Brain, Spine and Nervous System Tumors

Leading-edge treatment for brain, spinal cord and nerve tumors in San Diego

A collage of neuro-oncologists represent brain, spine and nervous system tumor treatment at Scripps Cancer Center.

Tresa McGranahan, MD, PhD, Kenneth Shimizu, MD, Jeremy Ciporen, MD and Chien Chen, MD, Scripps Clinic and Scripps Cancer Center

Leading-edge treatment for brain, spinal cord and nerve tumors in San Diego

Widely recognized as leaders in research and promising new cancer treatments, Scripps Cancer Center specialists diagnose and treat brain and central nervous system (CNS) tumors with expertise, compassion and a multidisciplinary team approach to care. Our physicians use precision diagnostics to enable personalized therapies and the most sophisticated treatment methods including minimally invasive robotic surgery and the most accurate radiation therapy technologies.

Your multidisciplinary neuro-oncology team

Optimal care for patients with nervous system tumors requires the type of multidisciplinary care that is the foundation of Scripps Cancer Center. Our collaborative board of cancer specialists reviews every patient’s complex care plan to ensure they receive care that is precisely personalized to their needs, from diagnosis through treatment and into recovery and survivorship.


Depending on your needs, your care team may include neurosurgeons, neuro-oncologists and radiation oncologists. We work closely with other oncology specialties and prioritize excellent communication and availability for our patients and referring clinicians. We also offer a wide array of support services including our brain rehabilitation team, neuropsychologists, cancer genetics, social workers, cancer nutritionists, nurse navigators, pharmacists, palliative care specialists and many other team members highly experienced in the unique needs of nervous system tumor patients. 

Neuro-oncologists

Scripps neuro-oncology physicians are specially trained in nervous system tumors, including both primary tumors and those that have spread (metastasized) to the brain, spinal cord or nerves. Our neuro-oncologists oversee testing, treatment and monitor patients with nervous system tumors into survivorship. We also specialize in managing neurologic symptoms associated with cancer treatments and nervous system tumors.

Neurosurgical oncologists

Scripps neurosurgical oncologists perform surgery to remove tumors that affect the brain, skull base and central nervous system. Many Scripps surgeons are experts in minimally invasive surgical techniques, including laparoscopic and robotic-assisted surgery. Our neurosurgeons are also trained in detailed mapping of the brain to ensure a precise balance between removing the tumor and protecting healthy brain tissue.

CNS radiation oncologists 

CNS radiation oncologists are physicians who specialize in using radiation therapy to treat, prevent or delay the recurrence of central nervous system (CNS) tumors.

Learn more about your cancer care team and Scripps' multidisciplinary approach to treatment.

Types of brain, spine and nervous system tumors

Nervous system tumors are groups of abnormal cells that grow out of control in the brain, spinal cord, nerves or layers of membrane that cover and protect your brain and spinal cord (leptomeninges).


Tumors in the nervous system may be noncancerous (benign) or cancerous (malignant). Knowing precisely what type of tumor you have and where it is in your brain or body is essential to understanding your risk. Each patient with a nervous system tumor is unique and requires a personalized treatment plan with advanced diagnostics and treatments.


There are numerous types of brain and central nervous system tumors. Depending on their location, tumors may affect different functions of the brain, spinal cord or nerves. In certain parts of the brain, nervous system tumors may cause no symptoms if treated early.

Primary brain and spinal cord tumors 

Primary brain and spinal cord tumors start from the tissue of the brain or spinal cord. There are many types of primary brain and spinal cord tumors. The treatment for each of these varies based on the disease, location and symptoms.

Pituitary tumors

A group of tumors that begin in the pituitary, a pea-sized gland in the brain that secretes and regulates hormones controlling many important body functions. Most pituitary tumors, classified as pituitary neuroendocrine tumor (PitNET - previously known as pituitary adenomas), are benign and slow-growing. They can however press on critical brain structures and require treatment. Less than 1% of pituitary tumors are malignant and can spread to other parts of the body; these are called pituitary carcinomas.


Learn more about a patient's pituitary tumor treatment at Scripps.

Cranial and paraspinal nerve tumors 

Neurofibroma

A slow-growing tumor that can occur on any of the peripheral nerves outside of the brain and spinal cord that are ensheathed by Schwann cells, which normally wrap around motor and sensory nerves. Neurofibroma symptoms can vary greatly, depending on the size, location, and subtype of tumor. Many neurofibromas cause no symptoms. Others, even though these tumors are classified as benign, may cause pain, numbness, or other neurologic symptoms.


Optic gliomas

A group of gliomas that are usually slow-growing, benign tumors that affect one or both optic nerves that transmit visual information from the eye to the brain. Rarely, these can be faster-growing tumors that are considered malignant. 


