BRAIN TUMOR

​​BRAIN TUMOR FACTS


About 17,000 people are diagnosed with cancer that began in or next to the brain every year. These are called primary brain cancers. Another 100,000 people are diagnosed with cancer in the brain or spinal cord that spread (metastasized) from another place in the body. These are called secondary brain cancers.

Most types of brain tumors are slightly more common in men than women. Meningiomas are more common in women.

Growth Causes Problems

Some brain tumors grow slowly and may become quite large before causing symptoms. Others may grow quickly and cause a sudden onset of symptoms. While most types of brain cancer may spread within the brain, few spread beyond the brain. Because the skull is rigid, providing no room for the tumor to expand, brain tumors may press on parts of the brain that control movement, speech, sight or other vital functions.

Even when brain tumors are benign (not cancer), they can cause serious problems. Although non-cancerous brain tumors usually grow slower than cancerous brain tumors, they may damage and press against normal brain tissue or the spine as they grow.

Brain Has Crucial Roles

Emotions, thought, speech, vision, hearing, movement and many more important parts of everyday life begin in the brain. The brain sends messages throughout the body via the spinal cord and cranial nerves in the head. The network of the brain and spinal cord is called the central nervous system (CNS). Tumors can develop in the spinal cord and cranial nerves.

The hard, bony skull protects the brain, and the bones (vertebrae) of the spine protect the spinal cord. A liquid called cerebrospinal fluid surrounds both the brain and the spinal cord.

The brain has four main parts:

Cerebrum: The outer and largest part of the brain. The cerebrum has two halves that are called hemispheres. It is responsible for:

  • Emotions
  • Reasoning
  • Language
  • Movement of muscles
  • Senses of seeing, hearing, smelling, touch
  • Perception of pain



Basal ganglia: These are found deeper inside the brain. They play a part in muscle movement.

Cerebellum: This section is at the back of the brain. It helps control and coordinate movement, such as walking and swallowing.

Brain stem: The brain stem is at the base of the brain. Its nerve fibers carry messages between the cerebrum and the rest of the body. This small area is very important and even plays a part in breathing and heartbeat.

Brain Tumor Types

Brain tumors are classified by the types of cells within the tumor. Each type of brain tumor grows and is treated in a different way.


The main types of brain tumors are as follows. The type of cells where they begin are in parentheses.

  • Adenoma (pituitary gland)
  • Chordoma (skull and spine)
  • Craniopharyngioma (pituitary gland)
  • Dermoid cysts and epidermoid tumors
  • Germ cell tumors, including germinomas (near the pineal gland)
  • Gliomas: This is the main group of brain tumors, occurring in 65% of cases. It includes:
  •                Glioblastoma multiforme (glial cells and oligodendrocytes), the type of brain cancer found most often in adults
  •                Astrocytoma (glial cells of tissue that supports nerve cells)
  •                Oligodendroglioma (oligodendrocytes in the myelin sheath around nerve fibers in the brain)
  •                Ependymoma (the ventricles in tissue lining the spaces within the brain)
  • Hemangioblastoma (cells that develop into blood vessels)
  • Medulloblastoma (cerebellum)
  • Meningioma (meninges, the layers of tissue covering the brain)
  • Osteoma and osteosarcoma (bones of the skull)
  • Pinealoma (pineal gland)
  • Pituitary adenoma (pituitary gland)
  • Sarcoma (connective tissue)



Brain Metastases

Cancers that metastasize (spread) to the brain are called metastases. They may grow in one or several parts of the brain. Many types of cancer can spread to the brain. The main types are breast cancer, lung cancer, gastrointestinal cancers, malignant melanoma, leukemia and lymphoma.

Lymphomas of the brain often are found in people who have AIDS. For unknown reasons, they are increasingly being found in people with normal immune systems.


Brain Tumor Risk Factors

Anything that increases your chance of getting a brain tumor is a risk factor. While no definite risk factors have been found for brain tumors, some factors may put you at increased risk, including:

  • Radiation exposure
  • Family history of certain conditions including:
  •              Neurofibromatosis type 1 and type 2
  •              Tuberous sclerosis
  •              Von Hippel-Lindau disease
  •              Li-Fraumeni syndrome
  • Immune system disorders, including AIDS and lymphoma



Some types of  brain tumors may be passed down from one generation to the next. Genetic counseling may be right for you. 



