Brain Tumors

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A tumor in the brain isnā€™t like tumors in other parts of your body. It has limited room for growth because of the skull. This means that a growing tumor can squeeze vital parts of the brain and lead to serious health problems. Learning about the possible symptoms of brain tumors can help you know when to tell a doctor about them.

What are the early warning symptomsĀ and signs of a brain tumor?

Cancer that has spread to the brain from another part of the body is called a metastatic brain tumor. Metastatic brain tumors are much more common than primary tumors.Ā 

The symptoms of a brain tumor depend on tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or harms a part of the brain. Also, they may be caused when a tumor blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid.

The most common early warning symptoms and signs of brain tumors include:

  1. A new onset or change in pattern of headaches

  2. Headaches in the morning

  3. Headaches that gradually become more frequent and severe

  4. Nausea and vomiting for no reason

  5. Changes in speech, vision, or hearing

  6. Problems balancing or walking

  7. Changes in mood, personality, or ability to concentrate

  8. Problems with memory

  9. Muscle jerking or twitching (seizures or convulsions)

  10. Numbness or tingling in the arms or legs

  11. Gradual loss of sensation or movement in an arm or a leg

  12. Confusion in everyday matters

  13. Personality or behavior changes

What are theĀ typesĀ of benign and cancerous brain tumors?

When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor. There are two types of brain tumors, primary and cancerous.

  1. Primary brain tumorsĀ can be benign (not cancer) or malignant (cancer).

    • Usually, benign tumors can be removed, and they seldom grow back.

    • Benign brain tumors usually have an obvious border or edge. Cells from benign tumors rarely invade tissues around them.

    • They don't spread to other parts of the body.

    • Benign tumors can press on sensitive areas of the brain and cause serious health problems.

    • Unlike benign tumors in most other parts of the body, benign brain tumors are sometimes life threatening.

    • Benign brain tumors may become turn into cancer.

  2. Malignant brain tumorsĀ (also called brain cancer) contain cancer cells:

    • Malignant brain tumors are generally more serious and often are a threat to life.

    • They are likely to grow rapidly and crowd or invade the nearby healthy brain tissue.

    • Cancer cells may break away from malignant brain tumors and spread to other parts of the brain or to the spinal cord. They rarely spread to other parts of the body.

What are theĀ gradesĀ for benign and cancerous brain tumors?

Doctors group brain tumors by grade. The grade of a tumor refers to the way the cells look under a microscope:

  • Grade I: The tissue is benign. The cells look nearly like normal brain cells, and they grow slowly.

  • Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a Grade I tumor.

  • Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing (anaplastic).

  • Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.

Cells from low-grade tumors (grades I and II) look more normal and generally grow more slowly than cells from high-grade tumors (grades III and IV).Ā Over time, a low-grade tumor may become a high-grade tumor. However, the change to a high-grade tumor happens more often among adults than children.

Early Warning Signs and Symptoms of a Brain Lesion

Symptoms of a brain lesion depend upon what part of the brain is affected. Large parts of the brain can be involved in some diseases and there may be relatively few symptoms. Alternatively, very tiny lesions may be catastrophic if they occur in a critical part of the brain.

Initial signs and symptoms of a brain lesion are often non-specific and may include:

  1. Worst headache of your life

  2. Nausea

  3. Fever (if an infection is present)

  4. Neck pain and stiffness (if the meninges are inflamed)

  5. Vision, speech problems, and difficulty forming words

  6. Weakness or paralysis to one side of the body

  7. Seizures

  8. Personality changes, loss of concentration, aggression and loss of personal control

Among adults, the most common types are:

  1. Astrocytoma: The tumor arises from star-shaped glial cells called astrocytes. It can be any grade. In adults, an astrocytoma most often arises in the cerebrum.

    • Grade I or II astrocytoma: It may be called a low-grade glioma.

    • Grade III astrocytoma: It's sometimes called a high-grade or an anaplastic astrocytoma.

    • Grade IV astrocytoma: It may be called a glioblastoma or malignant astrocytic glioma.

  2. Meningioma: The tumor arises in the meninges. ItĀ can be grade I, II, or III. It's usually benign (grade I) and grows slowly.

  3. Oligodendroglioma: The tumor arises from cells that make the fatty substance that covers and protects nerves. It usually occurs in the cerebrum. It's most common in middle-aged adults. It can beĀ grade II or III.

Among children, the most common types and stages of brain tumorsĀ are:

  1. Medulloblastoma: The tumor usually arises in the cerebellum. It's sometimes called a primitive neuroectodermal tumor. It is grade IV.

  2. Grade I or II astrocytoma: In children, this low-grade tumor occurs anywhere in the brain. The most common astrocytoma among children is juvenile pilocytic astrocytoma. It's grade I.

  3. Ependymoma: The tumor arises from cells that line the ventricles or the central canal of the spinal cord. It's most commonly found in children and young adults. It can beĀ grade I, II, or III.