Schwannoma

A benign, slow-growing tumor that can occur on any of the peripheral nerves outside of the brain and spinal cord that are ensheathed by Schwann cells, which normally wrap around motor and sensory nerves. This includes the cranial nerves, which transmit information between the brain and parts of the head and neck. Vestibular schwannomas (or acoustic neuromas) is a type of schwannomas on cranial nerve VIII (also called the vestibulocochlear nerve) which transmits sound and balance information from the inner ear to the brain.

Skull base tumors

Acoustic neuroma (or vestibular schwannoma)

A type of schwannomas on cranial nerve VIII (also called the vestibulocochlear nerve) which transmits sound and balance information from the inner ear to the brain. These may be associated with a genetic syndrome. 


Chondrosarcoma

A rare type of malignant bone tumor usually found along the bony structure behind the eyes or at the base of the skull.


Chordoma

A rare, malignant bone cancer that develops at the base of the skull or in the spine. Chordoma tumor cells begin in the notochord, a structure in the central nervous system of embryos. It usually disappears before birth, but sometimes notochord cells can remain; in patients with chordoma, these cells become abnormal and begin multiplying to form a tumor. Chordomas grow slowly but have a tendency to recur after treatment and can spread (or metastasize) through the bloodstream to other parts of the body. 


Craniopharyngioma

A benign tumor at the base of the brain that starts near the pituitary gland. Adamantinomatous craniopharyngioma mainly occurs in children, while papillary craniopharyngioma mainly occurs in adults. Both are benign tumors but, as they grow, they may put pressure on nearby brain regions and cause symptoms. Molecular evaluation of these tumors is critical for diagnosis and effectively developing multimodal treatments. 


Dermoid and epidermoid tumors (or cysts)

Slow-growing masses of oil and skin cells most commonly found in the head, neck and face. They are usually benign but if they press against a nerve, such as the optic nerve, they can cause symptoms. 


Germinoma

Rare tumors that start from germ cells. Normally, germ cells become eggs or sperm after migrating to the ovaries or testes during fetal development. Germinomas occur when these germ cells fail to migrate to the proper location and continue dividing in another part of the body. Germ cell tumors can be found in various parts of the body, but germinomas occur within the brain, primarily in children and adolescents but can be diagnosed in adults.

Metastatic nervous system tumors

Metastatic brain tumors and metastatic spinal cord tumors do not start in the brain or central nervous system but have spread to the area from other parts of the body (metastasized).

Brain metastasis 

Cancer spreading (metastasizing) from another part of the body is the most common cause of a brain tumor. Metastatic brain tumors do not start in the brain but have spread to the area from other parts of the body. Treatment options for brain metastasis are rapidly evolving and partnerships between medical oncologists, neuro-oncologists, radiation oncologist and neurosurgeons are critical for optimal management.

Spine metastasis

Cancer that spreads (metastasizes) from another part of the body to the spine is the most common cause of spine tumors in the bones surrounding the spinal cord. At times, cancer can spread to the spinal cord. Spinal cancers require multidisciplinary care from a team of oncologists to relieve symptoms and maintain quality of life.

Leptomeningeal metastasis 

Cancer from the body can spread to the covering of the brain or spinal cord, or to the cerebrospinal fluid (CSF) surrounding the brain and spinal cord. This is a serious complication of cancer and requires close multidisciplinary care with medical oncologists, neuro-oncologists and radiation oncologists. Treatment and monitoring of leptomeningeal metastasis is rapidly advancing and Scripps is at the forefront of cancer treatments to improve survival and quality of life of patients with leptomeningeal metastasis.

Diagnostic testing

Scripps Cancer Center physicians use various types of tests to detect and diagnose brain tumors or central nervous system tumors.

Advanced neuroimaging 

  • MRI brain 3T and 1.5T
  • MRI - perfusion
  • MRI - spectroscopy 
  • MRI - diffusion tensor imaging and tractography
  • MRI angiography 
  • CT 
  • CT angiography
  • Cerebral angiogram 
  • Nuclear imaging

Personalized tumor diagnostics 

Extended evaluation of tumor genetics may include next-generation sequencing and methylation array testing as well as histologic pathologic evaluation. This testing can enable us to identify specific, targetable treatments for tumors.

Advanced neurosurgical diagnostics 

  • Intraoperative tumor guided techniques (ex: 5-ALA, fluorescein, ICG) 
  • Advanced Neuromonitoring techniques for patient safety 
  • Awake and asleep monitoring 
  • Brainstem monitoring motor and sensory cranial nerves spinal cord mapping and monitoring 
  • Spinal cord functional mapping

Liquid biopsy

  • Cerebral spinal fluid (CSF) sampling with advanced testing including molecular markers

Neuropsychological testing

Detailed neurologic and cognitive testing to evaluate areas of the brain that may be impacted by tumors or treatments, this testing can also help guide neurosurgical and other treatment planning.

