to see that it’s

working well. 

The NCI has publications to help answer questions

about follow-up care and other concerns. You may find

it helpful to read the NCI booklet Facing Forward:

Life After Cancer Treatment. You may also want to

read the NCI fact sheet Follow-up Care After Cancer

Treatment. 

Sources of Support 

Learning you have a brain tumor can change your

life and the lives of those close to you. These changes

can be hard to handle. It’s normal for you, your family,

and your friends to need help coping with the feelings

that such a diagnosis can bring. 

Concerns about treatments and managing side

effects, hospital stays, and medical bills are common.

You may also worry about caring for your family,

keeping your job, or continuing daily activities. 

Here’s where you can go for support:

• Doctors, nurses, and other members of your health

care team can answer questions about treatment,

working, or other activities. 

• Social workers, counselors, or members of the

clergy can be helpful if you want to talk about your

feelings or concerns. Often, social workers can

suggest resources for financial aid, transportation,

home care, or emotional support.

28
• Support groups also can help. In these groups,

people with brain tumors or their family members

meet with other patients or their families to share

what they have learned about coping with the

disease and the effects of treatment. Groups may

offer support in person, over the telephone, or on the

Internet. You may want to talk with a member of

your health care team about finding a support group. 

• Information specialists at 1–800–4–CANCER

(1–800–422–6237) and at LiveHelp

(http://www.cancer.gov/help) can help you locate

programs, services, and publications. They can send

you a list of organizations that offer services to

people with cancer. 

For tips on coping, you may want to read the NCI

booklet Taking Time: Support for People With Cancer.

29
Taking Part in Cancer Research

Cancer research has led to real progress in the

detection and treatment of brain tumors. Continuing

research offers hope that in the future even more

people with brain tumors will be treated successfully. 

Doctors all over the country are conducting many

types of clinical trials (research studies in which people

volunteer to take part). Clinical trials are designed to

find out whether new approaches are safe and

effective. 

Doctors are trying to find better ways to care for

adults and children with brain tumors. They are testing

new drugs and combining drugs with radiation therapy.

They are also studying how drugs may reduce the side

effects of treatment.

Even if the people in a trial do not benefit directly,

they may still make an important contribution by

helping doctors learn more about brain tumors and how

to control them. Although clinical trials may pose some

risks, doctors do all they can to protect their patients.

If you’re interested in being part of a clinical trial,

talk with your doctor. You may want to read the NCI

booklet Taking Part in Cancer Treatment Research

Studies. It describes how treatment studies are carried

out and explains their possible benefits and risks.

The NCI Web site includes a section on clinical

trials at http://www.cancer.gov/clinicaltrials. It has

general information about clinical trials as well as

detailed information about specific ongoing studies

of brain tumors. NCI’s Information Specialists at

1–800–4–CANCER (1–800–422–6237) and at

LiveHelp at http://www.cancer.gov/help can answer

questions and provide information about clinical trials.

30
Dictionary

Definitions of thousands of terms are on the NCI

Web site in the NCI Dictionary of Cancer Terms. You

can access it at http://www.cancer.gov/dictionary. 

3-Dimensional conformal radiation therapy (3-dihMEN-shuh-nul kun-FOR-mul RAY-dee-AY-shun

THAYR-uh-pee): A procedure that uses a computer to

create a 3-dimensional picture of the tumor. This

allows doctors to give the highest possible dose of

radiation to the tumor, while sparing the normal tissue

as much as possible.

Anaplastic (an-ah-PLAS-tik): A term used to describe

cancer cells that divide rapidly and have little or no

resemblance to normal cells. 

Angiogram (AN-jee-oh-gram): An x-ray of blood

vessels. The person receives an injection of dye to

outline the vessels on the x-ray.

Antibiotic (an-tih-by-AH-tik): A drug used to treat

infections caused by bacteria and other

microorganisms. 

Astrocyte (AS-troh-site): A large, star-shaped cell that

holds nerve cells in place and helps them work the way

they should. It is a type of glial cell.

Astrocytoma (AS-troh-sy-TOH-muh): A tumor that

begins in the brain or spinal cord in small, star-shaped

cells called astrocytes.

Benign (beh-NINE): Not cancerous. Benign tumors

may grow larger but do not spread to other parts of the

body. 

