Things You Should Know About Brain Tumors

by Jane Ashley

A brain tumor is a growth of abnormal cells within our brain. Some are non-cancerous, i.e., benign. Other tumors in the brain are cancerous. 

Men Are More Likely To Develop Brain Cancer

These cancerous tumors are one of two types:

• Primary – this is a tumor that begins in our brain.
• Secondary/Metastatic – this is where cancer begins to grow somewhere else in our body and spreads to our brain.

Almost 24,000 adults in the U.S. are diagnosed with primary brain tumors annually. More men have brain tumors than women — about 57 percent to 43 percent. Sadly, almost 3,750 children are also diagnosed with brain tumors and other central nervous system cancers.

We’ll look at both types of brain tumors.

What are the types of primary brain tumors?

There are more than 120 types of primary brain tumors. These are the most common types of primary brain tumors.

• Gliomas – these are the most common kinds of brain tumors. These tumors are graded from Grade I to Grade IV, with Grade IV being the most aggressive type of glioma. Glioblastoma (GBM) – the kind of tumor that Senator John McCain had – is the most aggressive form of this class of brain tumors.
• Non-Glioma – these tumors include meningioma (can be malignant or benign), pituitary gland tumors, CNS (central nervous system) lymphoma, and medulloblastoma (most common type of brain tumor in children).

What are the symptoms of a brain tumor?

Symptoms may be quite specific or somewhat vague.

• Headaches, sometimes severe that get worse with activity or early in the morning.
• Seizures, especially in a person who does not have a history of seizures
• Balance problems
• Blurred or double vision
• Speech problems
• Memory problems
• Confusion
• Personality changes
• Nausea and vomiting
• Problems with walking
• Fatigue or drowsiness
• Hearing loss, especially if it’s sudden onset

Seizures

If any of these symptoms last for more than ten days, you should see your doctor.

How is a brain tumor diagnosed?

The first test is usually an MRI (magnetic resonance imaging). If the MRI shows the presence of a tumor, your medical team will do a biopsy of the suspicious tissue. Depending on the location of cancer, a surgeon may remove the entire tumor or get a sample of the tumor if it’s not impossible to remove the tumor because of its location. Other imaging tests including CT scans and PET scans may provide additional information necessary to obtain before a treatment plan is developed.

Hearing and visions tests help determine if the tumor is affecting brain function. A clinical neuropsychologist may administer a neurocognitive assessment to evaluate the patient’s overall brain function. These tests will serve as a baseline test for future evaluations.

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How are brain tumors treated?

Each patient’s situation is different. A multi-disciplinary team works together to determine the best way to help relieve a patient’s symptoms and over-all survival.

• Surgery. Surgery is the keystone treatment for most patients and is usually the first treatment that most patients receive. A skilled neuro-surgeon removes the tumor and some surrounding tissue. If the tumor is low-grade, surgery may be all that’s needed. Surgery helps relieve neurological symptoms, provides a biopsy sample for further evaluation, helps other treatments be more effective and improves the patient’s prognosis.
• Radiation. Most patients receive radiation after surgery to help ensure that no cancerous cells remain. If a tumor is inoperable due to its location, specialized radiation, called the CyberKnife or proton therapy, can kill the tumor without affecting the surrounding tissue.
• Medication. Chemotherapy or targeted therapy helps certain patients, particularly patients whose tumors recur after initial treatment.

Brain Anatomy


What is a metastatic brain tumor?

More people experience cancerous brain tumors because their cancer spreads to their brain from another part of their body. These tumors in the brain that spread from other parts of our body are often called metastatic brain cancer, or simply, “brain mets.”

Cancer that spreads to our brains is most often related to the following kinds of cancer:

• Breast
• Colon
• Kidney
• Lung
• Melanoma

Symptoms are similar to the symptoms of a primary brain tumor — headaches, seizures, behavior or cognitive changes, and coordination issues.

Metastatic brain tumors occur most frequently in patients over 65. It’s estimated that between 200,000 and 300,000 patients annually suffer from metastatic brain tumors.

Surgery or radiation is the usual treatment. It is not unusual for a patient to have several brain lesions in metastatic brain cancer — sometimes, whole brain radiation therapy (WBRT) can help these patients. Brain-specific chemotherapy and targeted therapy may be used after radiation.
To learn more about metastatic brain tumors, download this free 24-page information guide from the American Brain Tumor Association.

What role does the caregiver have?

Caregivers for patients who have primary or metastatic brain tumors are in a unique and challenging situation. Their loved one may experience both physical symptoms and emotional/behavior symptoms.

• Physical symptoms. Seizures present problems for a caregiver. Most patients are advised not to drive; they might injure themselves in a fall precipitated by a seizure. Headaches, nausea/vomiting, vision problems, and incontinence present challenges for each caregiver.
• Cognitive changes. Caregivers have a steep learning curve as they adjust to declining cognitive functions such as confusion, personality changes, memory loss, and inappropriate behavior. Many caregivers report that the personality changes are one of the most challenging situations for them.

Don’t be surprised if you are overwhelmed emotionally. Anger, frustration, and depression are emotions that virtually every caregiver will experience. Don’t try to go this alone — speak to your medical team about palliative care to help with symptom relief for your loved one.

Be sure to plan ahead and consider what you’ll do if your loved one’s condition deteriorates and if they don’t respond to treatment. Hospice is a good option for patients who are in poor overall health and unable to tolerate treatment.

The Bottom Line …

Brain tumors and other central nervous system tumors present unique challenges. Both patients and caregivers face particular trials because symptoms are not only physical but also behavioral and cognitive. Ask for help. No one should try to go this diagnosis alone.

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