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Brain Tumor
What is a Brain Tumor?
A brain tumor is a collection or massof abnormal cells in your brain. Your skull, which encloses your brain is very rigid. Any growth inside such a restricted space can cause problems. Brain tumors can be cancerous (malignant) or noncancerous (benign). When benign or malignant tumors grow, they can cause the pressure inside your skull to increase. This can cause brain damage, and it can be life-threatening.
Brain tumors are categorized as primary or secondary. A primary brain tumor originates in your brain. Many primary brain tumors are benign. A secondary brain tumor, also known as a metastatic brain tumor, occurs when cancer cells spread to your brain from another organ, such as your lung or breast.
Primary brain tumors
Primary brain tumors originate in your brain. Primary tumors can be benign or cancerous. In adults, the most common types of brain tumors are gliomas and meningiomas.
Gliomas
- Gliomas are tumors that develop from glial cells. Most common glial tumors areastrocytomas or oligodendroglialtumors
Other primary brain tumors
Other primary brain tumors include:
- pituitary tumors, which are usually benign
- pineal gland tumors, which can be benign or malignant
- ependymomas, which are usually benign
- craniopharyngiomas, which occur mostly in children and are benign but can have clinical symptoms like changes in vision and premature puberty
- primary central nervous system (CNS) lymphomas, which are malignant
- primary germ cell tumors of the brain, which can be benign or malignant
- meningiomas, which originate in the meninges
- schwannomas, which originate in cells that produce the protective cover of your nerves (myelin sheath) called Schwann cells
Most meningiomas and schwannomas occur in people between the ages of 40 and 70. Meningiomas are more common in women than men. Schwannomas occur equally in both men and women. These tumors are usually benign, but they can cause complications because of their size and location. Cancerous meningiomas and schwannomas are rare but can be very aggressive.
Secondary brain tumorsSecondary brain tumors make up the majority of brain cancers. They start in one part of the body and spread, or metastasize, to the brain. The following can metastasize to the brain:
- lung cancer
- breast cancer
- kidney cancer
- skin cancer
Secondary brain tumors are always malignant. Benign tumors don’t spread from one part of your body to another.
The incidence of central nervous system (CNS) tumors in India ranges from 5 to 10 per 100,000 population with an increasing trend and accounts for 2% of malignancies.
Risk factors for brain tumors include:
- Family history
- Age
- Race
- Chemical exposure
- Exposure to radiation
Symptoms of brain tumours depend on the location and size of the tumor. Some tumours cause direct damage by invading brain tissue and some tumours cause pressure on the surrounding brain. You’ll have noticeable symptoms when a growing tumor is putting pressure on your brain tissue.
Headaches are a common symptom of a brain tumor. You may experience headaches that:
- are worse in the morning when waking up
- occur while you’re sleeping
- are made worse by coughing, sneezing, or exercise
You may also experience:
- vomiting
- blurred vision or double vision
- confusion
- seizures (especially in adults)
- weakness of a limb or part of the face
- a change in mental functioning
Other common symptoms include:
- clumsiness
- memory loss
- confusion
- difficulty writing or reading
- changes in the ability to hear, taste, or smell
- decreased alertness, which may include drowsiness and loss of consciousness
- difficulty swallowing
- dizziness or vertigo
- eye problems, such as drooping eyelids and unequal pupils
- uncontrollable movements
- hand tremors
- loss of balance
- loss of bladder or bowel control
- numbness or tingling on one side of the body
- trouble speaking or understanding what others are saying
- changes in mood, personality, emotions, and behavior
- difficulty walking
- muscle weakness in the face, arm, or leg
Symptoms of pituitary tumors
The following symptoms can occur with pituitary tumors:
- nipple discharge, or galactorrhea
- lack of menstruation in women
- development of breast tissue in men, or gynecomastia
- enlargement of the hands and feet
- sensitivity to heat or cold
- increased amounts of body hair, or hirsutism
- low blood pressure
- obesity
- changes in vision, such as blurry vision or tunnel vision
Diagnosis of a brain tumor begins with a physical exam and a look at your medical history.
