Brain tumor (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Brain is a part of the central nervous system (CNS). It is the center of thought, feeling, memory, speech, vision, hearing, movement, and so on. Brain tumors include any tumor which starts in the brain. The cause of brain tumors is unknown. When person is damaged by the cancer, on one hand tumors can directly destroy brain cells. On the other hand, they can also indirectly damage cells by producing inflammation, compressing other parts of the brain and increasing pressure within the skull. Usual symptoms include epileptic seizures, numbness of part of the body, abnormal movements and an abnormal positioning of the body, fever, headache, etc. Treatments involve surgery, radiation therapy, chemotherapy, and a combination.

What are the symptoms of Brain tumor?
Early brain tumor does not have any symptoms. As the tumor grows larger, people may notice one or more of the following symptoms:


 * Epileptic seizures
 * Decreased sensation of a body area
 * Dysfunctional movement or uncontrollable movement
 * Speech difficulties
 * Double vision or decreased vision
 * Hearing loss
 * Personality and behavior changes
 * Emotional instability
 * Hiccups

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

What are the types of Brain tumor?
Brain tumors are classified depending on the exact site of the tumor, the type of tissue involved, whether they are noncancerous (benign) or cancerous (malignant), and other factors. Sometimes, tumors that start out being less invasive can become more invasive.

Tumors may occur at any age, but many types of tumors are most common in a certain age group. In adults, gliomas and meningiomas are most common.

Gliomas come from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. The gliomas are divided into three types:


 * Astrocytic tumors include astrocytomas (less malignant), anaplastic astrocytomas, and glioblastomas (most malignant).
 * Oligodendroglial tumors also can vary from less malignant to very malignant. Some primary brain tumors are made up of both astrocytic and oligodendrocytic tumors. These are called mixed gliomas.
 * Glioblastomas are the most aggressive type of primary brain tumor.

Meningiomas are another type of brain tumor. These tumors:


 * Occur most commonly between the ages of 40 - 70
 * Are much more common in women
 * Are usually (90% of the time) benign, but still may cause devastating complications and death due to their size or location. Some are cancerous and aggressive.

Other primary brain tumors in adults are rare. These include:


 * Ependymomas
 * Craniopharyngiomas
 * Pituitary tumors
 * Primary lymphoma of the brain
 * Pineal gland tumors
 * Primary germ cell tumors of the brain

Who is at highest risk?
Clinical data has suggested that the development of brain tumor is related to several factors.
 * Radiation exposure
 * Family history
 * Immune system disorders
 * Cell phone use: There has been a great deal of debate in recent years.

When to seek urgent medical care?
Call your health care provider if symptoms of brain tumor develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
 * New, or suddenly develop stupor
 * New, or suddenly develop vision changes
 * New, or suddenly develop speech changes
 * Consciousness disorders

Diagnosis

 * Magnetic resonance imaging (MRI) and biopsy: It is the most valuable test to detect the abnormal in brain. A head MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. Like computed tomography (CT), a contrast agent may be injected into a patient’s vein to create a better picture.


 * Computed tomography (CT) scan and biopsy: Head CT scans are often used to diagnose brain tumor. It can confirm the location of the cancer and show the surroundings nearby, as well as lymph nodes and distant organs where the cancer might have spread. These are helpful for determining the stage of the cancer and in determining whether surgery is a good treatment option. CT scans can also be used to guide biopsy and a biopsy sample is usually removed and looked at under a microscope.


 * Positron emission tomography (PET) scan: When doing this test, a small amount of a radioactive medium is injected into your body and absorbed by the organs or tissues. This radioactive substance gives off energy which in turn is used to produce the images. PET can provide more helpful information than either CT or MRI scans. It is useful to see if the cancer has spread to the lymph nodes and it is also useful for your doctor to locate where the cancer has spread.


 * Chest X-ray: This plain x-ray of your chest may be done to see if the cancer has spread to your lungs.


 * Whole bone scan: The goal of a whole body bone scan is to show if a cancer has metastasized to your bones.

Treatment options
Patients with brain tumor have many treatment options. The selection depends on the stage of the tumor. The options are surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these methods. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.


 * Surgery: If your stage and general health permitted, the neurosurgeon recommends to remove as much of the tumor as safe without affecting normal brain function.


 * Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.


 * Chemotherapy: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Usual used drugs include carboplatin, carmustine, cisplatin and etoposide.


 * Targeted therapy: This treatment is to use targeted drugs, such as bevacizumab, to aim at the gene changes in cells that cause cancer.

Diseases with similar symptoms

 * Essential seizures
 * Stroke
 * Chronic subdural hematoma
 * Meningitis
 * Orbital optic neuritis
 * Intraocular optic neuritis

Where to find medical care for Brain tumor?
Directions to Hospitals Treating Brain tumor

Prevention of Brain tumor
The cause of brain tumor is not clear. So most of these tumors cannot be prevented at this time.

What to expect (Outlook/Prognosis)?
The prognosis of brain tumor depends on the following:
 * Whether or not the tumor can be removed by surgery
 * The location of the tumor
 * The stage of the cancer: the size of the tumor, whether the cancer has spread outside the brain
 * Whether the cancer has just been diagnosed or has recurred
 * The patient’s general health

Possible complications

 * Brain herniation (often fatal)
 * Uncal herniation
 * Foramen magnum herniation
 * Loss of ability to interact or function
 * Permanent, worsening, and severe loss of brain function
 * Return of tumor growth
 * Side effects of medications, including chemotherapy
 * Side effects of radiation treatments

Source
http://www.nlm.nih.gov/medlineplus/ency/article/007222.htm