Brain Tumors

Brain tumors, like all tumors, fall into two broad categories, benign and malignant. A benign tumor is usually contained and does not spread, but that doesn't mean it isn't dangerous. According to the Brain Tumor Society (TBTS), brain tumors - even benign brain tumors - can recur and they can kill. (Read about "The Brain")

Malignant or cancerous brain tumors are even more dangerous. (Read about "Cancer: What It Is") More than 17,000 people in the United States this year will be diagnosed with a malignant brain tumor. Thirteen thousand will die. The difficulty of complete surgical removal also means that the cancer usually grows back. Right now, there are no blood tests or screenings available to detect brain cancer early, according to the American Cancer Society (ACS). (Read about "Cancer Check-ups") Survival depends more on the type and location of the tumor, than early detection.

Who is at risk

Anyone at any age can develop a brain tumor, but according to the National Cancer Institute (NCI), they are most common in two age groups: children aged 3-12 and adults aged 40-70.

In addition, most brain tumors happen for no apparent reason and because the cause is not known, it is not really preventable. However, NCI says some studies have revealed certain risk factors that may increase a person's chance of developing a brain tumor. People with these risk factors have a higher-than-average risk of developing a brain tumor. For example, some studies have shown brain tumors occur more often among workers in certain industries, like oil refining, rubber manufacturing and drug manufacturing. Other studies are underway to see if genetics or heredity might increase a person's risk. (Read about "Genetics") Right now, researchers do not believe that head injuries cause brain tumors to develop. (Read about "Head Injury")

Symptoms

Brain tumors can be difficult to diagnose because the symptoms are similar to many other problems. Also, if a tumor is slow growing, the symptoms could develop over a long period of time. Symptoms can sometimes show up as problems in other portions of the body such as numbness in legs or arms. If a tumor is blocking the flow of cerebrospinal fluid within the brain, hydrocephalus occurs. (Read about "Hydrocephalus") Hydrocephalus causes increased pressure within the skull, and this can damage the brain.

Pressure from a growing tumor, according to ACS, can cause specific symptoms such as a headache. (Read about "Headaches") ACS says 50 percent of all brain tumors cause headaches, but it is important to realize that less than 1 percent of headaches are the result of brain tumors. Here are some other things to watch out for according to ACS and NCI:

• seizures (Read about "Seizures")
• nausea and vomiting
• weakness or loss of feeling in the arms and legs
• stumbling or lack of coordination in walking
• abnormal eye movements or changes or blurriness in vision (Read about "The Eye")
• hearing problems such as ringing or buzzing (Read about "Tinnitus")
• drowsiness
• changes in personality, behavior or memory
• changes in communication skills such as speech and writing (Read about "Aphasia")

These symptoms could be an indication of a brain tumor or other problems such as stroke. (Read about "Stroke") Only a doctor can make a diagnosis. If you suffer any of these symptoms, you should seek medical help right away.

Types of brain tumors

There are two main types of brain tumors, primary and secondary. Secondary tumors, usually called metastatic tumors, are cancers that started elsewhere in the body and spread to the brain. Metastatic tumors are more common, according to ACS, and may be treated differently.

Primary brain tumors are those tumors that actually start in the brain. TBTS says that 44 percent of primary brain tumors are benign. Primary brain tumors are classified by grade, which refers to the way the cells look under a microscope. For example, cells from a grade IV tumor are more abnormal looking and generally grow faster than cells from lower grade tumors. Brain tumors are also classified by the type of tissue in which they begin. The most common brain tumors are classified as gliomas, which begin in the glial (supportive) tissue.

Some of the different types of brain tumors, according to NCI, include:

