Brain tumors:  Symptoms, Signs, Types, Causes, Treatments, and Survival Rates




Brain tumor :

Normal cells grow in a controlled manner as new cells replace old or damaged ones. For reasons not fully understood, tumor cells reproduce uncontrollably. When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

A primary brain tumor is an abnormal growth that starts in the brain and usually does not spread to other parts of the body. Primary brain tumors may be benign or malignant.

A benign brain tumor grows slowly, has distinct boundaries, and rarely spreads. Although its cells are not malignant, benign tumors can be life threatening if located in a vital area.

A malignant brain tumor grows quickly, has irregular boundaries, and spreads to nearby brain areas. Although they are often called brain cancer, malignant brain tumors do not fit the definition of cancer because they do not spread to organs outside the brain and spine. 


There are over 120 different types of brain tumors. Common brain tumors include:

  • Astrocytoma 
  • Pilocytic Astrocytoma (grade I)
  • Diffuse Astrocytoma (grade II)
  • Anaplastic Astrocytoma (grade III)
  • Glioblastoma Multiforme (grade IV)
  • Oligodendroglioma (grade II)
  • Anaplastic Oligodendroglioma (grade III)
  • Ependymoma (grade II)
  • Anaplastic Ependymoma (grade III)


What causes brain tumors ?

Medical science neither knows what causes brain tumors nor how to prevent primary tumors that start in the brain. People most at risk for brain tumors include those who have:
      1. cancer elsewhere in the body
      2. prolonged exposure to pesticides, industrial solvents, and other chemicals
      3. inherited diseases, such as neurofibromatosis
      What are the symptoms?


      Tumors can affect the brain by destroying normal tissue, compressing normal tissue, or increasing intracranial pressure. Symptoms vary depending on the tumor’s type, size, and location in the brain.

      General symptoms include: 


        • headaches that tend to worsen in the morning
        • seizures
        • stumbling, dizziness, difficulty walking
        • speech problems (e.g., difficulty finding the right word)
        • vision problems, abnormal eye movements
        • weakness on one side of the body
        • increased intracranial pressure, which causes drowsiness, headaches, nausea and vomiting, sluggish responses
        some symptoms include:

        2. Occipital lobe tumors may cause: vision loss in one or both eyes, visual field cuts; blurred vision, illusions, hallucinations
        3. Temporal lobe tumors may cause: difficulty speaking and understanding language; short-term and long-term memory problems; increased aggressive behavior
        4. Brainstem tumors may cause: behavioral and emotional changes, difficulty speaking and swallowing, drowsiness, hearing loss, muscle weakness on one side of the face (e.g., head tilt, crooked smile), muscle weakness on one side of the body, uncoordinated gait, drooping eyelid or double vision, and vomiting.
        5. Parietal lobe tumors may cause: impaired speech; problems writing, drawing or naming; lack of recognition; spatial disorders and eye-hand coordination.

            • Pituitary gland tumors may cause: increased secretion of hormones (Cushing’s Disease, acromegaly), a stop in menstruation, abnormal secretion of milk, and decreased libido.
            • Frontal lobe tumors may cause: behavioral and emotional changes; impaired judgment, motivation or inhibition; impaired sense of smell or vision loss; paralysis on one side of the body; reduced mental abilities and memory loss. 

            Who is affected?

            The American Brain Tumor Association estimates that about 80,000 people will be diagnosed with a primary brain tumor in the US this year. Metastatic (secondary) brain tumors are five times more common than primary brain tumors and they occur in 10% to 30% of cancer patients. People are surviving cancer longer than ever before. As a result, metastatic brain tumors will likely increase in the years to come. Although brain tumors can occur at any age, they are most common in children 3 to 12 years old and in adults 40 to 70 years old.


            Who treats brain tumors?

            There are so many kinds of brain tumors and some are complex to treat, many doctors may be involved in your care. Your team may include a neurosurgeon, oncologist, radiation oncologist, radiologist, neurologist, and neuro-ophthalmologist.


            What treatments are available?


            Treatment options vary depending on the type, grade, size and location of the tumor; whether it has spread; and your age and general health. The goal of treatment may be curative or focus on relieving symptoms (palliative care). Treatments are often used in combination with one another. The goal is to remove all or as much of the tumor as possible through surgery to minimize the chance of recurrence. Radiation therapy and chemotherapy are used to treat tumors that cannot be removed by surgery alone. For example, surgery may remove the bulk of the tumor and a small amount of residual tumor near a critical structure can later be treated with radiation. 


            How are brain tumors diagnosed?

              1. Neurologic exam: Your doctor checks your vision, hearing, alertness, muscle strength, coordination, and reflexes. Your doctor also examines your eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.
              2. MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your head. Sometimes a special dye (contrast material) is injected into a blood vessel in your arm or hand to help show differences in the tissues of the brain. The pictures can show abnormal areas, such as a tumor.
              3. CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head. You may receive contrast material by injection into a blood vessel in your arm or hand. The contrast material makes abnormal areas easier to see. Your doctor may ask for other tests:
              4. Angiogram: Dye injected into the bloodstream makes blood vessels in the brain show up on an x-ray. If a tumor is present, the x-ray may show the tumor or blood vessels that are feeding into the tumor.

              Recovery & prevention

              1. Self care
              Your primary care doctor and oncologist should discuss any home care needs with you and your family. Supportive measures vary according to your symptoms. For example, canes or walkers can help those having trouble walking. A plan of care to address changes in mental status should be adapted to each patient’s needs.
              Driving privileges may be suspended while taking anti-seizure medication. As each state has different rules about driving and seizures, discuss this issue with your doctor.
              It may also be appropriate to discuss advance medical directives (e.g., living will, health care proxy, durable power of attorney) with your family to ensure your medical care and wishes are followed.

              2. Rehabilitation

              Because brain tumors develop in parts of the brain that control movement, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Although the brain can sometimes heal itself after the trauma of treatment, it will take time and patience. A neuropsychologist can help patients evaluate changes caused by their brain tumor and develop a plan for rehabilitation. A neuropsychological evaluation assesses the patient's emotional state, daily behavior, cognitive (mental) abilities, and personality. 
              Physical therapy, occupational therapy, and speech therapy may be helpful to improve or correct lost functions. 


              3. Recurrence

              How well a tumor will respond to treatment, remain in remission, or recur after treatment depends on the specific tumor type and location. A recurrent tumor may be a tumor that still persists after treatment, one that grows back some time after treatment destroyed it, or a new tumor that grows in the same place as the original one.
              When a brain tumor is in remission, the tumor cells have stopped growing or multiplying. Periods of remission vary. In general, benign tumors recur less often than malignant ones. 
              Since it is impossible to predict whether or when a particular tumor may recur, lifelong monitoring with MRI or CT scans is essential for people treated for a brain tumor, even a benign lesion. Follow-up scans may be performed every 3 to 6 months or annually, depending on the type of tumor you had.


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