The physical exam includes a very detailed neurological examination. Your doctor will conduct a test to see if your cranial nerves are intact. The doctor may also evaluate your muscle strength, coordination, memory or ability to do mathematical calculations. Additionally following investigations are advised according to the location and symptoms of patient
- CT scan of the head
- MRI of the head
- Angiography
- Skull X-rays
- Biopsy
The treatment of a brain tumor depends on:
- the type of tumor
- the size of the tumor
- the location of the tumor
- your general health
SURGERY
The most common treatment for malignant brain tumors is surgery. The goal is to remove as much of the cancer as possible without causing damage to the healthy parts of the brain. While the location of some tumors allows for easy and safe removal, other tumors may be located in an area that limits how much of the tumor can be removed. Even partial removal of brain cancer can be beneficial.Metastatic brain tumors are treated according to guidelines for the type of original cancer.Surgery can be combined with other treatments, such as radiation therapy and chemotherapy. Additionally antiepileptics, steroids and Ventricular peritoneal shunt are also used as and when required. Physical therapy, occupational therapy, and speech therapy can help you to recover after neurosurgery.
RADIATION THERAPYRadiation therapy may be advised for tumors that are sensitive to this treatment. Conventional radiation therapy uses external beam of x-rays to kill cancer cells and shrink brain tumors. The therapy is usually given over a period of several weeks. Whole brain radiation therapy is an option in the case of multiple tumors or tumors that cannot be easily targeted with focal treatment.
Types of radiation therapy include:
Three-dimensional conformal radiation therapy (3D-CRT): a conventional form of radiation treatment delivery that uses a specific arrangement of x-ray beams designed to conform to the shape of the tumor to maximize tumor dose and minimize normal surrounding tissue dose. This form of treatment is tailored to the patient's specific anatomy and tumor location. CT and/or MRI scan is often required for treatment planning.
Intensity-modulated radiation therapy (IMRT): an advanced mode of high-precision radiotherapy that utilizes computer generated conformal plans to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. The radiation dose is designed to conform to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam to focus a higher radiation dose to the tumor while minimizing radiation exposure to healthy cells.
Stereotactic radiosurgery (SRS): a highly precise form of radiation therapy that directs narrow beams of radiation to the tumor from different angles. For this procedure, the patient may wear a rigid head frame. Computed tomography (CT) or magnetic resonance imaging (MRI) help the doctor identify the tumor's exact location and a computer helps the doctor regulate the dose of radiation. Stereotactic radiotherapy is similar physically to radiosurgery but involves fractionation (multiple treatments). This modality would be recommended for tumors within or close to critical structures in the brain that cannot tolerate a large single dose of radiation or for larger tumors.
CHEMOTHERAPY
Chemotherapy, or anticancer medications, may be recommended. Chemotherapy, along with radiation (concurrent therapy), has become the standard of care for primary malignant brain tumors. The use of these drugs or chemicals to slow down or kill rapidly dividing cells can be used before, during, or after surgery and/or radiotherapy to help destroy tumor cells and to prevent them from returning. Chemotherapy drugs may be taken by pill or by injection and are often used in combination with radiation therapy. Drugs called radiosensitizers, which are believed to make radiation therapy more effective, may also be prescribed.
The outlook for a brain tumor will depend on:
- the type of tumor
- the size of the tumor
- the location of the tumor
- your general health
Early treatment can prevent complications that can occur as a tumor grows and puts pressure on the skull and brain tissue.
There's no way to prevent brain cancer, but you can reduce your risk of getting it if you:
- Avoid exposure to pesticides and insecticides.
- Avoid exposure to carcinogenic chemicals.
- Avoid smoking.
- Avoid unnecessary exposure to radiation.
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Dr's Contact
- Sr. Consultant & Head, Department of Radiation Oncology,
Sterling Cancer Hospital, B/h, Sindhu Bhavan Marg, Off S G Highway, Bodakdev, Ahmedabad, Gujarat 380054 - +91 9825739897
- drpoojanandwani@gmail.com
