Symptoms, Diagnosis And Treatment Of Brain Cancer

November 4, 2020

What is brain cancer?
Brain cancer is the malignant growth of abnormal brain cells in the brain. The combination of abnormal cells is called a tumor. Some tumors are benign and some are malignant. There are several different types of tumors that occur in the brain and spinal cord. Different cells in the brain and spinal cord can cause a variety of tumors. Spinal cord tumors and brain tumors may grow quickly or slowly. Even benign tumors can cause symptoms. The brain is the central organ that governs the rest of the body’s organs and systems, so all brain tumors need to be taken seriously.

Dangers of brain tumors
The skull is a hard skeleton. Tumors in the brain are dangerous because they press against areas of the brain as they grow. The skull cannot expand to accommodate the tumor. When a tumor grows, it presses against the brain. Depending on which area of the brain is affected, this can lead to problems with thinking, behavior, vision, and sensation. Factors that determine how dangerous a brain tumor is include its location, whether it can be surgically removed, the rate of growth, and its ability to spread.

What is secondary brain cancer?
In the United States, about 200,000 to 300,000 people each year have tumors that start elsewhere in the body and then spread or metastasize to the brain. About 50 percent of cancers found in the brain begin in the lungs and later spread to other organs, including the brain. Other cancers that can spread to the brain include those of the colon, breast, kidneys and melanoma, a potentially deadly type of skin cancer. At least 80 percent of brain tumors occur in multiple growths in the brain. Another 10 to 20 percent of tumors that metastasize to the brain are solitary tumors.

Major primary brain tumors
Primary brain tumors begin in brain cells. Meningiomas are the most common primary brain tumors. More than 35% of primary brain tumors are meningiomas,? These tumors come from tissues that cover the brain and spinal cord. The next most common type of brain tumor is a glioma. Gliomas occur in the glial, supporting tissues of the brain. Nearly 25% of primary brain tumors are gliomas. Glioblastomas are the next most common type of primary brain tumor. They are a type of glioma and they account for nearly 15% of all primary brain tumors. They account for more than 55 percent of all gliomas. Senator John McCain has been diagnosed with a primary glioblastoma.

Other types of primary brain tumors
Meningiomas, gliomas, and glioblastomas are the main types of primary brain tumors, but there are others. They arise in different parts of the brain. Adenomas are tumors that arise in the pituitary gland. Chordomas are primary brain tumors that occur in the spine and skull. Sarcomas are primary brain tumors that occur in the dura mater, cartilage, or bones of the spine and skull. Medulloblastomas are primary brain tumors that arise from the cerebellum, the part of the brain located in the back of the skull.

What are the different grades of brain tumors?
Brain tumor grade describes the degree of invasion and likelihood of spread of the tumor. Brain tumors may be assigned a grade of 1 to 4. The lower the grade, the better the expected prognosis.Grade 1 brain tumors are considered low grade. They grow slowly, are the least malignant (non-cancerous) cells, and are unlikely to spread. Surgical removal of these tumors may be curative.Grade 2 tumors have slightly abnormal cells, but they do not contain dead or actively dividing cells.Grade 2 tumors are generally not cancerous.Grade 3 tumors are cancerous and contain actively dividing abnormal brain cells.Grade 4 tumors are high-grade tumors and are aggressive and cancerous.

Symptoms of brain tumors
Symptoms of brain tumors vary depending on the type of growth and where the patient is located in the brain. Symptoms may include abnormal behavior, confusion, sleep difficulties, seizures and balance problems. Patients with brain tumors may experience changes in vision, nausea, vomiting, hearing loss, seizures and memory problems. Some people may even experience seizures and loss of consciousness. Other symptoms may include muscle weakness, numbness, personality changes and paralysis. Some people with brain tumors develop headaches, often worse in the morning.

The main parts of the brain are the brain stem, cerebrum and cerebellum. If the tumor is in the meninges, there may be personality changes, seizures, weakness, and paralysis. Astrocytoma is a brain cancer that arises from glial cells in the meninges of the brain. Tumors in the cerebellum may cause motor difficulties. Children and young people tend to get low-grade astrocytomas, while high-grade astrocytomas are more likely to occur in adults. When growing in the brain stem, symptoms of a brain tumor may include double vision, weakness, and difficulty swallowing. If you experience symptoms that may indicate you have a brain tumor, such as numbness, loss of balance, confusion, and other troublesome symptoms, see your doctor immediately.

Radiation and tumors
There are several factors that are risk factors for developing primary brain tumors. One known risk factor for brain cancer is exposure to ionizing radiation. People who are treated with radiation for other diseases, such as leukemia, have an increased risk of developing a primary brain tumor. Ionizing radiation is a risk factor for cancer because it can cause a break in the genetic material (DNA), which can lead to mutations that can cause cells to change and grow out of control. Abnormal cells are a hallmark of malignant brain tumors.

Age is a risk factor
Anyone can develop a brain tumor at any age, but older people and children are most likely to develop brain tumors. Brain tumors are the leading cause of death in people ages 0 to 14. Tumors of the brain and central nervous system are the third most common cancer in people aged 15 to 39 years and the third leading cause of cancer death in this age group. The median age at diagnosis for patients with primary brain tumors is 59 years. Brain tumors in adults tend to be different from those occurring in children.

