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Brain Tumor

Overview

A cluster or bunch of abnormal cells in the brain (Malignant or non-malignant) is called a brain tumor or intracranial tumor. This abnormal growth, division, or collection of cells can primarily start in the brain or result from spreading any other tumor from somewhere else in the body. It is one of the life-threatening entities.

Causes

Defects in certain genes cause an uncontrollable division of cells, resulting in a brain tumor. Certain environmental factors can progress this division and result in an aggressive form of brain tumor. Among these factors, the most important include radiations or previous cancer treatment.

Types

There are many types of brain tumors, but they are subcategorized into two according to their origin and spread.

 1. Primary brain tumors.

 2. Secondary brain tumors.

1. Primary Brain Tumors

These tumors are the ones originating inside the brain cells. Most primary brain tumors are benign and not malignant (i.e., they do not metastasize). The primary brain tumor can originate from several locations in the brain; For example, it can arise from brain cells or meninges or nerves, or even in the glands within the brain. The Commonest type of primary brain tumors in adults are astrocytoma, meningioma, and oligodendroglioma. The list includes medulloblastoma, glioma, ependymoma, and brainstem glioma in children. 

Primary tumors are divided into

a.Glial tumors(originating in glial cells)

b.Non-glial tumors(develop in the brain, nerve, blood vessels, glands)

These can be Benign or Malignant tumors.

Types of benign tumors.

  • Chondroma’s
  • Craniopharyngioma
  • Gangliocytomas
  • Glomus jugulare
  • Meningioma’s
  • Pineocytomas
  • Pituitary adenomas
  • Schwannomas

Types of malignant tumors.

  • Astrocytomas
  • Epindyomas
  • Glioblastoma multiforme
  • Medulloblastoma
  • Oligodendrogliomas

2. Secondary Brain Tumours

These brain tumors are due to the spread of other cancers in the body. For example,  cancers of the lung, breast, kidney, thyroid gland, or skin.

Grading system by WHO: These grades are according to the histological features of the tumor. Grade one and Grade 2 are low-grade tumors. Whereas grade three and grade four are high-grade tumors. These could be Most malignant characterized by Rapid growth, widely infiltrative, with possible recurrence, and necrosis prone.

Risk Factors

Having one or more of the following factors can increase your chances of getting a brain tumor.

  • Age ( Common in children).
  • Gender (common in men).
  • Hereditary.
  • Exposure to Electromagnetic fields.
  • Race and ethnicity (Common in white people than black)
  • Exposure to Ionization radiation.
  • Head injury.
  • Seizures.
  • Exposure to infections, viruses, and allergens.
  • Exposure to N-nitroso compounds.

Epidemiology

The rate of occurrence of brain tumors is higher in developed countries than in developing countries. The incidence of primary malignant tumors is more in males than females. The yearly incidence of brain tumors in the world population is 7 per 100000. It is more common in white people than black and other races. Almost 30,000 and 35,000 new cases of primary brain tumors are diagnosed every year in the United States. American Cancer Society reports that some brain cancers have five years or longer survival rates between ages 20 and 44.

Signs And Symptoms

Some common signs and symptoms include;

  • headaches, 
  • vomiting, 
  • double vision, 
  • confusion, 
  • seizures. 
  • Weakness of part of the face or the limb.
  • Altered mental state 
  • memory loss 
  • confusion, 
  • difficulty in writing or reading. 
  • Decrease alertness, 
  • altered ability to smell or 
  • loss of balance
  • hand tremors, 
  • blurred vision, 
  • clumsiness, 
  • sensory changes like numbness and tingling, 
  • Drooping of eyelids, 
  • uncoordinated pupils, 
  • personality changes.

Diagnosis

Your doctor may take your history by asking questions about your symptoms and perform a complete physical and neurological examination to make a diagnosis. You may be advised on undergoing the following tests;

  • Computer tomography scan. (CT scan )
  • Magnetic resonance imaging. ( MRI scan)
  • Angiogram.
  • Spinal Tap.
  • Biopsy
  • Skull X-ray.

Differential Diagnosis

The signs and symptoms of a brain tumor may mimic any of the following conditions;

  • Acute subdural hematoma, 
  • Epidural hematoma 
  • hemorrhagic stroke 
  • ischemic stroke 

Treatment

Depending on the type, location, size, and grade of the tumor, you may be offered the following treatment options;

  • Surgery:

If the tumor is localized and in the initial stages, surgery is the best management choice without any delay. As slow-growing tumors can be treated with surgery alone. Some tumors, despite being benign, are closer to the sensitive areas of the brain and are risky to remove. So for this, the surgeon tries to remove the safest possible portion. Even by removing its specific part, there is a massive reduction of deteriorating signs and symptoms. Significant risks related to tumor extraction are infections and bleeding. If a Tumor is close to the optic tract, the risk of eyesight loss is also possible.

  • Radiation therapy:

 In this type of treatment, X-rays are used to kill the dividing tumor cells. Proton beam therapy is also successful as it helps the doctor control the number of radiations. It is very helpful in children and when the tumor is close to delicate areas of the brain. Hearing loss or memory loss could be a major side effect.

  • Radiosurgery

Gamma knife and linear accelerator radiosurgery techniques are used frequently nowadays.

  • Chemotherapy

Drugs are given orally and intravenously.

  • Biologic drugs.

It includes the drug Bevacizumab, which Inhibits the growth of blood vessels that help tumors grow.

Prognosis

The prognosis of brain tumors depends on the type, size, grade, and location of the tumor. General Health and underlying medical conditions also play a major role in the outlook of disease. Survival is a maximum of 10 years.

Lifestyle Modification

The following measures can be taken to prevent yourself from getting the tumor;

  • Least exposure to pesticides and insecticides.
  • Avoid smoking.
  • Avoid exposure to carcinogenic chemicals.
  • Avoid radiation exposure.
  • Healthy diet.
  • Vitamin and mineral supplementation.
  • Avoid alcohol
  • Living a stress-free life and avoiding a sedentary lifestyle.