Browser does not support script.
Skip to main content
Find out how we produce our information|
An ependymoma is a rare type of brain tumour.
This information describes ependymomas, their symptoms, tests and possible treatments. It should ideally be read with our general information about brain| and spinal cord tumours|.
We hope it answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having treatment.
The central nervous system (CNS) is made up of the brain and spinal cord. Cells in the CNS normally grow in an orderly and controlled way. If for some reason this process gets out of control, the cells continue to divide and form a lump called a tumour.
A tumour may be either benign or malignant. Benign tumours may continue to grow but the cells do not spread from the original site. In a malignant tumour, the cells can invade and destroy surrounding tissue and may spread to other parts of the brain.
Within the brain and spinal cord are nerve cells, and cells that support and protect the nerve cells. The supporting cells are called glial cells. A tumour of these cells is known as a glioma.
Ependymomas are a rare type of glioma. They develop from the ependymal cells, which line the ventricles (fluid-filled spaces in the brain), and from the central canal of the spinal cord. They can be found in any part of the brain or spine. In children, they are more commonly found in the cerebellum (see the diagram below).
Ependymomas may occasionally spread from the brain to the spinal cord in the cerebrospinal fluid (CSF). CSF is the fluid that surrounds and protects the brain and spinal cord.
About 9,000 people are diagnosed with tumours of the CNS each year in the UK. Around 1 in 20 (5%) of these are ependymomas. People of all ages can develop ependymomas, including children. Tumours at the base of the brain, in an area called the posterior fossa, and tumours found in the cerebellum (see diagram below) are more common in children. Ependymomas of the spine are more common in adults.
Diagram showing the lobes of the brain
View a large version of the diagram showing the lobes of the brain |
Your doctors need to find out as much as possible about the type, position and size of the tumour so they can plan your treatment.
You may have a number of tests and investigations. The doctor will examine you thoroughly and test your reflexes and the power and feeling in your arms and legs.
Your doctor will look into the back of your eyes using an ophthalmoscope to see if the nerve at the back of the eye is swollen. This can be caused by oedema (swelling of the tissues within the brain), which may occur due to an increase in the amount of fluid in the brain.
You will have a CT or MRI scan to find out the exact position and size of the tumour.
You may be given an injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. If you’re allergic to iodine or have asthma, you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.
Before the scan you may be asked to complete and sign a checklist. This is to make sure it’s safe for you to have an MRI scan. Before having the scan, you’ll be asked to remove any metal belongings, including jewellery. Some people are given an injection of a dye into a vein in the arm.
This is called a contrast medium and can help the images from the scan show up more clearly. During the test, you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones.
The treatment for an ependymoma depends on a number of things including your general health, the size and position of the tumour, and whether it has spread to other parts of the brain or spinal cord. The results of your tests will enable your doctor to decide on the best plan for you.
There are some risks associated with treatment to the brain and your doctor will discuss these with you. Your treatment will usually be planned by a team of specialists known as a multidisciplinary team (MDT|).
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. If you have been offered treatment that aims to cure your cancer, deciding whether to have the treatment may not be difficult. However, if a cure is not possible and the treatment is to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
If you feel that you can’t make a decision about the treatment| when it is first explained to you, you can always ask for more time to decide.
You are free to choose not to have the treatment and the staff can explain what may happen if you do not have it. Although you don’t have to give a reason for not wanting to have treatment, it can be helpful to let the staff know your concerns so that they can give you the best advice.
Surgery|, where possible, is the preferred first form of treatment for ependymoma. The aim of surgery is to remove as much of the tumour as possible without damaging the surrounding brain tissue. Depending on the size, position and spread of the tumour, it may not be possible to remove it completely and further treatment may be given as a follow-up to surgery.
Some tumours, particularly those that are high-grade, can’t be reached by surgery or the risk of damage to the surrounding brain cells may be too high. If surgery isn’t possible, your doctor will discuss other types of treatment with you.
Radiotherapy| treatment uses high-energy rays to destroy the cancer cells and is often used after surgery to destroy any remaining malignant cells. It is used alone to treat tumours that cannot be reached by surgery. Whenever possible, radiotherapy isn't given to children under the age of three in order to allow further development of the brain and spinal cord, and to reduce the risk of long-term side effects. Instead, a course of chemotherapy is given and, if necessary, radiotherapy when the child is older.
Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be given alone or together with surgery and/or radiotherapy to treat ependymoma.
If you experience seizures, you may be given a medicine called an anticonvulsant| to help prevent them.
You may find the idea of a tumour affecting your brain extremely frightening. You may experience many different emotions| including anxiety, anger and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition.
Many people find it helpful to talk things over with their doctor or nurse or with one of our cancer support specialists|. Family members and close friends can also offer support.
In some circumstances, you may not be allowed to drive for a period of time. If you have had an epileptic fit, the Drivers and Vehicle Licensing Association (DVLA|) will not allow you to drive for a year after your last fit. You can then drive again provided you remain well.
After treatment, you will not be able to drive for at least 1-2 years, depending on the grade of your tumour. However, this period will be extended if the tumour comes back.
You may not be allowed to drive some types of vehicle, such as an LGV (large goods vehicle) or a PCV (passenger carrying vehicle).
It is your responsibility to contact the DVLA and your doctor will advise you how to do this.
This information has been compiled using a number of reliable sources, including:
With thanks to: Dr Nick Plowman, Consultant Clinical Oncologist: and the people affected by cancer who reviewed this edition. Reviewing information is just one of the ways you could help when you join our Cancer Voices| network.
Content last reviewed: 1 January 2013
Next planned review: 2015
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
If you have any questions about Macmillan we would love to hear from you| .
You can also follow us| on Facebook, Twitter, Flickr or YouTube.
© Macmillan Cancer Support 2013
what are these?|