Biopsy (BY-op-see): The removal of cells or tissues for

examination by a pathologist. The pathologist may

study the tissue under a microscope or perform other

tests on the cells or tissue.

31
Brachytherapy (BRAY-kee-THAYR-uh-pee): A type

of radiation therapy in which radioactive material

sealed in needles, seeds, wires, or catheters is placed

directly into or near a tumor. Also called radiation

brachytherapy, internal radiation therapy, and implant

radiation therapy.

Brain stem: The part of the brain that is connected to

the spinal cord.

Brain stem glioma (glee-OH-muh): A tumor located

in the part of the brain that connects to the spinal cord

(the brain stem). It may grow rapidly or slowly,

depending on the grade of the tumor.

Burr hole: A small opening in the skull made with a

surgical drill. 

Cancer (KAN-ser): A term for diseases in which

abnormal cells divide without control. Cancer cells can

invade nearby tissues and can spread to other parts of

the body through the blood and lymph systems. 

Cell: The individual unit that makes up the tissues of

the body. All living things are made up of one or more

cells.

Cerebellum (ser-uh-BEL-um): The portion of the brain

in the back of the head between the cerebrum and the

brain stem. The cerebellum controls balance for

walking and standing, and other complex motor

functions.

Cerebral hemisphere (seh-REE-bral HEM-is-feer):

One half of the cerebrum, the part of the brain that

controls muscle functions and also controls speech,

thought, emotions, reading, writing, and learning. The

right hemisphere controls the muscles on the left side

of the body, and the left hemisphere controls the

muscles on the right side of the body. 

32
Cerebrospinal fluid (seh-REE-broh-SPY-nul): CSF.

The fluid that flows in and around the hollow spaces of

the brain and spinal cord, and between two of the

meninges (the thin layers of tissue that cover and

protect the brain and spinal cord). Cerebrospinal fluid

is made by tissue called the choroid plexus in the

ventricles (hollow spaces) in the brain. 

Cerebrum (seh-REE-brum): The largest part of the

brain. It is divided into two hemispheres, or halves,

called the cerebral hemispheres. Areas within the

cerebrum control muscle functions and also control

speech, thought, emotions, reading, writing, and

learning.

Chemotherapy (KEE-moh-THAYR-uh-pee):

Treatment with drugs that kill cancer cells.

Clinical trial: A type of research study that tests how

well new medical approaches work in people. These

studies test new methods of screening, prevention,

diagnosis, or treatment of a disease.

Contrast material: A dye or other substance that helps

to show abnormal areas inside the body. It is given by

injection into a vein, by enema, or by mouth. Contrast

material may be used with x-rays, CT scans, MRI, or

other imaging tests. 

Craniotomy (KRAY-nee-AH-toh-mee): An operation

in which an opening is made in the skull.

CT scan: A series of detailed pictures of areas inside

the body taken from different angles. The pictures are

created by a computer linked to an x-ray machine. Also

called CAT scan, computed tomography scan,

computerized axial tomography scan, and

computerized tomography.

33
Diffuse intrinsic pontine glioma (dih-FYOOS inTRIN-sik PON-teen glee-OH-muh): A type of central

nervous system tumor that forms from glial

(supportive) tissue of the brain and spinal cord. Diffuse

intrinsic pontine glioma usually occurs in children. It

forms in the brain stem. 

Ependymoma (eh-PEN-dih-MOH-muh): A type of

brain tumor that begins in cells lining the spinal cord

central canal (fluid-filled space down the center) or the

ventricles (fluid-filled spaces of the brain).

Ependymomas may also form in the choroid plexus

(tissue in the ventricles that makes cerebrospinal fluid).

Also called ependymal tumor.

External radiation therapy (RAY-dee-AY-shun

THAYR-uh-pee): A type of radiation therapy that uses

a machine to aim high-energy rays at the cancer from

outside of the body. Also called external beam

radiation therapy.

Gamma ray: A type of high-energy radiation that is

different from an x-ray.

General anesthesia (A-nes-THEE-zhuh): Drugs that

cause loss of feeling or awareness and put the person

to sleep.

Glial cell (GLEE-ul): Any of the cells that hold nerve

cells in place and help them work the way they should.

The types of glial cells include oligodendrocytes,

astrocytes, microglia, and ependymal cells. Also called

neuroglia.

