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Brain Tumor and Brain Cancer

Definition:
A brain tumor is a disease in which cells grow uncontrollably in the brain. There are two main types of brain tumors:

Benign tumors are incapable of spreading beyond the brain itself. Benign tumors in the brain usually do not need to be treated and their growth is self-limited. Sometimes they can cause problems because of their location, and surgery or radiation can be helpful.

Malignant tumors are typically called brain cancer. These tumors can spread outside of the brain. Malignant tumors of the brain will always develop into a problem if left untreated and an aggressive approach is almost always warranted. Brain malignancies can be divided into two categories:

Primary brain cancer–originates in the brain

Secondary or metastatic brain cancer–spreads to the brain from another site in the body

Cancer occurs when cells in the body (in this case brain cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer usually refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. A benign tumor does not spread.

Causes:
The cause of primary brain cancer is unknown. The causes of secondary brain cancers are those that caused the malignancy at the site of origin (eg, lung or breast).

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.

Risk factors for primary brain cancer include:

  • Radiation
  • Immune system dysfunction
  • Family history of rare types of cancer

Risk factors for metastatic brain cancer include:

Any cancer throughout the body can ultimately spread to the brain. The following is a list of the most common tumors that may spread to the brain at some point:

  • Lung cancer
  • Breast cancer
  • Malignant melanomas
  • Gastrointestinal tract cancer
  • Genital or urinary tract cancer
Symptoms:
Symptoms vary, depending on the tumor's size and location. A growing tumor is often associated with fluid buildup, which puts pressure on the brain. Symptoms may develop gradually or rapidly.

Symptoms may include:

  • Headache. The vast majority of headaches are not caused by brain tumors. Headaches associated with brain tumors tend to have the following features:
    • Progressively worse over a period of weeks to months
    • Worse in the morning or cause you to wake during the night
    • Different than normal headache
    • Worsens with change of posture, straining, or coughing
  • Seizures
  • Nausea or vomiting
  • Weakness in arms and/or legs
  • Loss of sensation in arms and/or legs
  • Difficulty walking
  • Vision changes
  • Speech problems
  • Drowsiness
  • Memory problems
  • Personality changes

Note: These symptoms may also be caused by other, less serious health conditions. Anyone experiencing these symptoms should see a doctor.

Diagnosis:
The doctor will ask about symptoms and medical history, and perform a physical exam, with particular attention to the neurologic exam. A neurologic exam tests muscle strength, coordination, reflexes, response to stimuli, and alertness. The doctor will also look into your eyes to check for signs of brain swelling.

Tests may include:

MRI Scan–a test that uses magnetic waves to make pictures of structures inside the body

CT Scan–a type of x-ray that uses a computer to make pictures of structures inside the body

PET Scan–a test that detects the level of metabolic activity in the brain and other organs by tracking a radioactive sugar molecule that is injected into the bloodstream. Pet scans are not approved to look at primary brain tumors, but can be very helpful if the doctor is trying to determine if symptoms are related to a growing tumor or injury from treatment (surgery or radiation).

Arteriography–a test that uses x-rays to make pictures of the vasculature in the brain after injection of contrast material into an artery.

Biopsy–removal of a sample of brain tissue to test for cancer cells.

Stereotaxis–use of a computer-assisted CT or MRI scan to locate the tumor and take a biopsy. The doctor drills a small hole in the skull, inserts a needle and withdraws the sample tissue.

Treatment:
Once cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Treatment depends on the type, size, and location of the cancer, and your overall health. Treatments may leave you with physical or mental limitations.

Before beginning treatment to eliminate the cancer, you may take medications including:

  • Steroids to decrease swelling and fluid buildup:
    • Dexamethasone
  • Anticonvulsants to prevent seizures:
    • Phenytoin
    • Carbamazepine
    • Phenobarbital
    • Valproic acid

Treatment may include:

Surgery:
Surgical removal of the cancerous tumor. Surgical procedures include:

Craniotomy–opening of the skull to remove the tumor or as much of the tumor as possible

Shunt–implanting a long thin tube in the brain to divert built-up fluid to another part of the body

Radiation Therapy
The use of radiation to kill cancer cells and shrink tumors. This is a common treatment for brain tumors, since surgical removal can often be difficult to achieve safely. Radiation may be:
  • External Radiation Therapy–Radiation directed at the tumor from a source outside the body
  • Internal Radiation Therapy–Radioactive materials placed into the body near the cancer cells
  • Stereotactic Radiosurgery–This involves the immobilization of the head and delivery of a concentrated, high dose of radiation to the brain tumor. It works the same way as traditional radiotherapy, but because the process allows very tight localization of the delivery, higher doses can be delivered to the affected areas of the brain, sparing nearby normal tissue. It is done using special immobilization and directing equipment, including MRI and CT scans to help localize the delivery of the radiation.
Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.

Rehabilitation Therapy
Rehabilitation therapy includes:
  • Physical therapy helps with walking, balance, and building strength.
  • Occupational therapy helps with mastering life skills, such as dressing, eating, and using the toilet.
  • Speech therapy helps you express thoughts and overcome swallowing difficulties.
Prevention:
There are no guidelines for preventing brain cancer.

There is no present conclusive data that using cell phones or living by electrical wires or power plants increases your risk of developing a brain tumor.

 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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