ConditionandTreatments

Overview

A brain tumor is a mass or growth of abnormal cells in the brain or nearby structures. Tumors can be benign (non-cancerous) or malignant (cancerous) and can originate in the brain (primary brain tumors) or spread from other parts of the body (secondary or metastatic brain tumors). Brain tumors can affect brain function, depending on their size, location, and type.

How Common Are Primary Brain Tumors?

Primary brain tumors (tumors that originate in your brain) are uncommon. Only about 5 per 100,000 people are diagnosed with a primary brain tumor each year in the United States. About 4,100 children under the age of 15 are diagnosed with a brain or central nervous system tumor each year in the United States.

Symptoms and Causes of Brain Tumors

Symptoms of Brain Tumors:

Brain tumors, whether benign (non-cancerous) or malignant (cancerous), can present a wide range of symptoms. Not everyone with a brain tumor will experience symptoms, especially if the tumor is small. The signs and symptoms of a brain tumor can vary based on its location, size, and type, and may include:

• Headaches: Often more severe in the morning or may wake you up at night.
• Seizures: Uncontrolled electrical activity in the brain.
• Cognitive Difficulties: Trouble thinking, speaking, or understanding language.
• Personality Changes: Alterations in behavior or mood.
• Weakness or Paralysis: Affecting one part or side of the body.
• Balance Problems or Dizziness: Difficulty maintaining coordination.
• Vision Issues: Changes in vision or blurred sight.
• Hearing Issues: Problems with hearing or auditory perception.
• Facial Numbness or Tingling: Sensory changes in the face.
• Nausea or Vomiting: Often related to increased intracranial pressure.
• Confusion and Disorientation: Difficulty with orientation and clarity of thought.

Causes of Brain Tumors:

Brain tumors develop when genetic material within brain cells becomes damaged, leading to abnormal cell growth and multiplication. While the exact cause of these genetic changes is not fully understood, several factors may contribute:

• Genetic Changes: Mutations or damage to the DNA in brain cells can result in abnormal cell behavior. This can include accelerated growth and prolonged survival of these cells, leading to tumor formation.
• Inherited Genetic Syndromes: Certain rare genetic conditions increase the risk of developing brain tumors. These include:
  • Neurofibromatosis Type 1 (NF1): Caused by mutations in the NF1 gene.
  • Neurofibromatosis Type 2 (NF2): Linked to mutations in the NF2 gene.
  • Turcot Syndrome: Associated with mutations in the APC gene.
  • Gorlin Syndrome: Related to mutations in the PTCH gene.
  • Tuberous Sclerosis Complex: Caused by mutations in TSC1 or TSC2 genes.
  • Li-Fraumeni Syndrome: Associated with mutations in the TP53 gene.
• Environmental Factors: Exposure to high levels of radiation, such as from previous cancer treatments, may also contribute to brain tumor development.
• Approximately 5% to 10% of individuals with brain tumors have a family history of the condition.

Types of Brain Tumors

Researchers have identified over 150 types of brain tumors, each with its own characteristics and behaviors. Brain tumors are classified based on their origin and nature, including whether they are glial (arising from glial cells) or non-glial (originating from other brain structures such as nerves, blood vessels, or glands), and whether they are benign (non-cancerous) or malignant (cancerous). Additionally, tumors can also develop in the spinal cord or column.

Typically Benign Brain Tumors:

• Chordomas: These slow-growing tumors generally start at the base of the skull or at the lower spine. They are mostly benign but can be challenging to treat due to their location.
• Craniopharyngiomas: Arising from a portion of the pituitary gland, these tumors are located near critical brain structures, making them difficult to remove.
• Gangliocytomas, Gangliomas, and Anaplastic Gangliogliomas: Rare tumors that develop in nerve cells (neurons).
• Glomus Jugulare Tumors: Found just under the base of the skull near the jugular vein, these are the most common type of glomus tumor.
• Meningiomas: The most common type of primary brain tumors, these usually grow slowly in the meninges, the protective layers around the brain and spinal cord. While often benign, they can occasionally be malignant.
• Pineocytomas: Slow-growing tumors that form in the pineal gland, which produces the hormone melatonin.
• Pituitary Adenomas: Tumors of the pituitary gland, located at the brain's base, which can affect hormone production. They generally grow slowly and may cause hormone imbalances.
• Schwannomas: Common benign tumors in adults, these arise from Schwann cells in the peripheral nervous system or cranial nerves. Acoustic neuromas, a type of schwannoma, occur on the vestibular nerve connecting the inner ear to the brain.

Cancerous (Malignant) Brain Tumors:

• Gliomas: Representing approximately 78% of malignant primary brain tumors, gliomas originate in glial cells that support nerve cells. Types include:
  • Astrocytomas: The most common glioma, formed in astrocytes (star-shaped glial cells). These tumors can occur in various brain regions, with a high prevalence in the cerebrum.
  • Ependymomas: Typically found near the brain’s ventricles, these tumors develop from ependymal cells (radial glial cells).
  • Glioblastoma (GBM): Known for rapid growth, GBMs arise from astrocytes and are among the most aggressive brain tumors.
  • Oligodendrogliomas: These rare tumors develop in cells that create myelin, the protective layer around nerve cells in the brain.
• Medulloblastomas: Fast-growing tumors located at the base of the skull. They are the most common cancerous brain tumors in children.

Who Do Brain Tumors Affect?

Brain tumors can affect individuals of all ages, though some types are more common in specific age groups. For example, medulloblastomas are most common in children, while gliomas and meningiomas are more frequently diagnosed in adults. Brain tumors can occur due to a variety of factors, including genetic predispositions and environmental influences. Regular medical check-ups and attention to symptoms can aid in early detection and treatment.