  4. Brain stem glioma: The tumor occurs in the lowest part of the brain. It can be a low-grade or high-grade tumor. The most common type is diffuse intrinsic pontine glioma.

What are the causes and risk factors for brain tumors?

When you're told that you have a brain tumor, it's natural to wonder what may have caused your disease. But no one knows the exact causes of brain tumors. Doctors seldom know why one person develops a brain tumor and another doesn't.

Researchers are studying whether people with certain risk factors are more likely than others to develop a brain tumor. A risk factor is something that may increase the chance of getting a disease.

Studies have found the following risk factors for brain tumors:

  • Ionizing radiation: Ionizing radiation from high dose x-rays (such as radiation therapy from a large machine aimed at the head) and other sources can cause cell damage that leads to a tumor. People exposed to ionizing radiation may have an increased risk of a brain tumor, such as meningioma or glioma.

  • Family history: It is rare for brain tumors to run in a family. Only a very small number of families have several members with brain tumors.

TreatmentsĀ for benign and cancerous brain tumors.

The choice of treatment depends mainly are:

  • The type and grade of brain tumor

  • Its location in the brain

  • Its size

  • Your age and general healthSurgery to open the skull is called a craniotomy. The surgeon makes an incision in your scalp and uses a special type of saw to remove a piece of bone from the skull.

  • You may be awake when the surgeon removes part or all of the brain tumor. The surgeon removes as much tumor as possible. You may be asked to move a leg, count, say the alphabet, or tell a story. Your ability to follow these commands helps the surgeon protect important parts of the brain.

  • After the tumor is removed, the surgeon covers the opening in the skull with the piece of bone or with a piece of metal or fabric. The surgeon then closes the incision in the scalp.

  • Sometimes surgery isn't possible. If the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove the tumor without harming normal brain tissue. People who can't have surgery may receive radiation therapy or other treatment.

  • You may have a headache or be uncomfortable for the first few days after surgery. However, medicine can usually control pain. Before surgery, you should discuss the plan for pain relief with your health care team. After surgery, your team can adjust the plan if you need more relief.

  • You may also feel tired or weak. The time it takes to heal after surgery is different for everyone. You will probably spend a few days in the hospital.

  • Other, less common problems may occur after surgery for a brain tumor. The brain may swell or fluid may build up within the skull. The health care team will monitor you for signs of swelling or fluid buildup. You may receive steroids to help relieve swelling. A second surgery may be needed to drain the fluid. The surgeon may place a long, thin tube (shunt) in a ventricle of the brain. (For some people, the shunt is placed before performing surgery on the brain tumor.) The tube is threaded under the skin to another part of the body, usually the abdomen. Excess fluid is carried from the brain and drained into the abdomen. Sometimes the fluid is drained into the heart instead.

  • Infection is another problem that may develop after surgery. If this happens, the health care team will give you an antibiotic.

  • Brain surgery may harm normal tissue. Brain damage can be a serious problem. It can cause problems with thinking, seeing, or speaking. It can also cause personality changes or seizures. Most of these problems lessen or disappear with time. But sometimes damage to the brain is permanent. You may need physical therapy, speech therapy, or occupational therapy. See the Rehabilitation section.

Radiation treatment for brain tumors.

External radiation therapy: You'll go to a hospital or clinic for treatment. A large machine outside the body is aimed to direct beams of radiation at either the whole brain or more commonly, at specific portions of the brain. Some people need radiation aimed at the spinal cord also. The treatment schedule depends on your age, and the type and size of the tumor. Fractionated external beam therapy, in which small doses or fractions of radiation are given usually once each day, is the most common method of radiation therapy used for people with brain tumors. Giving the total dose of radiation over several weeks helps to protect healthy tissue in the area of the tumor. Treatments are usually 5 days a week for several weeks. A typical visit lasts less than an hour, and each treatment takes only a few minutes.

Some treatment centers are studying other ways of delivering external beam radiation therapy:

  • Intensity-modulated radiation therapy or 3-dimensional conformal radiation therapy: These types of treatment use computers to more closely target the brain tumor to lessen the damage to healthy tissue.

  • Proton beam radiation therapy: The source of radiation is protons rather than X-rays. The doctor aims the proton beam at the tumor. The dose of radiation to normal tissue from a proton beam is less than the dose from an X-ray beam.

  • Stereotactic radiation therapy: Narrow beams of X-rays or gamma rays are directed at the tumor from different angles. For this procedure, you wear a rigid head frame. The therapy may be given during a single visit (stereotactic radiosurgery) or over several visits.

  • Internal radiation therapy (implant radiation therapy or brachytherapy): Internal radiation isn't commonly used for treating brain tumors and is under study. The radiation comes from radioactive material usually contained in very small implants called seeds. The seeds are placed inside the brain and give off radiation for months. They don't need to be removed once the radiation is gone.

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