Brain Cancer

Also called: Glioma, Meningioma

Cancer of the brain is usually called a brain tumor. There are two main
types. A primary brain tumor starts in the brain. A metastatic brain
tumor starts somewhere else in the body and moves to the brain. Brain
tumors can be benign, with no cancer cells, or malignant, with cancer
cells that grow quickly.
Brain tumors can cause many symptoms. Some of the most common
are
eadaches, usually worse in the morning
!ausea and vomiting
Changes in your ability to talk, hear, or see
"roblems with balance or walking
"roblems with thinking or memory
#uscle $erking or twitching
!umbness or tingling in arms or legs
%octors diagnose brain tumors by doing a neurologic e&am and tests
including an #'(, CT scan, and biopsy. "eople with brain tumors have
several treatment options. The options are surgery, radiation therapy,
and chemotherapy. #any people get a combination of treatments.
!() !ational Cancer (nstitute
Brain cancer facts
Brain cancer can arise from many di*erent types of brain cells
+primary brain cancer, or occur when cancer cells from another
part of the body spread +metastasi-e, to the brain.
Causes of brain cancer are di.cult to prove/ avoiding compounds
linked to cancer production is advised.
Symptoms of brain cancer vary but often include weakness,
di.culty walking, sei-ures, and headaches. 0ther common
symptoms are nausea, vomiting, blurry vision, or a change in a
person1s alertness, mental capacity, memory, speech, or
personality.
Tests for brain cancer involve a history, physical e&am, and
usually a CT or #'( brain scan/ sometimes a brain tissue biopsy
is done.
Treatments usually are directed by a team of doctors and are
designed for the individual patient/ treatments may include
surgery, radiotherapy, or chemotherapy, often in combination.
Side e*ects of treatments range from mild to severe, and
patients need to discuss plans with their treatment team
members to clearly understand potential side e*ects and their
prognosis +outcomes,.
%epending on the brain cancer type and overall health status of
the patient, brain cancer frequently has only a fair to poor
prognosis/ children have a somewhat better prognosis.
What is brain cancer?
Brain cancer is a disease of the brain in which cancer cells +malignant,
arise in the brain tissue. Cancer cells grow to form a mass of cancer
tissue +tumor, that interferes with brain functions such as muscle
control, sensation, memory, and other normal body functions. Tumors
composed of cancer cells are called malignant tumors, and those
composed of mainly noncancerous cells are called benign tumors.
Cancer cells that develop from brain tissue are called primary brain
tumors while tumors that spread from other body sites to the brain are
termed metastatic or secondary brain tumors. Statistics suggest that
brain cancer occurs infrequently and is likely to develop in about
23,444 new people per year with about 53,444 deaths as estimated by
the !ational Cancer (nstitute +!C(, and American Cancer Society.
!ot all brain tumors are alike, even if they arise from the same type of
brain tissue. Tumors are assigned a grade depending on how the cells
in the tumor appear microscopically. The grade also provides insight as
to the cell1s growth rate. !C( lists the following grades)
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 ( tumor.
Grade III) The malignant tissue has cells that look very di*erent
from normal cells. The abnormal cells are actively growing and
have a distinctly abnormal appearance +anaplastic,.
Grade IV) The malignant tissue has cells that look most
abnormal and tend to grow quickly.
The most common primary brain tumors are usually named for the
brain tissue type from which they originally developed. These are
gliomas, meningiomas, pituitary adenomas, vestibular schwannomas,
and primitive neuroectodermal tumors +medulloblastomas,. 6liomas
have several subtypes which include astrocytomas,
oligodendrogliomas, ependymomas, and choroid ple&us papillomas.
7hen the grades are coupled with the tumor name, it gives doctors a
better understanding about the severity of the brain cancer. 8or
e&ample, a grade ((( +anaplastic, glioma is an aggressive tumor, while
an acoustic neuroma is a grade ( benign tumor. owever, even benign
tumors can cause serious problems if they grow big enough to cause
increased intracranial pressure or obstruct vascular structures or
cerebrospinal 9uid 9ow.
Brain cancers are staged +stage describes the e&tent of the cancer,
according to their cell type and grade because they seldom spread to
other organs, while other cancers, such as breast or lung cancer, are
staged according to so:called T#! staging which is based on the
location and spread of cancer cells. (n general, these cancer stages
range from 4 to ;, with stage ; indicating the cancer has spread to
another organ +highest stage,.
