Since the German Brain Tumor Association (Deutsche Hirntumorhilfe e.V.) made this day an occasion to raise awareness of brain tumors, the 8th of June has been observed as World Brain Tumor Day. To assist patients who suffer symptoms suggestive of a brain tumor, it is essential to understand brain tumors.
Early morning headache, persistent or late onset headache (after 50 years of age), vomiting, sudden blurring of vision like an ongoing headache, double vision, weakness, balance issues, and problems walking are a few symptoms that should be taken as a warning to seek medical attention. Depending on the size, nature, and location of the tumor, some symptoms may change. A fundamental understanding of tumors is necessary for a better understanding of brain tumors.
A tumor is an unneeded cellular development. These tumors can develop in any area of the body and can be either malignant (cancer) or benign (non-cancerous). As the name implies, a brain tumor can occur anywhere in the brain. Primary or secondary brain tumors are also possible. While secondary brain tumors start in other places of the body and spread to the brain, primary brain tumors start in the brain itself. Primary brain tumors are less frequent than secondary ones. In actuality, the brain received 40% of all malignant tumors that spread.
Approximately 26% of all pediatric malignancies are the brain and central nervous system tumors, making them the second most prevalent type of cancer in children. The majority of brain tumors are benign (not cancerous). Of all brain tumors, only one-third are malignant. Ionizing radiation exposure and a family history of brain malignancies are the main risk factors. Early detection of this tumor is crucial for a greater chance of recovery.
MRI or a CT scan can both be used to detect brain malignancies (magnetic resonance imaging). After diagnosis, depending on the type of tumor, there are several treatment choices (whether primary or secondary). With neuron navigation, micro neurosurgery, skull-based surgery, endoscopic neurosurgery, gamma knife, radiosurgery, or radiotherapy, many brain cancers, including low-grade astrocytomas, gangliogliomas, meningiomas, schwannoma, epidermoid, etc., are entirely curable. Additionally, if other brain cancers are detected early, their prognosis can be greatly improved. Because of this, early diagnosis is crucial and can only happen when people are informed of the symptoms and hazards involved.
Different Benign Brain Tumor Types
- A benign, slow-growing tumor, chordomas are most common in persons between the ages of 50 and 60. The base of the skull and the lower part of the spine is where they are most frequently found. Despite being benign, these tumors may penetrate the neighboring bone and impose pressure on the nearby brain tissue. Only 0.2 percent of initial brain tumors are caused by these uncommon malignancies.
- Although most craniopharyngiomas are benign, their positioning so close to vital brain regions makes them challenging to remove. Nearly all patients will need some form of hormone replacement medication because they typically originate from a pituitary gland section (the organ that controls numerous hormones in the body).
- Rare tumors called gangliocytomas, ganglions, and anaplastic gangliogliomas, which mostly affect young adults, contain relatively well-differentiated neoplastic nerve cells.
- The majority of glomus jugulare tumors are benign and are normally found at the top of the jugular vein, directly below the base of the skull. They represent the most typical variety of glomus tumors. However, only 0.6 percent of head and neck neoplasms are caused by glomus tumors in general.
- Meningiomas, which make up 10 to 15 percent of all brain neoplasms but only a very small fraction of malignant ones, are the most frequent benign intracranial tumors. The meninges, the membrane-like structures that cover the brain and spinal cord, are the source of these malignancies.
- Pineocytomas are typically benign tumors that develop from pineal cells and mostly affect adults. Most frequently, they are slow-growing, homogeneous, well-defined, and non-invasive.
- After schwannomas, meningiomas, and gliomas, pituitary adenomas are the most prevalent intracranial tumors. Pituitary adenomas are benign and generally slow-growing in the vast majority of cases. Even cancerous pituitary tumors seldom metastasize to other organs. The most frequent condition affecting the pituitary is by far adenomas. Though they can be identified in youth, they typically afflict persons in their 30s or 40s. The majority of malignant cancers are successfully treatable.
- Adults frequently develop benign brain tumors called schwannomas. They develop along nerves and are made up of cells that typically act as the nerve cells’ “electrical insulation.” Instead of entering the remaining portion of the healthy nerve, schwannomas frequently displace it. The eighth cranial nerve, also known as the vestibulocochlear nerve, which connects the brain to the ear, gives rise to acoustic neuromas, which are the most prevalent type of schwannoma. Even though these tumors are benign, if they progress and put pressure on nerves and eventually the brain, they can result in severe consequences and even death. Additionally, the spine and, less frequently, the nerves that supply the limbs are possible destinations.