Risk factors for medical conditions
A small number of brain tumors (about 5%) occur as a result of hereditary conditions or certain medical conditions. These include von Hippel-Lindau disease, neurofibromatosis, tuberous sclerosis, Turcot syndrome, Li-Fraumeni syndrome, and nevoid basal cell carcinoma syndrome. Sometimes there are multiple people in a family with brain tumors due to genetic conditions that run in the family. Medical conditions that weaken the immune system, such as AIDS, can also increase the risk of developing a brain tumor.

Do cell phones cause brain cancer?
There are no conclusive studies showing a link between cell phones and brain tumors. Long-term studies have attempted to examine the issue more thoroughly. If you are concerned about the radiation your cell phone emits, keep it away from your head when you are talking on the phone. Don’t put your phone in your pocket. Use a hands-free device or earbuds to further reduce the radiation from your phone. Limit the amount of time you spend on phone calls and avoid using your phone for long periods of time on the Internet.

How is brain cancer diagnosed?
Routine screening tests for brain cancer are not performed. Brain cancer is usually diagnosed when a patient begins to have symptoms, and then the doctor will perform diagnostic tests such as a CT or MRI of the brain (see slides below). Once the brain cancer is diagnosed, the doctor can determine a treatment plan. This may include chemotherapy, radiation therapy, surgery, or a combination of methods. The most appropriate brain cancer treatment depends on the type, location, and size of the tumor, as well as the patient’s age and overall health.

What tests can detect brain cancer?
Imaging tests, such as magnetic resonance imaging (MRI), CT scans, positron emission tomography (PET) scans, and cerebral arteriograms, may be used to detect brain tumors and gather information about their size and location. Doctors may order neurological, vision and hearing tests. Doctors may want to take a biopsy of the tumor. Samples may be subjected to molecular testing. Lumbar puncture, spinal tap, neurocognitive evaluation, electroencephalogram (EEG), and spinal cord mapping may also be ordered. Doctors may examine the cerebrospinal fluid of a patient suspected of having brain cancer.

It may be appropriate to wait carefully.
If a patient has a slow-growing brain tumor that is not causing any problems, immediate treatment may not be necessary. In these cases, watchful waiting may be appropriate. This includes monitoring the tumor and following the patient’s symptoms through testing. If the tumor increases in size and/or begins to cause new symptoms, further treatment may be necessary.

Brain cancer surgery
Some tumors may be partially or completely removed through surgery. If the surgeon has access to the tumor, surgery is often the first step in treating the brain tumor. If the tumor is small, it may be completely removed (cut out). If the tumor is close to delicate brain tissue, it may not be possible to remove it completely. In these cases, part of the tumor may be removed to help relieve symptoms. Removing as much of the cancer as possible may help relieve symptoms. In some people, the anesthetic used during surgery can cause nausea and vomiting.

chemotherapy
One form of treatment for brain cancer is chemotherapy. These are powerful drugs that kill or destroy cancer cells. Chemotherapy may be given as a pill, an injection, or through an intravenous (IV) drip. Sometimes, patients receive a catheter or port, and IV drugs are usually given after surgery to remove the tumor. These drugs usually work by affecting the ability of cells to grow and divide. One or more chemotherapy drugs may be used at the same time. These drugs are administered in a series of cycles. Certain types of chemotherapy are given directly to the brain in the form of a microchip. These wafers are given slowly over a period of time to deliver a dose directly to the tumor. Nausea and vomiting are potential side effects of chemotherapy.

radiotherapy
In the treatment of brain cancer, radiation therapy may be used in combination with surgery and chemotherapy. x-rays are high-energy beams of light directed at the tumor. Newer forms of radiation therapy use a more highly concentrated beam of light. This allows the maximum dose of radiation to be directed to the tumor without affecting the surrounding healthy tissue. Generally, people receive radiation therapy over a series of periods of time after surgery, following a certain course of treatment. Sometimes an implant is placed in the brain for internal radiation therapy. This is known as brachytherapy. Radiation therapy to the brain may produce nausea and vomiting.

targeted therapy
Cancer cells behave differently than normal cells. Targeted therapy is a mode of treatment that uses the unique characteristics of cancer cells to attack them. Targeted therapies are drugs that inhibit the activities that cancer cells rely on to survive. Targeted therapy seeks to minimize side effects because it only targets cancer cells. One of these targeted therapies inhibits the development of new blood vessels that are needed for tumor growth.

What happens after treatment?
After you are treated for brain cancer or a brain tumor, your doctor may monitor your progress with regular checkups to make sure the cancer hasn’t come back. Surgery, chemotherapy, radiation therapy, and other treatments may impair the function of your brain. You may need speech therapy to improve your ability to speak and swallow. Physical therapy can help you develop strength and a full range of motion. Occupational therapy can help you if you have trouble doing daily activities and work tasks.

The National Cancer Institute conducts clinical trials for patients with brain tumors and other types of cancer. Clinical trials provide patients with the ability to receive new and experimental cancer treatments when other methods have not worked. If you think you or a loved one may benefit from a clinical trial, ask your doctor about it.