What is metastatic brain cancer?
Cancer cells that develop in a body organ such as the lung +primary
cancer tissue type, can spread via direct e&tention, or through the
lymphatic system and<or through the bloodstream to other body
organs such as the brain. Tumors formed by such cancer cells that
spread +metastasi-e, to other organs are called metastatic tumors.
#etastatic brain cancer is a mass of cells +tumor, that originated in
another body organ and has spread into the brain tissue. #etastatic
tumors in the brain are more common than primary brain tumors. They
are usually named after the tissue or organ where the cancer =rst
developed +for e&ample, metastatic lung or breast cancer tumors in the
brain, which are the most common types found,. 0ccasionally, an
abbreviated name may be used that often confuses people/ for
e&ample, >small cell brain cancer> actually means >small cell lung
cancer that has metastasi-ed to the brain.> "eople should not hesitate
to ask their doctor about any terms they do not understand.
What causes brain cancer?
"rimary brain tumors arise from many types of brain tissue +for
e&ample, glial cells, astrocytes, and other brain cell types,. #etastatic
brain cancer is caused by the spread of cancer cells from a body organ
to the brain. owever, the causes for the change from normal cells to
cancer cells in both metastatic and primary brain tumors are not fully
understood. %ata gathered by research scientists show that people
with certain risk factors are more likely to develop brain cancer.
(ndividuals with risk factors, such as having a $ob in an oil re=nery,
handlers of $et fuel or chemicals like ben-ene, chemists, embalmers, or
rubber:industry workers, show higher rates of brain cancer than the
general population. Some families have several members with brain
cancer, but heredity as a cause for brain tumors has not been proven.
0ther risk factors such as smoking, radiation e&posure, and viral
infection +(?, have been suggested but not proven to cause brain
cancer. There is no good evidence that brain cancer is contagious,
caused by head trauma, or caused by cell phone use. Although many
lay press and web articles claim that aspartame +arti=cial sweetener,
causes brain cancer, the 8%A maintains that it does not cause brain
cancer and base their =ndings on over 544 to&icological and clinical
studies regarding the sweetener1s safety.
Do cell phones cause brain cancer?
There is an ongoing concern by a number of people that cell phones
cause brain cancer. Some in popular press and some web sites suggest
that avoiding cell phone use and using a macrobiotic diet will help
avoid brain cancer. This situation has been e&acerbated by a recent
ruling to put cell phones on a list of items that >may> cause cancer by
the (nternational Agency for 'esearch on Cancer +(A'C,. This was done
because the (A'C suggested that an increase in gliomas may occur
with high use of cell phones. The (A'C classi=ed cell phones as group
2b carcinogens/ these substances are considered possibly
carcinogenic, but evidence is limited in both humans and e&perimental
animals. The report does not say that cell phones cause brain cancer.
Currently, many researchers are convinced there is no good evidence
for these cancer:causing claims. (n %ecember 2454, a large study of
about @A,444 cell phone users, with use times ranging over =ve to 54
years, indicates that no substantial change in brain cancer incidence
could be found in these individuals. (nvestigators suggest that >high
usage> of cell phones over long time periods is yet to be investigated.
7ith over @ billion phones in use and no signi=cant increase in gliomas
+the most frequent type of brain cancer, reported worldwide, many
investigators think that normal cell use likely causes no harm.
owever, for those readers who want to minimi-e any electromagnetic
radiation dose from cell phones, the reader can consult the web for a
list of phones that produce the highest and lowest radiation levels +for
e&ample, http)<<reviews.cnet.com<2B5A:CC42DB:2A5:2.htmlE
tagFpage/page,. (n addition, the use of earphones or the speaker
function will allow usage without the phone having close pro&imity to
the brain.
What are the symptoms and signs of brain cancer?
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Although there are few early signs, the most common symptoms of
brain cancer are weakness, di.culty walking, sei-ures, and headaches.
0ther common symptoms are nausea, vomiting, blurry vision, or a
change in a person1s alertness, mental capacity, memory, speech, or
personality. These symptoms can also occur in people who do not have
brain cancer, and none of these symptoms alone or in combination can
predict that a person has brain cancer. Cancer can occur in any part of
the brain +for e&ample, occipital, frontal, parietal, or temporal lobes,
brainstem, or meningeal membranes,. A few brain cancers may
produce few or no symptoms +for e&ample, some meningeal and
pituitary gland tumors,.