Glioblastoma (GLEE-oh-blas-TOH-muh): A fastgrowing type of central nervous system tumor that

forms from glial (supportive) tissue of the brain and

spinal cord and has cells that look very different from

normal cells. Glioblastoma usually occurs in adults and

34
affects the brain more often than the spinal cord. Also

called GBM, glioblastoma multiforme, and grade IV

astrocytoma. 

Glioma (glee-OH-muh): A cancer of the brain that

begins in glial cells (cells that surround and support

nerve cells).

Grade: The grade of a tumor depends on how

abnormal the cancer cells look under a microscope and

how quickly the tumor is likely to grow and spread.

Grading systems are different for each type of cancer.

Implant radiation therapy (RAY-dee-AY-shun

THAYR-uh-pee): A type of radiation therapy in which

radioactive material sealed in needles, seeds, wires, or

catheters is placed directly into or near a tumor. Also

called brachytherapy, radiation brachytherapy, and

internal radiation therapy.

Incision (in-SIH-zhun): A cut made in the body to

perform surgery.

Intensity-modulated radiation therapy (in-TEN-sihtee-MAH-juh-LAY-tid RAY-dee-AY-shun THAYR-uhpee): A type of 3-dimensional radiation therapy that

uses computer-generated images to show the size and

shape of the tumor. Thin beams of radiation of different

intensities are aimed at the tumor from many angles.

This type of radiation therapy reduces the damage to

healthy tissue near the tumor.

Internal radiation therapy (in-TER-nul RAY-dee-AYshun THAYR-uh-pee): A type of radiation therapy in

which radioactive material sealed in needles, seeds,

wires, or catheters is placed directly into or near a

tumor. Also called brachytherapy, radiation

brachytherapy, and implant radiation therapy. 

Intravenous (IN-truh-VEE-nus): IV. Into or within a

vein. Intravenous usually refers to a way of giving a

drug or other substance through a needle or tube

inserted into a vein.

35
Ionizing radiation (I-uh-NYZ-ing RAY-dee-AY-shun):

A type of radiation made (or given off ) by x-ray

procedures, radioactive substances, rays that enter the

Earth’s atmosphere from outer space, and other

sources. At high doses, ionizing radiation increases

chemical activity inside cells and can lead to health

risks, including cancer.

Juvenile pilocytic astrocytoma (JOO-veh-NILE PYloh-SIH-tik AS-troh-sy-TOH-muh): A slow-growing

type of central nervous system tumor that forms from

glial (supportive) tissue of the brain and spinal cord.

Juvenile pilocytic astrocytoma usually occurs in

children and young adults. It forms in the brain more

often than the spinal cord. 

Local anesthesia (A-nes-THEE-zhuh): Drugs that

cause a temporary loss of feeling in one part of the

body. The patient remains awake but cannot feel the

part of the body treated with the anesthetic.

Malignant (muh-LIG-nunt): Cancerous. Malignant

tumors can invade and destroy nearby tissue and

spread to other parts of the body.

Medical oncologist (MEH-dih-kul on-KAH-loh-jist):

A doctor who specializes in diagnosing and treating

cancer using chemotherapy, hormonal therapy, and

biological therapy. A medical oncologist often is the

main health care provider for someone who has cancer.

A medical oncologist also gives supportive care and

may coordinate treatment given by other specialists.

Medulloblastoma (MED-yoo-loh-blas-TOH-muh):

A malignant brain tumor that begins in the lower part

of the brain and that can spread to the spine or to other

parts of the body. Medulloblastomas are a type of

primitive neuroectodermal tumor (PNET).

Meninges (meh-NIN-jees): The three thin layers of

tissues that cover and protect the brain and spinal cord.

36
Meningioma (meh-NIN-jee-OH-muh): A type of slowgrowing tumor that forms in the meninges (thin layers

of tissue that cover and protect the brain and spinal

cord). Meningiomas usually occur in adults.

Mental health counselor: A specialist who can talk

with patients and their families about emotional and

personal matters, and can help them make decisions.

Metastatic (meh-tuh-STA-tik): Having to do with

metastasis, which is the spread of cancer from one part

of the body to another.