• Astrocytomas arise from small, star-shaped cells called astrocytes. This type of glioma may grow anywhere in the brain or spinal cord. (Read about "Nervous System") In adults, astrocytomas most often arise in the cerebrum. In children, they occur in the brain stem, the cerebrum and the cerebellum. A grade III astrocytoma is sometimes called anaplastic astrocytoma. A grade IV astrocytoma is usually called glioblastoma multiforme.
• Brain stem gliomas occur in the lowest, stem like part of the brain. The brain stem controls many vital functions. Tumors in this area generally cannot be removed, according to NCI. Most brain stem gliomas are high-grade astrocytomas.
• Ependymomas usually develop in the lining of the ventricles and may also occur in the spinal cord. This is another type of glioma, according to NCI. Although these tumors can develop at any age, they are most common in childhood and adolescence.
• Medulloblastomas are sometimes called primitive neuroectodermal tumors (PNET). Most medulloblastomas arise in the cerebellum; however, they may occur in other areas as well. These tumors occur most often in children and are more common in boys than in girls. NCI says it is believed that medulloblastomas develop from primitive (developing) nerve cells that normally do not remain in the body after birth.
• Meningiomas grow from the meninges, which are the membranes that cover and protect the brain and spinal cord. NCI says they are usually benign. Because these tumors grow very slowly, the brain may be able to adjust to their presence; meningiomas often grow quite large before they cause symptoms. They occur most often in women between 30 and 50 years of age.
• Schwannomas are benign tumors that begin in Schwann cells, which produce the myelin that protects the acoustic nerve, which is the nerve of hearing. (Read about "The Ear and Hearing") Acoustic neuromas (Read about acoustic neuromas in "Balance Disorders") are a type of schwannoma. They occur mainly in adults. These tumors affect women twice as often as men.
• Craniopharyngiomas develop in the region of the pituitary gland near the hypothalamus. They are usually benign; however, they are sometimes considered malignant because they can press on or damage the hypothalamus and affect vital functions. These tumors occur most often in children and adolescents. (Read about "Endocrine System")
• Germ cell tumors arise from primitive (developing) sex cells, or germ cells. The most frequent type of germ cell tumor in the brain is the germinoma.
• Pineal region tumors occur in or around the pineal gland, a tiny organ near the center of the brain. (Read about "Endocrine System") The tumor can be slow growing (pineocytoma) or fast growing (pineoblastoma). The pineal region is very difficult to reach, and these tumors often cannot be removed.
• Oligodendrogliomas arise in the cells that produce myelin, the fatty covering that protects nerves. This type of glioma usually arises in the cerebrum, grows slowly and usually does not spread into surrounding brain tissue. Oligodendrogliomas are considered rare. NCI says they are more common in middle-aged adults but have been found in all age groups. (Read about "Nervous System")

Diagnosis and treatment

A number of tests can be used to test for brain tumors. In addition to a physical and neurological examination, they include x-rays, CT scans, MRI and biopsy. (Read about "X-rays" "CT Scan - Computerized Tomography" "MRI - Magnetic Resonance Imaging" "Biopsy")

If a brain tumor is diagnosed, there are several types of treatment available. (Read about "Cancer Treatments") More than one treatment may be used depending on the patient's needs.

Surgery is the usual treatment for most brain tumors. (Read about "Neurosurgery") Surgery to open the skull is called a craniotomy. It is performed under general anesthesia. (Read about "Anesthesia") Doctors will remove as much of the tumor as possible. If the entire tumor cannot be removed, another treatment may be used to destroy the rest of it.

Radiation therapy uses high-powered x-rays to damage cancer cells and stop them from growing. It is used to destroy tumors that cannot be removed surgically, or to kill cancer cells that may remain after surgery. (Read about "Radiation Therapy")

Stereotactic radiosurgery or radiotherapy is another option. It uses robotics and multiple beams of high-power energy to target the cancer cells. Stereotactic radiosurgery is very precise and can help save surrounding tissue from damage. In spite of its name, it is not an actual surgical procedure, but rather a form of radiation therapy.

Chemotherapy uses powerful drugs to destroy cancer cells. One drug may be used, or a combination of drugs. They may be given by mouth or by injection. Chemotherapy is usually given in cycles; a treatment period followed by a recovery period. It usually does not require hospitalization, but might, depending on the patient's needs.

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

Proton beam radiation therapy is a type of high-energy, external radiation therapy that uses streams of protons (small, positively-charged pieces of matter) to make radiation. This type of radiation kills tumor cells with little damage to nearby tissues. It is used to treat cancers of the head, neck, and spine and organs such as the brain, eye, lung, and prostate. Proton beam radiation is different from x-ray radiation.

Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy. (Read about "The Immune System")

Other options

There are also clinical trials. (Read about "Clinical Studies") These are studies to test new cancer treatments and determine their effectiveness. These carry some risk because no one involved in the study knows in advance if the treatment will work or what the side effects might be. Still, taking many factors into account, a patient may decide that a clinical trial will be beneficial for them. However, not every patient is eligible for clinical trials. If you have questions about this form of treatment, you can talk to your doctor.

Once you have a diagnosis and treatment plan, you may want a second doctor to review it. When you visit your doctor, it can be helpful to bring a list of questions, take notes and even bring a family member or friend along.

Rehabilitation

A brain tumor often affects a person ability to function. It may impact movement, speech or other bodily functions. Rehabilitation is an important part of any treatment program for brain cancer. The sooner it is begun the better the chances of recovery of function. (Read about "Rehabilitation")

More Cancer Information:

    Cancer & Children

    Cancer Check-ups

    Cancer Support

    Cancer Treatments

    Reduce Cancer Risks

    Cancer Glossary

For a list of individual types of cancer, see Cancer: What It Is

Related Information:

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