Brain cancer

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Brain cancer is a disease of the brain in which malignant tumors, which are abnormal growths of cells, are present in the brain tissue. Malignant tumors are aggressive and invasive, taking space, nutrients and blood from healthy cells.

Contents

Types

  • Primary brain cancer is the growth of malignant tumors that originates from the brain. Primary brain tumors are named based on the brain tissue from which they developed. These are gliomas, meningiomas, pituitary adenomas, vestibular schwannomas, and primitive neuroectodermal tumors.
  • Metastatic brain cancer is the growth of malignant tumors that starts from another body organ, such as the lungs and breast, and spreads to the brain in a process called metastasis.

Cause

The exact cause is unknown. Possible risk factors include genetics, radiation exposure, HIV infection and smoking. Additional research is needed to confirm that brain cancer is caused by head trauma or cellphone use.

Signs and symptoms

Symptoms depend on the size, location, and growth of the tumor in the brain. Most common symptoms include:

  • Severe headaches that are usually worse in the morning
  • Abnormal eye movements
  • Nausea and vomiting
  • Weakness
  • Drowsiness
  • Changes in personality and/or mental capacity
  • Changes in speech
  • Changes in ability to talk, hear and/or see
  • Problems with balance
  • Numbness in arms and legs
  • Muscle twitching or jerking

Diagnosis

If findings from the medical consultation and general physical exam suggest brain tumor, the patient will be referred to a neurologist, who is a doctor that specializes in brain disorders, or an oncologist, who is a doctor who specializes in cancers.

The doctor performs a neurologic exam to test the nervous system. Procedure includes:

  • Mental exercises, where the patient answers basic math problems and/or other simple questions.
  • Hearing tests.
  • Facial muscle tests.
  • Checking of reflexes, sensation, muscle strength and coordination.
  • An eye examination, where the doctor shines a light at the back of the eye to check for swelling.

The doctor orders any of the following tests:

  • Brain Magnetic Resonance Imaging (MRI) Scan – is a radiology test that uses magnetic fields to make detailed computer images of areas inside the head. The patient is injected with a special dye which is used to help provide a clear image of the differences in brain tissue. Then the patient lies down a movable bed, which is inserted into the MRI scanner. The MRI scanner is a large, tube-like machine with a strong magnetic field.
  • Brain Computerized Axial Tomography (CT/CAT) Scan – is a series of x-rays that provides cross-sectional views of the inside of the head. A contrast material is injected into the patient’s blood vessel in the arm or hand to improve the accuracy of the images. Then the patient lies down inside the CT Scanner, which is a large, donut-shaped x-ray machine linked to a computer.
  • Positron Emission Tomography (PET) Scan – is an imaging test that measures the cells’ metabolic changes. A small dose of radiopharmaceutical substance, called a radiotracer, is injected into the patient’s vein. The tracer travels through the brain and gives off energy in the form of gamma rays. The patient lies down inside the PET scanner, which is a large, donut-shaped machine that detects the energy emitted by the radiotracer. The scanner is linked to a computer, which records the energy and produces three-dimensional images. Compared to the MRI and CT Scan, PET scan can detect brain cancer at earlier stages, as well as the tumor’s response to treatment.
  • Brain Biopsy – is an invasive medical procedure which requires the removal of a sample of brain tissue to look for abnormal cells. The patient is administered with general anesthesia. Then the doctor drills a hole into the skull and inserts a needle into the brain. The sample is sent to a pathologist, who evaluates the abnormal cells.

Treatment

Treatment depends on the following factors:

  • Age and general health status of the patient;
  • The type and grade of the tumor; and,
  • The location and size of the tumor.

Surgery

Surgery is the removal of the tumor from the brain by cutting it off from the brain tissue. The patient is given general anesthesia. Then the surgeon performs craniotomy, which is an operation that involves opening the skull. The patient may have to be awake while undergoing surgery to check and monitor brain function. In some cases, surgery may be too difficult and dangerous, and the doctor will suggest another method of treatment.

A patient usually experiences a headache for the first few days after surgery, for which a pain reliever is administered. Other surgical side effects include brain swelling, damage to normal brain tissue, and seizures. Change in brain functions may occur. These side effects are most prevalent immediately following surgery. They may decline after some time, but there are cases where the side effects do not go away.

Chemotherapy

Chemotherapy is the use of cytotoxic drugs or anti-cancer chemicals to destroy tumor cells. Drugs may be given orally and intravenously then the chemicals enter the bloodstream and travel inside the body. Intrathecal chemotherapy is a procedure where the drugs are injected in the cerebrospinal fluid.

Adults with high-grade glioma may be given biodegradable chemically impregnated polymers, which are small, gel wafers or discs that are implanted in the brain.

A patient usually experiences fever, chills, weakness, hair loss, nausea and vomiting. Other parts of the body, such as the kidneys, may be damaged. The immune system is affected by chemotherapy, making the patient highly susceptible to infections.

Radiation therapy

Radiation therapy is the use of high-energy x-rays, gamma rays, or protons to destroy tumors. This method is used after surgery to target cancer cells that may have been left behind or when the tumor cannot be removed surgically.

There are two ways to perform radiation therapy.

  • External radiation therapy. - The use of a large machine to the tumor, the surrounding tissue, or the entire brain.
  • Internal radiation therapy or Brachytherapy. - The use of small, radioactive capsules which are implanted in the brain to provide localized radiation.

A patient experiences nausea after treatment. The scalp and the ears may become red, dry and tender. Loss of hair is common, but hair usually grows back after a few months. Radiation necrosis, which is the killing of healthy brain tissue, may occur. This leads to headaches and seizures, and may possibly lead to death.

Children receiving radiation therapy may experience damage in the pituitary gland, which affects learning, growth and development. The risk of acquiring secondary tumor also increases.


Philippine Scenario

The country’s Food and Drug Administration (FDA)] has approved the drug Bevacizumab as treatment for glioblastoma, a type of primary brain tumor.

References