MRI: Magnetic resonance imaging (mag-NEH-tik

REH-zuh-nunts IH-muh-jing). A procedure in which

radio waves and a powerful magnet linked to a

computer are used to create detailed pictures of areas

inside the body. These pictures can show the difference

between normal and diseased tissue. MRI makes better

images of organs and soft tissue than other scanning

techniques, such as computed tomography (CT) or

x-ray. MRI is especially useful for imaging the brain,

the spine, the soft tissue of joints, and the inside of

bones. Also called NMRI and nuclear magnetic

resonance imaging.

Nerve cell: A type of cell that receives and sends

messages from the body to the brain and back to the

body. The messages are sent by a weak electrical

current. Also called neuron.

Neuro-oncologist (NOOR-oh-on-KAH-loh-jist): A

doctor who specializes in diagnosing and treating brain

tumors and other tumors of the nervous system. 

Neurologic (NOOR-oh-LAH-jik): Having to do with

nerves or the nervous system.

Neurologist (noo-RAH-loh-jist): A doctor who

specializes in the diagnosis and treatment of disorders

of the nervous system.

37
Neuroradiologist (NOOR-oh-RAY-dee-AH-loh-jist):

A doctor trained in radiology who specializes in

creating and interpreting pictures of the nervous

system. The pictures are produced using forms of

radiation, such as x-rays, sound waves, or other types

of energy.

Neurosurgeon (NOOR-oh-SER-jun): A doctor who

specializes in surgery on the brain, spine, and other

parts of the nervous system.

Occupational therapist: A health professional trained

to help people who are ill or disabled learn to manage

their daily activities. 

Oligodendroglioma (AH-lih-goh-DEN-droh-gleeOH-muh): A rare, slow-growing tumor that begins in

oligodendrocytes (cells that cover and protect nerve

cells in the brain and spinal cord). Also called

oligodendroglial tumor.

Oncology nurse (on-KAH-loh-jee): A nurse who

specializes in treating and caring for people who have

cancer.

Paralysis (puh-RAL-ih-siss): Loss of ability to move

all or part of the body.

Pathologist (puh-THAH-loh-jist): A doctor who

identifies diseases by studying cells and tissues under a

microscope.

Physical medicine specialist (FIH-zih-kul MEH-dihsin SPEH-shuh-list): A doctor who specializes in

physical medicine (the prevention and treatment of

disease or injury with physical methods, such as

exercise and machines). Also called physiatrist.

Physical therapist: A health professional who teaches

exercises and physical activities that help condition

muscles and restore strength and movement. 

38
Pituitary gland (pih-TOO-ih-TAYR-ee): The main

endocrine gland. It produces hormones that control

other glands and many body functions, especially

growth.

Primitive neuroectodermal tumor (PRI-muh-tiv

NOOR-oh-EK-toh-DER-mul TOO-mer): PNET. One

of a group of cancers that develop from the same type

of early cells, and share certain biochemical and

genetic features. Some primitive neuroectodermal

tumors develop in the brain and central nervous system

(CNS-PNET), and others develop in sites outside of

the brain such as the limbs, pelvis, and chest wall

(peripheral PNET).

Proton (PROH-ton): A small, positively charged

particle of matter found in the atoms of all elements.

Streams of protons generated by special equipment can

be used for radiation treatment.

Proton beam radiation therapy (PROH-ton beem

RAY-dee-AY-shun THAYR-uh-pee): A type of highenergy, external radiation therapy that uses streams of

protons (small, positively charged particles) that come

from a special machine. Proton beam radiation is

different from x-ray radiation.

Radiation oncologist (RAY-dee-AY-shun on-KAHloh-jist): A doctor who specializes in using radiation to

treat cancer.

Radiation therapy (RAY-dee-AY-shun THAYR-uhpee): The use of high-energy radiation from x-rays,

gamma rays, neutrons, protons, and other sources to

kill cancer cells and shrink tumors. Radiation may

come from a machine outside the body (external-beam

radiation therapy), or it may come from radioactive

material placed in the body near cancer cells (internal

radiation therapy). Systemic radiation therapy uses a

radioactive substance, such as a radiolabeled

39
monoclonal antibody, that travels in the blood to

tissues throughout the body. Also called irradiation and

radiotherapy.

Radioactive (RAY-dee-oh-AK-tiv): Giving off

radiation.

Registered dietitian (dy-eh-TIH-shun): A health

professional with special training in the use of diet and

nutrition to keep the body healthy. A registered

dietitian may help the medical team improve the

nutritional health of a patient.