Our approach to treating brain and spinal cord tumors

When you’ve been diagnosed with a brain or central nervous system tumor, you want a team of expert specialists on your side. The multidisciplinary teams at Scripps Cancer Center use the latest evidence-based treatments and therapies, including minimally invasive surgery and targeted therapy.


Your Scripps care team includes professionals from every area of oncology, including expertly trained neurologists, surgeons, radiation oncologists, medical oncologists and nurses who specialize in this care. Our multidisciplinary team includes sub-specialty trained, nationally and internationally recognized experts who have been widely published. 


In addition, our oncology nurse navigators can help coordinate your care and ensure you have support and guidance throughout your treatment and recovery. Learn more about how Scripps puts you at the center of care.

Brain and spinal cord tumor treatment options at Scripps Cancer Center

Treatment for brain and spinal cord tumors depends on several factors, including where the tumor is located, whether it is cancerous or benign, how far it has advanced and the patient’s overall health. Treatment plans may include the following methods.

Neurosurgery

Scripps neurosurgeons may perform maximal safe tumor resections. That means our surgeons consider both the amount of tumor to be removed and neurologic functioning. Neurosurgery at Scripps involves a tailored approach to the patient and the type of tumor. Surgical planning may be in consultation with multiple specialists including neuropsychologists, neuro radiologists, intra neuro-operative monitoring, other surgeons, radiation oncologists, medical oncologists and neuro-oncologists. 


Some specialized neurosurgical techniques at Scripps include:


  • Minimally invasive brain surgery options
  • Keyhole approaches
  • Endoscopic skull base and pituitary surgery
  • Endoscopic intraventricular tumor surgery
  • Trans orbital surgical approach 


  • Intracranial tumor advanced neurosurgical approaches
  • Functional brain mapping
  • Skull base surgery
  • Awake craniotomy
  • Complex reconstructive surgery


  • Spine tumor (primary and metastatic) specialization
  • Spinal cord functional mapping for both intramedullary and extra medullary intradural spine tumors
  • Spinal bone tumor resection
  • Spine reconstruction 


  • Advanced safety monitoring
  • Advanced neuromonitoring techniques for patient safety
  • Awake and asleep monitoring 
  • Brainstem monitoring motor and sensory cranial nerves spinal cord mapping and monitoring
  • Spinal cord functional mapping

Radiation therapy

Radiation therapy may be used alone or after surgery to treat many types of brain and spinal cord cancer. Scripps offers several types of highly targeted radiation treatments, including stereotactic radiosurgery, and stereotactic body radiation therapy (SBRT) for tumors such as acoustic neuroma tumors.

Chemotherapy

Chemotherapy for brain and central nervous system tumors is most often used with other treatments, such as surgery and radiation therapy. Several chemotherapy drugs are FDA-approved for use with brain tumors.

Targeted therapy

FDA-approved drugs, such as bevacizumab, vorasidenib, tovorafenib and beltizufan may be used in combination with chemotherapy or alone to treat patients with brain tumors. Scripps Cancer Center physicians provide the best possible course of treatment for patients who may benefit from targeted therapies for tumors in the brain or central nervous system.

Immunotherapy

Also called biologic therapy, immunotherapy is designed to use the body’s own immune system to fight cancer.

Brain rehabilitation services

Some cancer patients may be appropriate for Scripps’ brain injury day treatment program. The program provides comprehensive rehabilitation evaluations for patients who have had an acquired brain injury or illness. The evaluations can assist patients, their families and their medical team in determining the appropriate rehabilitation. Patients may work individually or in groups with a comprehensive team that includes physical therapists, occupational therapists, speech therapists, an audiologist and social services.

Brain and spinal cord tumor treatment locations

Scripps Cancer Center diagnoses and treats brain and central nervous system tumors at numerous locations throughout San Diego County. From Chula Vista and La Jolla to Encinitas and beyond, our extensive network of Southern California cancer care centers includes:


  • Four Scripps hospitals on five campuses
  • Outpatient clinics
  • Specialty cancer treatment centers


For details on specific centers and their services, visit cancer care locations.

Support groups, services and resources

As leaders in the treatment of cancerous and non-cancerous central nervous system tumors, we know what it takes to fight a winning battle. That’s why we equip our patients with the support and resources necessary to achieve their best possible outcome. From connecting you with support groups and services to empowering you with the latest resources and research, Scripps helps you along every step of the way.