According to HEALTHKNOWING, the term ependymoma is a relatively rare tumor that develops in the central nervous system. The ependymoma is one of the solid tumors that occur due to cell degeneration in the brain or in the spinal cord.
What is an ependymoma?
Since there are different ependymomas (which are all malignant), some tumors can grow rather quickly, while others grow more slowly.
Due to the fact that there is only limited space in the skull for growing tissue, the ependymoma can have fatal consequences in the course of the disease, as vital regions of the brain are affected.
Just ten percent of all tumors that occur in the central nervous system are ependymomas, so that the type of tumor can be classified as relatively rare. Children and adolescents are primarily affected.
So far there are no exact causes or development mechanisms why an ependymoma forms. Sometimes, however, doctors have come to the conclusion that radiation treatments in childhood – for example for malignant eye tumors or leukemia – can certainly promote the development of an ependymoma.
Symptoms, ailments & signs
The symptoms and signs depend on the location and spread of the tumor. Doctors differentiate between general and local or non-specific and specific signs. General symptoms occur regardless of location and do not necessarily have to be related to the ependymoma.
Classic unspecific symptoms are back pain or headache, loss of appetite, weight loss, dizziness, tiredness, morning vomiting, concentration disorders as well as a change in personality and sometimes a delay in development.
Specific or local symptoms can sometimes be gait or balance disorders if the tumor is in the region of the cerebellum. On the other hand, if seizures occur repeatedly, the tumor may be in the spinal cord area. Any sleep, consciousness or vision disorders can also provide an indication of where or where the tumor is definitely not located.
If the doctor – based on the anamnesis and physical examinations – expresses the suspicion that it may be a tumor in the central nervous system, the patient is subsequently admitted to the hospital. Institutions are selected that have specialized primarily in childhood cancer; these include clinics for pediatric oncology or hematology.
It is important that only in the event of a mere suspicion that it is mainly specialists from a wide variety of disciplines that are consulted when it comes to the final diagnosis and localization of the tumor. In the case of an ependymoma, it is necessary to diagnose not only the diagnosis, but also the location and shape; those factors play an essential part in the treatment.
The specialists carry out physical as well as neurological examinations; Imaging methods (computed tomography and magnetic resonance tomography) are also used so that doctors can determine whether there is a tumor on the one hand and where it is on the other and whether metastases have already occurred that have spread to the spinal canal or the brain.
The imaging tests also help determine how large the tumor already is. However, so that the diagnosis can finally be confirmed, a tissue sample must be taken and subsequently examined in terms of tissue. The prognosis depends mainly on the stage at which the diagnosis was made.
If the ependymoma can be completely removed, the five-year survival rate is just under 70 percent and around 60 percent when it comes to the ten-year survival rate. However, if the tumor cannot be completely removed or if subsequent irradiation can help, the 10-year survival rate is around 35 percent.
The complications and the further course of ependymoma depend heavily on the spread of the tumor and the affected area. Most of the time, the symptoms that are common with cancer are common. The patient mainly suffers from loss of appetite, headaches and severe weight loss.
Often there is tiredness that cannot be compensated for by sleep. The patient is exhausted and complains of a general feeling of weakness. Vomiting and diarrhea can occur, and concentration also decreases. The affected person is severely restricted in his everyday life by the symptoms and can usually no longer carry out his normal activities.
If it spreads to a large extent, it can also lead to impaired vision or balance disorders. Since the cancer spreads mainly in the back area, there is more pain and seizures there. The treatment takes place surgically and is primarily aimed at removing the tumor.
The earlier treatment is started, the fewer complications there will be. In some cases, several surgical procedures are necessary to completely remove the tumor. After the operation there is chemotherapy. If the treatment is successful, there should be no further complications.
When should you go to the doctor?
If you experience recurrent seizures, dizziness, back pain, headache and other symptoms of ependymon, your doctor should be consulted. Gait and balance disorders as well as impaired consciousness, sleep or vision must also be clarified before further complications arise. If there are serious complaints, a visit to the hospital is indicated. In the event of severe convulsions or accidents as a result of an attack, it is best to call the emergency services directly.