Risk factor: Something that may increase the chance

of developing a disease. Some examples of risk factors

for cancer include age, a family history of certain

cancers, use of tobacco products, certain eating habits,

obesity, lack of exercise, exposure to radiation or other

cancer-causing agents, and certain genetic changes.

Seizure (SEE-zhur): Convulsion; a sudden, involuntary

movement of the muscles.

Shunt: In medicine, a passage that is made to allow

blood or other fluid to move from one part of the body

to another. For example, a surgeon may implant a tube

to drain cerebrospinal fluid from the brain to the

abdomen. A surgeon may also change normal blood

flow by making a passage that leads from one blood

vessel to another.

Side effect: A problem that occurs when treatment

affects healthy tissues or organs. Some common side

effects of cancer treatment are fatigue, pain, nausea,

vomiting, decreased blood cell counts, hair loss, and

mouth sores.

Social worker: A professional trained to talk with

people and their families about emotional or physical

needs, and to find them support services. 

40
Speech therapist: A specialist who evaluates and treats

people with communication and swallowing problems.

Also called a speech pathologist.

Spinal tap (SPY-nul): A procedure in which a thin

needle called a spinal needle is put into the lower part

of the spinal column to collect cerebrospinal fluid or to

give drugs. Also called lumbar puncture.

Stereotactic biopsy (STAYR-ee-oh-TAK-tik BY-opsee): A biopsy procedure that uses a computer and a

3-dimensional scanning device to find a tumor site and

guide the removal of tissue for examination under a

microscope.

Stereotactic radiation therapy (STAYR-ee-oh-TAKtik RAY-dee-AY-shun THAYR-uh-pee): A type of

external radiation therapy that uses special equipment

to position the patient and precisely deliver radiation to

a tumor. The total dose of radiation is divided into

several smaller doses given over several days.

Stereotactic radiation therapy is used to treat brain

tumors and other brain disorders. It is also being

studied in the treatment of other types of cancer, such

as lung cancer. Also called stereotactic external-beam

radiation therapy and stereotaxic radiation therapy.

Stereotactic radiosurgery (STAYR-ee-oh-TAK-tik

RAY-dee-oh-SER-juh-ree): A type of external radiation

therapy that uses special equipment to position the

patient and precisely give a single large dose of

radiation to a tumor. It is used to treat brain tumors and

other brain disorders that cannot be treated by regular

surgery. It is also being studied in the treatment of

other types of cancer. Also called radiation surgery,

radiosurgery, and stereotaxic radiosurgery.

Steroid drug (STAYR-oyd): A type of drug used to

relieve swelling and inflammation. Some steroid drugs

may also have antitumor effects.

41
Supportive care: Care given to improve the quality of

life of patients who have a serious or life-threatening

disease. The goal of supportive care is to prevent or

treat as early as possible the symptoms of a disease,

side effects caused by treatment of a disease, and

psychological, social, and spiritual problems related to

a disease or its treatment. Also called comfort care,

palliative care, and symptom management.

Surgeon: A doctor who removes or repairs a part of

the body by operating on the patient.

Surgery (SER-juh-ree): A procedure to remove or

repair a part of the body or to find out whether disease

is present. An operation. 

Tissue (TISH-oo): A group or layer of cells that work

together to perform a specific function.

Tumor (TOO-mer): An abnormal mass of tissue that

results when cells divide more than they should or do

not die when they should. Tumors may be benign (not

cancerous), or malignant (cancerous). Also called

neoplasm.

Ventricle (VEN-trih-kul): A fluid-filled cavity in the

heart or brain.

X-ray: A type of high-energy radiation. In low doses,

x-rays are used to diagnose diseases by making

pictures of the inside of the body. In high doses, x-rays

are used to treat cancer.

42
National Cancer Institute Services

You may want more information for yourself, your

family, and your doctor. The NCI offers comprehensive

research-based information for patients and their

families, health professionals, cancer researchers,

advocates, and the public.

