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

A brain tumor can occur at any age and it generally occurs in people in the age group of 40-60 years. The common types of brain tumor are termed as meningioma and gliomas. These supratentorial brain tumors generally occur above the covering of the cerebellum tissue. In children, brain tumors occur at the age of 1-12 years and the most common tumors are ependymomas, astrocytoma and meduloblastomas. Brain tumor is the common cause of death even in children.

Tips to Detecting a Brain Tumor

The general symptoms that are indications of a brain tumor include severe headaches, memory changes, nausea, drowsiness, sleep problems, fatigue and sudden involuntary movements of muscles of an individual. The symptoms can be either specific or generic and the general symptoms are mainly caused by the pressure of the tumor on the brain. The specific symptoms on the other hand are caused when specific parts of the brain does not function properly. Many people even experience loss of control of body functions.

The other problems that are experienced by individuals include changes in the ability to perform daily activities and loss of balance. They find difficulty in hearing, speech and at times are very aggressive. If these symptoms exist, then your doctor would recommend a physical examination and ask about your health history and that of your family.

Tests to Detect Brain Tumor
The tests that are advised by doctors to detect a brain tumor include MRI, neurologic exam, CT scan, biopsy, angiogram and spinal tap.

In the neurologic exam the vision, alertness, hearing, coordination, muscle strength and reflexes are checked by the doctor. The doctor also checks for any swelling in the eyes which can be caused by the pressing of the nerve which connects the brain and the eye.

The CT scan done for detecting brain tumor provides detailed pictures of your head and it is done through an X-ray machine which is connected to a computer. The contrast material is injected into the blood vessel of your hand and abnormal areas can be seen easily.

Biopsy
In this method tissues from the brain are removed and tested for tumor cells. The cells are observed by a pathologist under a microscope mainly to check for abnormal cells. The biopsy method is used to show tissue changes that can further lead to cancer. Brain tumor can be easily diagnosed with this method.

MRI:
Magnetic Resonance Imaging or MRI as it is commonly referred to is of great use as it helps to diagnose brain tumors. In this procedure, a dye is injected through a vein in the arm using which the variances in the tissues of the brain can be identified.

Consult your doctor today for more information on the same.

Tips For Detecting A Brain Tumor!

Grading of brain cancer is entirely different as compared to the staging of other cancers in the body. Cancer in the breast, lung, colon etc. are staged depending on the possible spread, location of a tumor and lymph node involvement etc. However, brain tumors are graded based on the aggressiveness of the tumor cells under a microscope. The resect ability and the grade of the tumor cells guide a doctor on the treatment decisions. The decision of a brain surgery depends on factors such as the location, spread of a tumour and the general health of the patient.

Types of Brain Tumor Grading:

Grade 1 tumor- These sets of tumors are medically known as the juvenile pilocytic astrocytoma and subependymoma. They are slow growing and non-invasive. There is a likelihood of the patient getting cured with surgery.
Grade 2 tumor- These are brain tumors that do not possess dead cells as part of the tumour. But, they do portray a lot of abnormal cells. Tumors of this type can be categorized under oligodendroglioma, astrocytoma, and ependymoma.
Grade 3 tumor- Tumors of this type are graded based on the cell type of the cancer cells. For instance, an anaplastic astrocytoma is a grade 3 tumor that has no dead cells but possesses dividing cells. In contrast, anaplastic ependymoma and anaplastic oligodendroglioma are grade 3 tumor cells that have dead cells in them.
Grade 4 tumor- Tumors of this type are referred to as glioblastoma. The tumor cells are actively dividing, the growth of blood vessels is witnessed and areas of dead tissue keep expanding.

Treatment options:
Surgery- If the location of a brain tumor is such that it is accessible to a surgeon, the latter goes ahead and removes most of the tumor if not the whole. If, however, the brain tumor cells are placed very near to the surrounding very sensitive brain tissues, a doctor might remove a small portion of the tumor to curb its growth.
Radiation Therapy- This mode of treatment uses high energy X-ray beams to kill targeted cells of the brain. External beam radiation usually targets a small area of the brain. A whole brain radiation, on the other hand, is usually employed when a tumor has spread to most parts of the brain. Radiotherapy is now so evolved that it is highly targeted to tutor cells that kills cancer and spares normal brain .
Chemotherapy- Chemotherapy employs drugs to kill cancer cells. Chemotherapy can either be taken in the form of an IV or in the form of pills. The dosage of chemotherapy is decided based on the concentration of cancer cells, spread frequency, platelet count of the patient etc. The most common chemotherapy drug that is prescribed by doctors to fight cancer cells is temozolomide.

Brain Tumor - Stages and Treatment!

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

Abnormal blood vessels
Aneurysm
Bleeding
Blood clots in the brain
When the protective tissue or dura is damaged
Epilepsy
Due to nerve damage
Parkinson's disease
Any kind of pressure after an injury
Abscesses
Skull fractures
In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Risks:
Brain surgeries may be associated with several risks. They may be:

Allergic reactions to anesthesia
Bleeding
Blood clot formations
Swelling of the brain
A state of coma
Impairment in speech, coordination and vision.
Problems in memory
Strokes and seizures
Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.

Brain Surgery - When It Is Required?

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

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

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