What tests are used to diagnose brain cancer?
The initial test is an interview that includes a medical history and
physical e&amination of the person by a health:care provider. The
results of this interaction will determine if other speci=c tests need to
be done.
The most frequently used test to detect brain cancer is a CT scan
+computeri-ed tomography,. This test resembles a series of H:rays and
is not painful, although sometimes a dye needs to be in$ected into a
vein for better images of some internal brain structures. Another test
that is gaining popularity because of its high sensitivity for detecting
anatomic changes in the brain is #'( +magnetic resonance imaging,.
This test also resembles a series of H:rays and shows the brain
structures in detail better than CT. #'( is not as widely available as CT
scanning. (f the tests show evidence +tumors or abnormalities in the
brain tissue, of brain cancer, then other doctors such as neurosurgeons
and neurologists that speciali-e in treating brain ailments will be
consulted to help determine what should be done to treat the patient.
0ccasionally, a tissue sample +biopsy, may be obtained by surgery or
insertion of a needle to help determine the diagnosis. 0ther tests
+white blood cell counts, electrolytes, or e&amination of cerebrospinal
9uid to detect abnormal cells or increased intracranial pressure, may
be ordered by the health:care practitioner to help determine the
patient1s state of health or to detect other health problems.
What is the treatment for brain cancer?
A treatment plan is individuali-ed for each brain cancer patient. The
treatment plan is constructed by the doctors who speciali-e in brain
cancer, and treatments vary widely depending on the cancer type,
brain location, tumor si-e, patient age, and patient1s general health
status. A ma$or part of the plan is also determined by the patient1s
wishes. "atients should discuss treatment options with their health:
care providers.
Surgery, radiation therapy, and chemotherapy are the ma$or treatment
categories for most brain cancers. (ndividual treatment plans often
include a combination of these treatments. Surgical therapy attempts
to remove all of the tumor cells by cutting the tumor away from normal
brain tissue. This surgery is often termed invasive surgery to
distinguish it from noninvasive radiosurgery or radiation therapy
described below.
'adiation therapy attempts to destroy tumor cells by using high:energy
radiation focused onto the tumor to destroy the tumor cells1 ability to
function and replicate. 'adiosurgery is a nonsurgical procedure that
delivers a single high dose of precisely targeted radiation using highly
focused gamma:ray or H:ray beams that converge on the speci=c area
or areas of the brain where the tumor or other abnormality is located,
minimi-ing the amount of radiation to healthy brain tissue. Iquipment
used to do radiosurgery varies in its radiation source/ a gamma knife
uses focused gamma rays, and a linear accelerator uses photons, while
heavy:charged particle radiosurgery uses a proton beam.
Chemotherapy attempts to destroy tumor cells using chemicals +drugs,
that are designed to destroy speci=c types of cancer cells. There are
many chemical agents used/ speci=c drug therapies are numerous, and
each regimen is usually designed for the speci=c type of brain cancer
and individuali-ed for each patient. 8or e&ample, bevaci-umab
+Avastin, is a drug approved for treatment of glioblastomas.
Chemotherapy can be administered intrathecally +by a spinal tap or
through a surgically placed permanent reservoir under the scalp
attached through a sterile tubing placed into the 9uid:containing
chambers in the brain,, by (? administration, and biodegradable
chemically impregnated polymers. All treatments attempt to spare
normal brain cells.
0ther treatment options may include hyperthermia +heat treatments,,
immunotherapy +immune cells directed to kill certain cancer cell
types,, or steroids to reduce in9ammation and brain swelling. These
may be added on to other treatment plans.
Clinical trials +treatment plans designed by scientists and physicians to
try new chemicals or treatment methods on patients, can be another
way for patients to obtain treatment speci=cally for their cancer cell
type. Clinical trials are part of the research e*orts to produce better
treatments for all disease types. Stem cell treatments for brain and
brain stem cancers and other conditions may be available, because
research with patients is ongoing using these potential therapies. The
best treatment for brain cancer is designed by the team of cancer
specialists in con$unction with the wishes of the patient.