BRAIN TUMOUR SYMPTOMS


​Brain tumor symptoms depend on the area of the brain affected. Brain tumors can:

  • Invade and destroy brain tissue
  • Put pressure on nearby tissue
  • Take up space and increase pressure within the skull (intracranial pressure)
  • Cause fluids to accumulate in the brain
  • Block normal circulation of cerebrospinal fluid through the spaces within the brain
  • Cause bleeding



Brain tumor symptoms vary from person to person. They may include:

  • Headaches, which are often the first symptom. A headache due to a brain tumor usually becomes more frequent as time      passes. It is often worse when you lie down or first awaken.
  • Seizures
  • Changes in mental function, mood or personality. You may become withdrawn, moody or inefficient at work. You may feel    drowsy, confused and unable to think. Depression and anxiety, especially if either develops suddenly, may be an early          symptom of a brain tumor. You may become uninhibited or behave in ways you never have before.
  • Changes in speech (trouble finding words, talking incoherently, inability to express or understand language)
  • Changes in the ability to hear, smell or see, including double or blurred vision
  • Loss of balance or coordination
  • Change in the ability to feel heat, cold, pressure, a light touch or sharp objects
  • Changes in pulse and breathing rates if brain tumor compresses the brain stem


These symptoms do not always mean you have a brain tumor. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.


BRAIN TUMOR DIAGNOSIS


​​If you have a brain tumor, it is important to get the most accurate diagnosis possible. This will help your doctor pinpoint the tumor to give you the most advanced treatment with the least impact on your body.

At NGHL, we have the most modern and accurate equipment available to home in on brain tumors and find out exactly how far they may have spread.

Our specialized staff truly sets us apart. The Brain and Spine Center has four renowned neuropathologists who focus only on diagnosing brain and spine tumors. They are an essential part of our team, and their expertise and experience can make a big difference in brain tumor treatment success.

Brain Tumor Diagnostic Tests

If you have symptoms that may signal a brain tumor, your doctor will examine you and ask you questions about your health, your lifestyle and your family history.

One or more of the following tests may be used to find out if you have a brain tumor and if it has spread. These tests also may be used to find out if treatment is working.

Biopsy: While imaging tests may show an area that may be a brain tumor, a biopsy is almost always needed to diagnose a brain tumor. A biopsy may be done by either of two methods.

Surgery: A biopsy may be done during surgery in which all or part of the brain tumor is removed. The operation also is called a craniotomy. If a tumor is difficult to reach, a CT (computed tomography) scan may be used for three-dimensional needle placement (stereotactic biopsy). This helps doctors precisely locate the tumor.

Sterotactic (needle) biopsy: This method may be used if the suspicious area is in a place that makes surgery too risky or difficult.

Imaging tests, which may include:

  • CT (computed tomography) scans
  • MRI (magnetic resonance imaging)
  • PET (positive emission tomography) scan


Lumbar puncture: A small amount of cerebrospinal fluid (clear liquid in and around the brain and spine) is removed with a needle and looked at with a microscope. This test may be done if:

  • Doctors suspect tumor has invaded the layers of tissue that cover the brain (meninges)
  • When the diagnosis or type of tumor is not clear​


BRAIN TUMOR STAGING

Staging is a way of determining how much disease is in the body and where it has spread. However, staging systems are not used for brain tumors.

While primary brain tumors (that start in or next to the brain) sometimes spread (metastasize) to other parts of the brain or the spine, they usually do not spread to other places in the body.


TREATEMENT


In brain tumor care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatment. This is called a multidisciplinary team. 

Descriptions of the most common treatment options for a brain tumor are listed below, including treatments that help manage symptoms. Treatment options and recommendations depend on several factors:

  • The size, type, and grade of the tumor
  • Whether the tumor is putting pressure on vital parts of the brain
  • If the tumor has spread to other parts of the CNS or body
  • Possible side effects
  • The patient’s preferences and overall health.


Some types of brain tumors grow rapidly; other tumors grow slowly. Considering all these factors, your doctor will talk with you about how soon treatment should start after diagnosis.

Treatment options include those described below, such as surgery, radiation therapy, and chemotherapy. Your care plan may also include treatment for symptoms and side effects, an important part of your medical care.

For a low-grade brain tumor, surgery may be the only treatment needed especially if all of the tumor can be removed. If there is visible tumor remaining after surgery, radiation and chemotherapy may be used. For higher-grade tumors, treatment usually begins with surgery, followed by radiation therapy and chemotherapy. Your exact treatment plan will be made by your health care team.

Successfully treating brain tumors can be challenging. The body’s blood-brain barrier normally protects the brain and spinal cord from harmful chemicals entering those structures through the bloodstream. However, this barrier also keeps out many types of chemotherapy. Surgery can be difficult if the tumor is near a delicate part of the brain or spinal cord. Even when the surgeon can completely remove the original tumor, there may be parts of the tumor remaining that are too small to be seen or removed during surgery. And, radiation therapy can damage healthy tissue.