Malignant Brain Tumor Types
With gliomas making up 78% of malignant brain tumors, gliomas are the most common type of adult brain tumor. They develop from the glia, or the brain’s supporting cells. Astrocytes, ependymal cells, and oligodendroglial cells are the different types of these cells (or oligos). The following are examples of glial tumors:
- The majority of primary brain and spinal cord tumors, or around 50% of all gliomas, are astrocytomas. Astrocytes, glial cells with a starlike form that are a component of the brain’s supporting tissue, give rise to astrocytomas. They can happen everywhere in the brain, but the cerebrum is where they most frequently happen. Astrocytomas can occur in people of any age, but they are more common in adults, especially middle-aged males. Most pediatric brain tumors are astrocytomas, which are located in the base of the brain and are more common in youngsters or younger people. While most of these tumors are high-grade in adults, the majority of them are low-grade in children.
- Two to three percent of all brain tumors are ependymomas, which result from the neoplastic transformation of the ependymal cells lining the ventricular system. While most are well defined, some are not.
- The most aggressive kind of glial tumor is called glioblastoma multiforme (GBM). These tumors frequently have a bad prognosis, a quick rate of growth, and tissue dissemination. They could include a variety of cells, including oligodendrocytes and astrocytes. GBM is more prevalent in men than in women and is more common in adults between the ages of 50 and 70.
- The cerebellum is where medulloblastomas typically develop, most frequently in children. Despite being high-grade tumors, they frequently respond to chemotherapy and radiation.
- Myelin, the insulating material used in the wiring of the brain, is produced by the cells that give rise to oligodendrogliomas.
Additional Forms of Brain Tumors
- Slow-growing tumors known as hemangioblastomas are frequently found in the cerebellum. They can be big, come from blood vessels, and frequently include a cyst along with them. Ages 40 to 60 are when these tumors are most prevalent, and males are more likely than women to develop them.
- Rare, extremely aggressive tumors called rhabdoid tumors have a propensity to spread throughout the central nervous system. They frequently manifest in several locations throughout the body, particularly in the kidneys. They can affect adults as well, although young children are more likely to experience them.
Children’s Brain Tumors
Children’s brain tumors often originate from different tissues than those that harm adults. Treatments that are generally well-tolerated by the adult brain (such as radiation therapy) may impede a child’s brain from developing normally, especially in younger children under the age of five.
Around 4,200 kids in the U.S. are diagnosed with brain tumors, and 72 percent of them are under the age of 15. This information comes from the Pediatric Brain Tumor Foundation. The posterior fossa, or the rear of the brain, is where the majority of these tumors develop. Children frequently come with hydrocephalus (fluid accumulation in the brain) or with facial or physical dysfunction.
Several brain tumor kinds affect youngsters more frequently than adults. Medulloblastomas, low-grade astrocytomas (pilocytic), ependymomas, craniopharyngiomas, and brainstem gliomas are the most prevalent pediatric tumor types.
Based on a tumor’s histological characteristics as seen under a microscope, the World Health Organization (WHO) has created a grading system to reflect a tumor’s malignancy or benignity.
- The most harmful
- The quick growth and combative
- Prominent infiltration
- Quick recurrence
- Prone to necrosis
Causes of Brain Tumors
It is believed that specific genes on a cell’s chromosomes become damaged and cease to function correctly when brain tumors develop. These genes generally control how quickly a cell divides (if at all), repair genes that correct other genes’ flaws, and genes that should trigger the cell to self-destruct if the damage is too great to be repaired. An individual may occasionally be born with one or more of these genes partially defective. Then, environmental conditions can result in additional harm. In other situations, the genetic damage caused by the environment might be the only factor. Why some persons in an “environment” have brain tumors while others don’t is unknown.
When a cell begins to divide quickly and the internal controls that regulate its growth are compromised, the cell may eventually develop into a tumor. The immune system of the body, which ideally would recognize the aberrant cell and eliminate it, might be another line of defense. Tumors can create chemicals that prevent the immune system from identifying the abnormal tumor cells, ultimately overcoming all internal and external inhibitors of their growth.
The local blood supply meant for normal tissue may not be able to meet a tumor’s increased need for oxygen and nutrients. Angiogenesis factors are chemicals that tumors can make to encourage the formation of blood vessels. The tumor receives more nutrients from the new vessels as they develop, and eventually, the tumor starts to rely on them. Although some research is being done in this area, a more in-depth study is required to turn this information into potential treatments.
The following symptoms may be present with various forms of brain tumors, albeit they differ depending on where the tumor is located in the brain:
- headaches that can be worse in the morning or keep the sufferer awake at night
- convulsions or seizures
- difficulty articulating, expressing, or thinking
- Behavioral shifts
- weakness or paralysis in a single body portion or side
- imbalance or lightheadedness
- Vision alters
- alterations in hearing
- facial tingling or numbness
- nausea, vomiting, and trouble swallowing
- Disorientation and confusion
Treatments for Brain Tumors
The type, location, and size of the tumor, as well as the patient’s age and overall health, all affect how the tumor is treated. Adults and children receive treatment using different schedules and approaches.
