June is known as the Brain Tumour Month worldwide. It s worthwhile to raise public awareness and educate people about brain tumour, a disease which, though is rare is but can be really deadly. More than 500 new cases are diagnosed with brain tumour every day worldwide. The number of patients with secondary tumours are even higher than 500. However, it is common across all ages.  A primary brain tumour is a tumour that begins in the brain. It can be either malignant, which means it contains cancer cells or benign i.e. does not contain cancer cells. A secondary or metastatic brain tumour is usually cancerous. It starts elsewhere in the body and sends cancerous cells which grow in the brain.

Here are a few facts that each one of us should know about this dangerous disease

Brain tumours can occur at any age.
We don t know what causes brain tumors. Family history and high dose radiation like X-rays increases your risk.
Doctors group brain tumors by grade which means the way the brain cells look under a microscope. A higher grade number means the cells appear more abnormal and the more aggressively the tumour usually behaves.
Brain tumors are graded as grade I, grade II, or grade III, or grade IV.
Symptoms
The symptoms of brain tumour depend on the size, type, and location of the brain tumour. Some common symptoms which should not be ignored are-

Headaches
Seizures
Problems with vision
Vomiting
Mental and personality changes
Balance problems and trouble walking
Problems in speaking
Diagnosis
Brain tumours are diagnosed by the doctor based on the medical history and physical examination along with a slew of specialized tests of the brain and nervous system.

Treatment

Surgery
Radiation therapy
Chemotherapy
Anti-seizure medicines
Steroids
Ventricular peritoneal shunt
Combination of treatments
How can you safeguard yourself?
The primary tool to prevent brain tumours is by controlling your lifestyle. This means eating healthy, exercising, avoiding known carcinogens in your environment, and reducing stress.

Sleep: Sleep is a friend for brain health. An adequate amount of rest with eyes shut keeps your brain health.
Frankincense oil: Along with yoga, meditation, and breathing exercises to reduce stress, inhaling frankincense oil can help alleviate inflammation in the brain.
Anti cancer diet: Consuming a diet rich in cancer-fighting nutrients like antioxidants is critical in preventing brain tumors.
Ketogenic diet: A ketogenic diet is a high protein diet. It reduces oxidative stress and inflammation in the brain which is associated with brain tumours. It also shuts down the nutrient supply to tumors.
Calorie restriction: Dietary restriction, especially fasting has anti-carcinogenic properties just as the ketogenic diet.
Limit exposure to mobile phones: Cell phones use increases risk for brain tumours. So restriction prevents these tumours.

World Brain Tumor Day - 6 Tips To Help You Prevent Yourself Against It!

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Brain tumours vary in shape and size and the same is the case with their symptoms. The location of the tumour affects the symptoms greatly. Just like in any other type of a malignant tumour, brain tumour has a rapid growth and proliferation of abnormal cells that may have its origin in affected site or areas adjacent to it. As per studies, every 2 in 1,00,000 people are said to be affected by brain tumour in India. However, it may come as a relief to some as not all brain tumors are cancerous or life threatening. Some are benign tumors and seldom pose any threat to the affected individual.

Types of Brain Tumor
Brain tumors may be primary or secondary.

Primary brain tumor: Here the abnormal mass of cells that originated in the brain do not metastasize to the other organs. Based on their location in the brain, the primary brain tumors may be of the following types.
Gliomas: One of the most common types of primary brain tumors, gliomas can have their origin in the spinal cord or the brain. Some of the common types of gliomas include Astrocytomas (originates in the cerebrum of the brain), Glioblastomas (these tumors form from the Astrocytes which form the supportive tissues of the brain), Ependymoma (these develop from the ependymal cells which are present within the CNS), Oligodendrogliomas (these tumors are found to arise from the oligodendrocytes).
Schwannomas: Also called as Acoustic neuromas, these primary brain tumors form on the nerves that play an important role in regulating the balance and hearing from the inner ear to the brain.
Meningiomas: These type of tumors are usually benign and have their origin in the meninges (membranes surrounding the spinal cord and the brain).
Primitive neuroectodermal tumors (PNETs): Primitive neuroectodermal tumors (PNETs) are rare malignant tumors that originate from the fetal (embryonic) cells in the brain.
Pituitary adenomas: As the name suggests, these tumors arise from the pituitary gland located at the base of the brain.
Medulloblastomas: Common among the children, these malignant primary tumors develop in the brain (lower back) and gradually spread via the spinal fluid.
Other types of primary brain tumors include Craniopharyngiomas and the Germ cell tumors.
Secondary brain tumors: Unlike the primary brain tumors, these tumors have their origin in the other body parts and organs (mostly in the lungs, skin, colon, breast, and kidney) and then gradually metastasize to the brain. The secondary brain tumors are found to be more common.
Symptoms or warning signs associated with brain tumors:
Some of the signs and symptoms that may be indicative of a brain tumor include

People with brain tumors often get seizures (due to the irritation caused by the tumors in the brain).
A headache (mild to severe depending on the part of the brain affected by the tumor).
A person experiences numbness or a tingling sensation in the legs and arms.
There may be difficulties in walking or balancing.
A person finds it difficult to concentrate.
There may be some problems with hearing, speech or even vision.
A person may experience weakness restricted to only one part of the body.
The symptoms may not necessarily indicate a brain tumor but it is always wise not to neglect the symptoms either.

Brain Tumor - What Are The Types?