An ependymon must be diagnosed and treated in any case, because if left untreated, the tumor causes increasingly severe symptoms and in the worst case can even lead to death. Therefore: Consult a doctor at the first sign. Once the tumor has been diagnosed, surgical treatment usually takes place immediately.
If the ependymon has already caused personality changes, therapeutic measures may also have to be taken. Close monitoring by a doctor is definitely required after treatment. In addition, regular check-ups are necessary in order to identify and treat any recurrences at an early stage.
Treatment & Therapy
Due to the fact that nurses and specialized doctors work in children’s oncology facilities, treatment should definitely take place in such a facility. This is the only way to be sure that the patient is not only given the best possible treatment, but that relatives are also carefully introduced to the subject. Furthermore, such facilities are also known for being able to take action against the ependymoma with the latest therapeutic and procedural methods.
The ependymoma is treated surgically in almost all cases; the doctor speaks of a tumor resection or removal of the tumor. Tumor resection has impressively shown in recent years that the course of the disease can be positively favored and the prognosis (with regard to the five- or ten-year survival rate) can be significantly improved.
However, if the ependymoma is only diagnosed at an advanced stage, so that only a partial resection is possible, not only the course of the disease deteriorates, but also the prognosis. The main problem is when the ependymoma is located in the 4th cerebral ventricle or grows into the cerebellopontine angle; in those cases only partial removal is possible.
If the doctor opted for a complete removal, this could mean that vital (and healthy) brain tissue would be injured. If a complete removal of the tumor is not achieved in the first operation, a second operation can be scheduled later so that a tumor resection can be achieved in the second attempt. Radiation therapy is carried out after the operation; chemotherapy may also be prescribed in some cases.
Outlook & forecast
An ependymoma can take very different courses depending on the cause and location of the tumor. If the tumor is localized in the superficial tissue, in most cases it can be completely removed. Further treatment measures are then not necessary. However, the patient must undergo extensive follow-up care so that any recurrences and other complications can be identified quickly.
If the tumor was completely removed, there is a 60 to 75 percent chance that the patient will survive more than ten years. The prerequisite for this is that the disease does not progress. If the ependymoma cannot be completely removed, for example because it is located under a vital organ, there is a 30 to 40 percent chance that the patient will survive longer than ten years.
The prospect of recovery can be improved through self-help measures and comprehensive follow-up care. Nevertheless, complications can always arise that worsen the prognosis. In principle, however, an ependymoma offers a good prognosis. If the tumor has not yet spread, the prospect is good that the patient can lead a long, symptom-free life.
So far, no preventive measures are known. Due to the fact that so far no definitive causes that could trigger an ependymoma have been found, no preventive accents are possible so that the ependymoma does not occur.
In the case of an ependymoma, the options for follow-up care are relatively limited in most cases. The patient is primarily dependent on direct and medical treatment by a specialist in order to prevent further complications and the further spread of the tumor. In general, follow-up care for an ependymoma is therefore aimed at regular control of the body for other tumors in order to detect and remove them at an early stage.
In some cases, however, this disease also limits the life expectancy of the person affected, although treatment is not always possible. In the case of ependymoma, the person affected also depends on the help and support of friends and their own family. This can also prevent psychological complaints.
In some cases, contact with other people with the ependymoma can also be useful. Since a complete treatment of the disease is not always possible, those affected are often dependent on the help of other people in their everyday lives. Above all, loving care has a positive effect on the further course of the disease. Early detection of the ependymoma is also in the foreground.
You can do that yourself
An ependymoma definitely requires specialist treatment. The measures parents of affected children can take themselves always depend on the individual circumstances of the tumor disease.
Basically, the child must be informed about the disease. Any questions are best answered in consultation with a doctor. Since those affected and their relatives usually feel great anxiety, therapeutic advice should also be sought. Visiting a self-help group enables the exchange with other affected persons and can thus give a better perspective on the disease and how to deal with it.
If chemotherapy or radiation therapy has to be carried out, an individual therapy should be worked out together with a nutritionist and the responsible doctor. An adapted diet, physical activity and other measures can support the treatment and improve well-being.
The most important thing to do after treatment is regular check-ups. An ependymon can form recurrences, which must be identified and treated promptly in order to rule out a negative course. If the tumor disease is already well advanced, further therapeutic measures are indicated. In the event of death, professionally guided grief coping is necessary.