Brain Tumors

BRAIN TUMORS

What is brain tumor? 

Brain tumor is the abnormal cell growth in the brain. The growth may be benign (non-cancerous) or malignant (cancerous). Brain tumors can affect any age group.

What causes brain tumor?

Exact cause is unknown for most brain tumors. There are genetic factors and environmental factors involved. Some tumors begin in the brain and are called primary. Other brain tumors are called secondary. Brain is a frequent site of metastasis for other tumors, most commonly cancers of the breast, lungs & kidney.Risk of brain tumor increases if there is history of  radiation exposure or immune system disorder.  Rarely, certain types of tumors run in families.

Cancers never discriminate, it is equally common in all social economic groups, male and females and in adults and children.

Although sometimes brain tumors are more common in  smokers, tobacco chewers, or alcoholic but it is also very common in persons who do not have  any addiction.

 Common symptoms of brain tumor?

The symptoms can be caused by pressure, as the tumor gets larger, or can be caused by the location, size, and type of tumor. Brain tumor may present as seizure, vomiting, headache, mood change, difficulty in speech,  difficulty in walking, diminished vision or  weakness of the limbs.  Other common symptoms are: memory loss, confusion, loss of concentration, personality and  behaviour changes, lack of balance and dizziness, loss of sense of smell and hearing.

How to recognize brain tumors?

Any person should not ignore the symptoms of brain tumor like headache,              vomiting, visual deficits, seizures, hearing loss or paralysis of a part of body. Brain tumor is a deadly  disease but early detection may be life saving. Thorough clinical examination,  fundus examination, CT scan or MRI brain can diagnose brain tumor. Brain tumors can be benign or malignant which can be confirmed by biopsy.

What are the treatment options?

The outcome depends on several factors. These include type of tumor, its size, location, spread of tumor, other cancer in the body, age and health of the patient, and the patient's response to treatment. Medications are used  to reduce swelling of the brain tissue, to control seizures, to relieve headache and decrease intracranial tension.

Because there are over 100 different types of brain tumors, treatment needs to be specific for each person.

Neurosurgical decompression or excision is required for majority of brain tumors  which may be safely excised and patients may have normal life after surgery. For complete treatment radiotherapy and chemotherapy is also required in some tumors. Treatment can include surgery, radiation, chemotherapy (anticancer drugs), and immunotherapy.  Surgery is often needed. It may involve removal of all or part of the tumor and nearby tissue. Radiation may be used for certain stages of the tumor. It is normally not used for children under age 3.  After neurosurgical intervention, long term rehabilitation is required for brain tumor patients to prevent morbidity. Now a days, some non surgical treatment options like Gamma Knife, cyber knife, stereotactic, radiotherapy are also available for some type and small sized tumors.

Can brain tumors be prevented?

Awareness about the radiation exposure, ill effects of smoking ,and tobacco and alcohol may greatly reduce the occurrence of brain tumors. Screening of patients for primary concerns elsewhere in body reduces the risk of metastasis to brain.

Education of the people about the symptoms of brain tumor helps in early detection.

Newer diagnostic modalities like CT scan, MRI of the brain, help prompt neurosurgical intervention in effective treatment of the brain tumor and prevent the further spread or recurrence of the brain tumor.

What are the Rehabilitation options for patients with brain tumors?  

Some patients may develop sensory or motor deficit following excision of the brain tumor. Multidisciplinary  approach involving  neurooncologist,  physiotherapist, oocupational  therapist  may be required for the rehabilitation of brain tumor patients who were operated and received chemotherapy and  radiotherapy.

Care givers are educated  for prevention of contracture, deformities, or bed sore in paralysed  patients with spasticity.

Training in ADL activities is done  to improve independence .

Vocational training , home modification ,cognitive and perceptual training  is also helpful in rehabilitating brain tumor patients.

Prognosis

Due to technological advancements and better understanding of brain tumors, there had been a significant improvement in the clinical outcome of brain tumors. The majority of the brain tumors are now diagnosed at a very early stage. CT scan or MRI of the brain is a very common diagnostic tool and help to diagnose any lesion inside the brain.

All the brain tumors need not be operated. Non invasive single dose radiation therapy like Gamma knife or Cyberknife is a noninvasive way of treating small lesions of the brain.

Stereotactic biopsy helps in minimal invasive way of diagnosing brain tumor.

Stereotactic Radiotherapy ( SRT) is used to treat malignant lesions of the brain. Even multiple metastasis of systemic cancers of the body to the brain can be treated with surgery and SRT.

Meningioma which constitute about 15% of all the primary brain tumors can be excised completely without any recurrence.

So, if somebody is diagnosed as a case of brain tumor should not lose hope. Unlike other tumors of the body, the brain tumors are not labeled as cancer and non cancer. Rather, there are differerent grades of the tumor ( WHO Grade 1 to IV). Grade 1 tumors are usually benign and do not require chemotherapy or radiotherapy.

Source: IHBAS, Delhi Team, Online resources