How Are Brain Tumors Diagnosed?

Diagnosing a brain tumor can be complex and often involves multiple specialists. In some cases, a brain tumor may be discovered incidentally during imaging tests conducted for other medical conditions.

If you present symptoms suggestive of a brain tumor, your healthcare provider will begin with a comprehensive physical exam and gather detailed information about your:

• Symptoms: Current and previous issues you're experiencing.
• Health History: Past and ongoing health conditions.
• Medications: Any current prescriptions or over-the-counter drugs.
• Medical History: Previous surgeries and treatments.
• Family History: Any relevant familial health conditions.

A neurological exam may also be conducted to assess changes in:

• Balance and Coordination: Evaluating your ability to maintain equilibrium.
• Mental Status: Checking cognitive functions.
• Hearing: Assessing auditory function.
• Vision: Examining visual acuity.
• Reflexes: Observing responses to stimuli.

These evaluations can help pinpoint the area of the brain potentially affected by a tumor.

Diagnostic Tests for Brain Tumors:

To confirm a diagnosis of a brain tumor, healthcare providers may use several tests:

• Brain MRI or CT Scan: Magnetic Resonance Imaging (MRI) is the preferred method for detecting brain tumors, providing detailed images of the brain. Computed Tomography (CT) scans are used as an alternative if MRI is not feasible. Often, a contrast agent is injected into a vein to enhance the visibility of the tumor. These scans help determine the tumor’s size and location, and may also be used to check other body areas for metastasis.
• Biopsy: A biopsy involves removing a sample of the tumor tissue for microscopic examination to identify the type of tumor and determine if it is cancerous. A neurosurgeon typically performs this procedure, which may be done during surgery to remove the tumor or via a stereotactic biopsy if the tumor is hard to reach. The latter involves a small incision in the skull and a needle to collect a tissue sample.
• Spinal Tap (Lumbar Puncture): This procedure involves using a needle to extract cerebrospinal fluid (CSF) from around the spine. The fluid is then analyzed in a lab to detect cancer cells. This test is particularly useful if there is suspicion that the tumor has spread to the meninges, the protective layers surrounding the brain.
• Specialized Tests: Additional tests may be conducted to support diagnosis, such as blood and CSF tests for tumor markers or genetic testing for specific gene abnormalities associated with certain tumors.

How Are Brain Tumors Treated?

The treatment of brain tumors depends on several factors, including:

• Tumor Characteristics: Location, size, and type of the tumor.
• Number of Tumors: Whether there are multiple tumors present.
• Patient Factors: Age and overall health.

For benign (noncancerous) brain tumors, treatment usually involves surgical removal, which is often successful and does not typically lead to recurrence, provided the neurosurgeon can safely excise the entire tumor.

Treatment Options for Brain Tumors:

Healthcare providers often use a combination of therapies tailored to the individual’s needs:

• Brain Surgery (Craniotomy): Neurosurgeons aim to remove the tumor while minimizing damage to surrounding functional brain areas. In some cases, surgery may be performed with the patient awake to ensure critical functions are preserved.
• Radiation Therapy: This treatment uses high doses of X-rays to destroy or shrink tumor cells. It can be effective for tumors that cannot be surgically removed or in conjunction with surgery.
• Radiosurgery: A type of radiation therapy that uses precise beams of radiation (such as gamma rays or proton beams) to target and destroy the tumor without the need for an incision.
• Brachytherapy: This involves placing radioactive seeds or implants directly into or near the tumor to deliver targeted radiation.
• Chemotherapy: Anticancer drugs are used to kill cancer cells throughout the body. Chemotherapy may be administered through an injection or as oral medication, and is often used after surgery to eliminate any remaining cancer cells or to prevent regrowth.
• Immunotherapy: Also known as biological therapy, this treatment boosts the body's immune system to better target and fight cancer cells.
• Targeted Therapy: This approach uses drugs that specifically target cancer cells' unique features, aiming to minimize damage to healthy cells and reduce side effects compared to traditional chemotherapy.
• Watchful Waiting/Active Surveillance: For small tumors that are not causing symptoms, regular monitoring with tests may be recommended to track any changes in the tumor’s size or behavior.

Additional Treatments for Symptom Management:

• Shunts: If the tumor causes increased pressure within the skull, a shunt may be placed to drain excess cerebrospinal fluid and alleviate pressure.
• Medications: Drugs such as mannitol and corticosteroids can reduce swelling and pressure around the tumor.
• Palliative Care: Focuses on providing relief from symptoms, enhancing comfort, and supporting both patients and their families throughout the course of the illness.

Meditation and Lifestyle:

• Meditation: Can help manage stress, improve mental well-being, and support overall health during treatment. Mindfulness practices and relaxation techniques may be beneficial.
• Healthy Lifestyle: Maintaining a balanced diet, regular exercise, and adequate rest can support overall health and recovery.

FAQ:

• What causes brain tumors? The exact cause of most brain tumors is unknown. However, certain genetic factors, exposure to radiation, and some environmental factors may increase risk.
• How are brain tumors treated? Treatment options include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy, depending on the tumor type and location.
• Can brain tumors be prevented? There is no known way to prevent brain tumors. However, reducing exposure to known risk factors and maintaining a healthy lifestyle may help.
• What is the prognosis for brain tumors? The prognosis depends on various factors including tumor type, location, size, and how well it responds to treatment. Early diagnosis and treatment improve outcomes.
• Are there support services available? Yes, support services including counseling, support groups, and rehabilitation programs are available to help patients and families cope with the impact of brain tumors.