A brain tumor is a mass or growth of abnormal cells in the brain. Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant).
What’s the Difference Between Benign and Malignant Brain Tumors?
A primary brain tumor is one that originates in the brain, and most primary brain tumors are benign. Benign brain tumors are noncancerous.
Malignant primary brain tumors are cancers that originate in the brain, typically grow faster than benign tumors, and aggressively invade surrounding tissue. Although brain cancer rarely spreads to other organs, it can spread to other parts of the brain and central nervous system.
Symptoms Of Brain Tumors
The signs and symptoms of a brain tumor vary greatly and depend on the brain tumor’s size, location and rate of growth.
General signs and symptoms caused by brain tumors may include:
- New onset or change in pattern of headaches
- Headaches that gradually become more frequent and more severe
- Unexplained nausea or vomiting
- Vision problems, such as blurred vision, double vision or loss of peripheral vision
- Gradual loss of sensation or movement in an arm or a leg
- Difficulty with balance
- Speech difficulties
- Personality or behavior changes
- Seizures, especially in someone who doesn’t have a history of seizures
- Hearing problems
In most people with primary brain tumors, the cause of the tumor is not clear. But here are some factors that may increase the risk of a brain tumor.
Risk factors include:
- Exposure to radiation.People who have been exposed to a type of radiation called ionizing radiation have an increased risk of brain tumor. Examples of ionizing radiation include radiation therapy used to treat cancer and radiation exposure caused by atomic bombs.
- Family history of brain tumors.A small portion of brain tumors occurs in people with a family history of brain tumors or a family history of genetic syndromes that increase the risk of brain tumors.
How Are Brain Tumors Diagnosed?
Sophisticated imaging techniques can pinpoint brain tumors. Diagnostic tools include:
- Imaging studies such as a CT(CAT) scan or MRI to see detailed images of the brain
- Angiogram MRA, which involve the use of dye and X-rays of blood vessels in the brain to look for signs of a tumor or abnormal blood vessels
Sometimes the only way to make a definitive diagnosis of a brain tumor is through a biopsy. A biopsy is required to determine whether or not the tumor is cancer. A biopsy is a sample of tissue removed from the brain either during surgery to remove the tumor or with a needle inserted through a small hole drilled into the skull before treatment is started. The sample is then sent to a lab for testing.
How Are Brain Tumors Treated?
Surgery to remove the tumor is typically the first option once a brain tumor has been diagnosed. To remove a brain tumor, a small opening in made the skull. This operation is called a craniotomy to access the tumor and remove as much of it possible. A drain (EVD) may be left in the brain fluid cavities at the time of surgery to drain the normal brain fluid as the brain recovers from the surgery.
Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor to be treated by radiation therapy or chemotherapy.
Stereotactic biopsy is another procedure that is commonly performed before a craniotomy. This smaller operation allows doctors to obtain tissue in order to make an accurate diagnosis.
Ventriculoperitoneal Shunting may be required for some patients with brain tumors. Everyone has cerebrospinal fluid (CSF) within the brain and spine that is slowly circulating all the time. If this flow becomes blocked, the sacs that contain the fluid (the ventricles) can become enlarged, creating increased pressure within the head, resulting in a condition called hydrocephalus. If left untreated, hydrocephalus can cause brain damage and even death. In this case, a shunt may be used to divert the spinal fluid away from the brain and, therefore, reduce the pressure.
The body cavity in which the CSF is diverted usually is the peritoneal cavity (the area surrounding the abdominal organs). The shunt usually is permanent. If it becomes blocked, the symptoms are similar to that of the original condition of hydrocephalus and may include headaches, vomiting, visual problems and/or confusion or lethargy, among others. Another method that may be used to control obstruction of the brain fluid pathways is called an Endoscopic Third Ventriculostomy. This helps the brain fluid be diverted around the obstruction without the need for a shunt.
Radiation therapy, also called radiotherapy, is the use of high-powered rays to damage cancer cells and stop them from growing. It is often used to destroy tumor tissue that cannot be removed with surgery or to kill cancer cells that may remain after surgery. Radiation therapy also is used when surgery is not possible.
The Gamma Knife or stereotactic radiosurgery, is another way to treat brain tumors. The Gamma Knife isn’t actually a knife, but a radiation therapy technique that delivers a single, finely focused, high dose of radiation precisely to its target. Treatment is given in just one session. High-energy rays are aimed at the tumor from many angles. In this way, a high dose of radiation reaches the tumor without damaging other brain tissue.
Chemotherapy is the use of drugs to kill cancer cells. The doctor may use just one drug or a combination, usually giving the drugs orally or by injection into a blood vessel or muscle. Intrathecal chemotherapy involves injecting the drugs into the cerebrospinal fluid.
Chemotherapy is usually given in cycles. A treatment period is followed by a recovery period, then another treatment period and so on. Patients often don’t need to stay in the hospital for treatment and most drugs can be given in the doctor’s office or clinic. However, depending on the drugs used, the way they are given and the patient’s general health, a short hospital stay may be necessary.
Because treatment for cancer also can damage healthy tissue, it’s important to discuss possible side and long-term effects of whatever treatment is being used. The risk and the possibility of losing certain faculties needs to be explained along with the importance of planning for rehabilitation following treatment. Rehabilitation could involve working with several different therapists, such as:
- Physical therapist to regain strength and balance
- Speech therapist to address problems with speaking, expressing thoughts, or swallowing
- Occupational therapist to help manage daily activities such as using the bathroom, bathing, and dressing