There is no trustworthy evidence regarding what causes brain tumors, but there are a few risk factors that have been substantiated through research. Children and young people who receive radiation around the head are susceptible to developing tumors in the brain once they grow up. Also, people with a certain kind of rare genetic condition like neurofibromatosis may develop a brain tumor though such cases are very few in number. Age is also an important factor as people aged over 65 years are diagnosed with brain tumors at quadruple times higher than children and younger people.

Types of Brain Tumours-

A primary brain tumor originates in the brain, and they may or may not be cancerous. Some tumors can be benign, which do not spread in the surrounding tissues and are not very malicious. However, that does not signify that they will not cause any harm over time. Sometimes these tumors can be severe and cause a threat to the life of the sufferer. The National Cancer Institute reports that approximately there were 23, 380 fresh cases of brain tumors in 2014.

Identifying the Symptoms of Brain Tumors...

The symptoms of the brain tumor are dependent on various factors such as the size, type as well as the exact location of the tumor. These symptoms are triggered when any tumor is pressed or clashed against a nerve or disturbs a part of the brain. Symptoms are also felt when any tumor particle blocks the fluid flowing around the brain or when there is a swelling in the brain owing to the build-up of fluid.

Common symptoms include- headaches that get worse in the morning, nausea along with vomiting, an alteration in the speech, hearing and imbalances in walking and movement, mood swings, change in personality and ability to concentrate or remember things and seizures or convulsions.

Treatment for Brain Tumor-

Surgery is normally the most usual treatment for brain tumors, and the patient is given anaesthesia, and the scalp is shaved before the surgery. Then, craniotomy is performed to open the skull, and the surgeon removes a bone piece out of the skull. Then the tumor is removed as much as possible. The bone is then restored back, and the incision on the scalp is closed. Sometimes surgery is not viable in case the tumor has developed in the brain stem or some other complex parts.

Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it (called partial removal). Even partial removals can relieve symptoms and facilitate or increase the effectiveness of other treatments.

The role of surgery in treating brain tumors

Surgery can provide:

- The complete removal of some brain tumors
- A sample to enable doctors to diagnosis the tumor and recommend the most appropriate treatment
- Better quality of life:
- Reduced symptoms and improved ability to function (e.g., to think, speak or see better)
- Less pressure within the skull from the tumor
- A longer life

In case you or any of your near ones is affected with brain tumor, you should visit the doctor to know the possible treatments other than surgery and other important questions related to brain tumor.

Brain Tumor - Causes, Symptoms and Treatment

A tumor is an uncontrolled and abnormal growth of cells. A brain tumor is thus an abnormal growth and multiplication of cells in the brain. The cell growth can also be in areas adjacent to the brain. The brain tumor may

Have its origin in the brain (Primary brain tumor), or
Its origin may be in some other parts or organs of the body, which gradually spreads to the brain (Secondary/metastatic brain tumor).
Not all brain tumors are harmful and life threatening.

Brain tumors that exist as noncancerous cell growths are known as Benign brain tumors. Benign brain tumors seldom pose any threat to life.

Brain tumors that are cancerous and, thus, harmful, are known as Malignant brain tumors.

Do not neglect any brain tumors (malignant or not). It is better to be safe than to be sorry.

Types of Primary brain tumors:

Based on its cell of origin, primary brain tumors (benign as well as malignant) may be of the following types:

Meningiomas: Brain tumors that originate from the meninges (the membranes that cover the brain and the spinal cord). Meningiomas are seldom malignant.
Acoustic Neuromas: A noncancerous cell growth that has its origin in the vestibulocochlear nerve (the eighth cranial nerve). This nerve connects the brain with the inner ear.
Gliomas: Here, the tumor has its origin in the brain and the spinal cord (glial cells). This type of brain tumors, in most cases (~80%), are malignant.
Primitive Neuroectodermal Tumors (PNETs): Extremely rare, PNETs are malignant tumors that develop in the embryonic cells in the brain.
Medulloblastomas: Medulloblastomas is a malignant brain tumor that mostly affects children. It originates in the cerebellum (lower part of the brain).
Craniopharyngiomas: A benign brain tumor that has its origin near the pituitary gland (base of the brain). Craniopharyngiomas are common in children.
Probability of a secondary brain tumor are more in people who have had;

Kidney cancer
Breast cancer
Lung cancer
Colon cancer
Melanoma
Symptoms:

The symptoms of brain tumor include:

Chronic and regular headaches.
A change in the headache pattern.
Seizures.
A person may experience vision problems (Peripheral vision may be affected, double or blurred vision).
There may be difficulty in hearing.
Nausea and vomiting.
Behavioral and speech problems.
An arm or a leg may lose sensation.
A person has difficulty with balance.
Diagnosis and Treatment:
Though brain tumor can affect anyone and everyone, its chances are higher in

People who are more exposed to ionizing radiation. People having undergone a radiation therapy are equally vulnerable.
Children as well as older people.
People having a family history of brain tumors.
The diagnosis includes;

An imaging test like the MRI, CT scan and PET (Positron Emission Tomography).
Biopsy, whereby samples of the abnormal tissue is collected and examined.
Neurological examination.
Treatment:

Surgery is an effective treatment for brain tumors.
One can also opt for:

Radiations, whereby the abnormal tumor cells are destroyed using protons and x-rays (high-energy beams).
Chemotherapy: In this treatment, the tumor cells are destroyed using strong drugs (taken orally or intravenously).
Radiosurgery.
Targeted drug therapy: This treatment blocks the abnormalities that are characteristically present only in the cancer cells.

Brain Tumors: Types, Symptoms, Diagnosis, and Treatment

Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

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