Radiation treatment, chemotherapy, and surgery are all used to treat brain tumors. Additionally, glioma, a recurrent cancer of the central nervous system that mostly affects the brain, is being researched by our specialists as a potential vaccine.
Several techniques might be employed, depending on your demands. To deliver the finest care possible, our team consists of neurosurgeons, medical oncologists, radiation oncologists, nurses, a dietitian, and social workers.
Most patients receive steroid drugs that reduce swelling or edema—before their treatments even start. You might be given anticonvulsant medication to stop or manage seizures.
You could require a shunt to drain cerebrospinal fluid if hydrocephalus is present. A shunt is a long, thin tube that is inserted into a brain ventricle and threaded beneath the skin to another area of the body, typically the belly. Like a drainpipe, it functions. The extra fluid is removed from the brain and taken up by the abdomen. The fluid may occasionally be discharged into the heart.
The most common form of treatment for brain tumors is surgery. An aperture is made in the skull by a neurosurgeon to remove a brain tumor. The procedure is known as a craniotomy. The surgeon makes every effort to get rid of the whole tumor. Your doctor may remove as much of the tumor as feasible if it cannot be eliminated without harming important brain tissue. By relieving pressure on the brain, partial removal aids in symptom relief and minimizes the quantity of tumor that requires radiation therapy or chemotherapy.
Unremovable tumors include some. Your doctor might only perform a biopsy in such circumstances. A pathologist will take a small portion of the tumor and analyze it under a microscope to identify the sort of cells it contains. This aids your doctor in selecting the best course of action.
A needle is occasionally used to do a biopsy. To determine the precise position of the tumor, doctors employ a specialized head frame (similar to a halo) and CT or MRI scans. A small hole is made in the skull by the surgeon, who then inserts a needle to reach the tumor. Stereotaxis is the practice of performing a biopsy or receiving therapy using this method.
Other cutting-edge methods used during surgery include sophisticated frameless stereotaxic computer-assisted tumor resections, endoscopy to do biopsies and open spinal fluid routes through a small scope, and brain mapping to locate functional pathways close to tumors. To ensure that most tumors can be removed, intraoperative MRI is also an option.
High-powered rays are used in radiation therapy, commonly known as radiotherapy, to harm cancer cells and inhibit their growth. It is frequently used to eliminate tumor tissue that cannot be surgically removed or to eliminate any cancer cells that might endure surgery. Additionally, when surgery is not an option, radiation therapy is done.
There are two techniques to administer radiation treatment. A big machine emits radiation outside. External radiation treatments are typically administered five days a week for a few weeks. The course of treatment is determined by the kind, size, and age of the tumor. The healthy tissue around the tumor is protected by spreading out the total radiation exposure over a long time.
The brain as a whole or only the tumor itself may be exposed to external radiation. The spinal cord is occasionally exposed to radiation as well. The patient frequently receives an additional dose of radiation to the tumor location when the entire brain is being treated. This boost may come from an implant or external radiation.
Radiation can also originate from implant radiation therapy or radioactive material injected right into the tumor. The implant may remain in the brain indefinitely or for a limited period, depending on the material utilized. Every day, implants lose a small amount of radioactivity. During the radiation’s peak activity, the patient spends several days in the hospital.
Another method of treating brain tumors is with the Gamma Knife or stereotactic radiosurgery. In reality, the Gamma Knife is a radiation therapy procedure that accurately directs a single, highly concentrated dosage of radiation at its target. Only one session is required for treatment. Multiple angles of high-energy radiation are directed at the tumor. In this manner, the tumor receives a high dosage of radiation without harming surrounding brain tissue.
Drugs are used in chemotherapy to kill cancer cells. The medication is often administered orally or by injection into a blood vessel or muscle by the doctor, who may use one medication alone or a combination. The medications are administered intrathecally by being injected into the cerebrospinal fluid.
Cycles of chemotherapy treatment are typical. After a therapy phase, there is a recovery phase, then another treatment phase, and so on. Most treatments don’t require patients to stay in the hospital, and the majority of medications can be administered in a clinic or doctor’s office. However, a brief hospital stay can be required depending on the medications used, how they are administered, and the patient’s general condition.
New chemotherapy techniques, such as convection-enhanced delivery, allow for direct implantation into the tumor cavity.
Everyone must comprehend the information stated above concerning brain tumor and their treatments. I urge all readers to adopt a lifestyle that supports maintaining both a healthy body and a healthy brain in my capacity as a neurologist.
Although there are numerous facets to fully comprehending brain health, keep in mind the following five points:
- Engage in regular exercise.
- Adopt a healthy diet that includes walnuts, dark green leafy vegetables, and other nutritious foods.
- Abstain from alcohol and smoking.
- Continue to think critically.
- Develop stress management skills.