• Call the NCI Contact Center at

1–800–4–CANCER (1–800–422–6237)

• Visit us at http://www.cancer.gov or

http://www.cancer.gov/espanol

• Chat using LiveHelp, NCI's instant messaging

service, at http://www.cancer.gov/livehelp

• E-mail us at cancergovstaff@mail.nih.gov

• Order publications at http://www.cancer.gov/

publications or by calling 1–800–4–CANCER

• Get help with quitting smoking at

1–877–44U–QUIT (1–877–448–7848)

43
National Cancer Institute Publications

NCI provides publications about cancer, including

the booklets and fact sheets mentioned in this booklet.

Many are available in both English and Spanish. 

You may order these publications by telephone, on

the Internet, or by mail. You may also read them online

and print your own copy.

• By telephone: People in the United States and its

territories may order these and other NCI

publications by calling the NCI Contact Center at

1–800–4–CANCER (1–800–422–6237).

• On the Internet: Many NCI publications may be

viewed, downloaded, and ordered from

http://www.cancer.gov/publications on the

Internet. People in the United States and its

territories may use this Web site to order printed

copies. This Web site also explains how people

outside the United States can mail or fax their

requests for NCI booklets.

• By mail: NCI publications may be ordered by

writing to the address below: 

Publications Ordering Service

National Cancer Institute

P.O. Box 24128

Baltimore, MD 21227

Clinical Trials

• Taking Part in Cancer Treatment Research Studies

44
Finding a Doctor, Support Groups, or Other

Organizations

• How To Find a Doctor or Treatment Facility If You

Have Cancer (also in Spanish)

• Cancer Support Groups

• National Organizations That Offer Services to

People With Cancer and Their Families (also in

Spanish) 

Diagnosis

• Tumor Grade

Cancer Treatment and Supportive Care

• Radiation Therapy and You (also in Spanish)

• Understanding Radiation Therapy: What To Know

About External Beam Radiation Therapy (also in

Spanish)

• Understanding Radiation Therapy: What To Know

About Brachytherapy (A Type of Internal Radiation

Therapy) (also in Spanish)

• Chemotherapy and You (also in Spanish)

• Eating Hints for Cancer Patients (also in Spanish)

• Pain Control (also in Spanish)

Coping with Cancer

• Taking Time: Support for People with Cancer 

• Managing Radiation Therapy Side Effects: What To

Do When You Feel Weak or Tired (Fatigue) (also in

Spanish)

45
Life After Cancer Treatment

• Facing Forward: Life After Cancer Treatment (also

in Spanish)

• Follow-up Care After Cancer Treatment

• Facing Forward: Ways You Can Make a Difference

in Cancer

Advanced or Recurrent Cancer

• Coping With Advanced Cancer

• When Cancer Returns

Complementary Medicine

• Thinking about Complementary & Alternative

Medicine: A guide for people with cancer

• Complementary and Alternative Medicine in Cancer

Treatment (also in Spanish)

Caregivers

• When Someone You Love Is Being Treated for

Cancer: Support for Caregivers

• When Someone You Love Has Advanced Cancer:

Support for Caregivers

• Facing Forward: When Someone You Love Has

Completed Cancer Treatment

• Caring for the Caregiver: Support for Cancer

Caregivers

Possible Risk Factors

• Cellular Telephone Use and Cancer Risk

• Magnetic Field Exposure and Cancer

• Secondhand Smoke

46
The National Cancer Institute 

The National Cancer Institute (NCI), part of the

National Institutes of Health, is the Federal

Government’s principal agency for cancer research

and training. NCI conducts and supports basic and

clinical research to find better ways to prevent,

diagnose, and treat cancer. The Institute also supports

education and training for cancer research and

treatment programs. In addition, NCI is responsible

for communicating its research findings to the

medical community and the public.

Copyright permission

You must have permission to use or reproduce the

artwork in this booklet for other purposes. The

artwork was created by private sector illustrators,

designers, and/or photographers, and they retain the

copyrights to artwork they develop under contract to

NCI. In many cases, artists will grant you permission,

but they may require a credit line and/or usage fees.

To inquire about permission to reproduce NCI

artwork, please write to: 

Office of Communications and Education

National Cancer Institute

6116 Executive Boulevard, Room 3066 

MSC 8323

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You do not need our permission to reproduce or

translate NCI written text. The written text of this

NCI booklet is in the public domain, and it is not

subject to copyright restrictions. However, we would

appreciate a credit line and a copy of your translation

of this NCI booklet.
NIH Publication No.09-1558

Revised February 2009

Printed May 2009