Brain Cancer - Things You May Not Know

by Jane Ashley

Brain cancer is a family of different types of cancer that occur in the brain and spinal cord. Brain cancers occur in both adults and children. Almost 24,000 adults and 3,500 children are diagnosed with brain cancer annually. Over 60,000 additional adults are diagnosed with benign brain tumors. Our likelihood of developing brain cancer is less than 1%. About 18,000 people die annually in the U.S. of brain and spinal cord cancer.

Drawing Of The Brain

What are the symptoms?

Recognizing symptoms is critical to early diagnosis of any brain tumor. Even benign brain tumors are dangerous.

• Headaches. These may be severe or get worse with daily activities. Some of these headaches occur early in the morning.
• Seizures. Patients can experience different kinds of seizures, varying from simple muscle jerks or twitches to grand mal seizures. Some patients may have sensory seizures that include changes in vision, hearing, or smell. Other patients suffer a complex partial seizure, which may include a partial loss of consciousness and/or loss of muscle control or twitching.

• Personality or memory changes.
• Nausea or vomiting.
• Fatigue or drowsiness.
• Sleep problems.
• Memory issues.
• Changes in ability to walk or perform common daily activities.

Some patients experience symptoms related to the location of their tumor. These symptoms would include:

• Headache or pressure at the tumor location
• Loss of balance or problems with fine motor skills
• Loss of vision, partial or complete
• Changes in speech, memory, or emotions
• Altered perceptions or loss of sensation on just one side
• Inability to look upward (could be caused by a pineal gland tumor)
• Lactation (secretion of breast milk) or change in mensural periods or growth in hands or feet (all of which can be caused by a pituitary tumor)
• Double vision, facial weakness or numbness, or difficulty swallowing can be caused by a brain stem tumor

Severe Headaches

Many of these symptoms are dramatic and serious enough to warrant a visit to the emergency room. If you experience any of the more subtle symptoms for more than two weeks, schedule an appointment with your doctor.

How is brain cancer diagnosed?

If your medical team (internist or neurologist) suspects a tumor in your brain, they will order a brain MRI (magnetic resonance imaging). An MRI is better than a CT scan because the MRI provides more detailed images of the brain. If a spinal cord tumor is suspected, patients have an MRI of their spines.

If a tumor is detected, a neurosurgeon obtains a small sample of the tumor for a biopsy. If the tumor is in a place where all of the tumor can safely be removed, the surgeon will remove the entire tumor during the procedure.

Other tests may be needed to evaluate the extent of the tumor completely. These tests may include CT scan, PET scan, cerebral angiogram, spinal tap, or myelogram. Molecular testing of the tumor may also be ordered.

Your doctor will usually order neurological, vision, and hearing tests to determine how much the tumor has affected your brain’s function. You probably will have a neurocognitive assessment of your brain’s functions, including memory, language skills, dexterity, calculation skills, and overall mental functions. If a patient has suffered a seizure, they will be evaluated with electroencephalography (EEG).

What determines the grade of the tumor and the patient’s prognosis?

Brain tumor cancer uses a grading system instead of the staging system used for cancer located in other parts of the body. Brain tumors don’t usually spread beyond the central nervous system. The biopsy results determine the stage of the tumor. Gliomas are the most common type of brain tumor. The grades below are for gliomas. Glioblastoma is the most common type of cancerous brain tumor and accounts for almost half of all brain cancer tumors.
1. Grade I – the tumor is slow-growing and is not likely to spread. May be cured with surgery alone.
2. Grade II – these tumors are less likely to grow or spread, but are more likely to recur after treatment.
3. Grade III – these tumors are more likely to have rapidly-dividing cells and may grow quickly. They don’t have any dead cells.
4. Grade IV – the cells in these tumors are actively dividing, have areas of dead tissue, and have blood vessel growth.

Generally, younger patients have better survival rates. A patient’s functional neurologic score (Karnofsky Performance Scale – KPS) is predictive of a patient’s possible outcome; the higher their functional score, the better their prognosis.

Brain Mri

How is brain cancer treated?

Surgery and radiation are the primary means of treating brain cancer. Because of the blood-brain barrier, only five FDA-approved drugs exist to treat brain cancer, and none are particularly effective.

Part of the patient’s treatment includes treating symptoms caused by the tumor. Anti-seizure medications help prevent seizures. Corticosteroids help relieve pain from swelling within the brain without the use of pain medications.

What are brain metastases?

Unfortunately, cancers in other parts of our body can spread to the brain. It is estimated that over 200,000+ cancer patients experience a spread of their primary cancer to the brain. Almost half of melanoma patients will experience a brain met (President Jimmy Carter is the best known). Other cancers that spread to the brain include breast, colorectal, lung, and renal. These tumors that have spread are usually treated with radiation.

The Bottom Line

Brain cancer is one of the most serious cancers — they are difficult to treat and can cause lasting physical and cognitive side effects. Early detection is critical. If you experience any of the symptoms, don’t delay seeking medical help.

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