Malignant Growth
Malignant Growth
Depending on the tape, size and location of the tumour, there are various treatments available such as radiation therapy, radio surgery, chemotherapy, or targeted drug therapy
By Amresh K Tiwary
| If a brain tumour is diagnosed, relieving symptoms remain an important part of care and treatment. Today, most tumours can be removed safely with microsurgical techniques in a manner that maximizes tumour removal and minimizes harm to the patients |
How quickly a brain tumour grows can vary greatly. The growth rate as well as location of a brain tumour determines how it will affect the function of your nervous system. Brain tumour treatment options depend on the type of brain tumour the patient has, as well as its size and location.
A brain tumour is a mass or growth of abnormal cells in your brain or close to your brain.Brain tumours can begin in the brain (primary brain tumours), or cancer can begin in other parts of the body and spread to the brain (secondary, or metastatic, brain tumours).Many different types of brain tumours exist. Some brain tumours are noncancerous (which are called benign), and some brain tumours are cancerous (which are called malignant).
Primary brain tumours have many types. Each gets its name from the type of cells involved. Among them, Gliomas begin in the brain or spinal cord and include astrocytomas, ependymoma, glioblastomas, oligoastrocytomas and oligodendrogliomas.
A meningioma is a tumour that arises from the membranes that surround your brain and spinal cord (meninges). Most meningiomas are noncancerous.Acoustic neuromas (schwannomas)-these are benign tumours that develop on the nerves that control balance and hearing leading from your inner ear to your brain.Pituitary adenomas-These are mostly benign tumours that develop in the pituitary gland at the base of the brain. These tumours can affect the pituitary hormones with effects throughout the body.Medulloblastomas-These are the most common cancerous brain tumours in children. A medulloblastoma starts in the lower back part of the brain and tends to spread through the spinal fluid. These tumours are less common in adults, but they do occur.
According to Dr Sonia Lal Gupta, Consultant Neurologist and Headache & Stroke Specialist at Metro Centre for Neurosciences, Noida, primitive neuroectodermal tumours (PNETs) are rare, cancerous tumours that start in embryonic (foetal) cells in the brain. They can occur anywhere in the brain.Germ cell tumours may develop during childhood where the testicles or ovaries will form. But sometimes germ cell tumours move to other parts of the body, such as the brain.”
Craniopharyngiomasrare, noncancerous tumours start near the brain’s pituitary gland, which secretes hormones that control many body functions. As the craniopharyngioma slowly grows, it can affect the pituitary gland and other structures near the brain.
Cancer that begins elsewhere and spreads to the brain
Secondary (metastatic) brain tumours are tumours that result from cancer that starts elsewhere in the body and then spreads to thebrain. Secondary brain tumours most often occur in people who have a history of cancer. But in rare cases, a metastatic brain tumour may be the first sign of cancer that began elsewhere in your body.Secondary brain tumours are far more common than are primary brain tumours. Any cancer can spread to the brain, but the most common types include breast cancer, colon cancer, kidney cancer, lung cancer and melanoma
Risk factors
In most people with primary brain tumours, the cause of the tumour is not clear. But doctors have identified some factors that may increase your risk of brain tumour. Risk factors include:
Age –Your risk of a brain tumour increases as one ages. Brain tumours are most common in older adults. However, a brain tumour can occur at any age. And certain types of brain tumours occur almost exclusively in children.
Exposure to radiation- People who have been exposed to a type of radiation called ionizing radiation have an increased risk of brain tumour. Examples of ionizing radiation include radiation therapy used to treat cancer and radiation exposure caused by atomic bombs.
More common forms of radiation, such as electromagnetic fields from power lines and radiofrequency radiation from cell phones and microwave ovens have not been proved to be linked to brain tumours.
Family history of brain tumours – A small portion of brain tumours occur in people with a family history of brain tumours or a family history of genetic syndromes that increase the risk of brain tumours.
Diagnosis: If it’s suspected that the patient can have a brain tumour, the doctor may recommend a number of tests and procedures. Magnetic resonance imaging (MRI) is commonly used to help diagnose brain tumours. In some cases, a dye may be injected through a vein in the arm during the MRI study called MRI brain with contrast.Other imaging tests may include computerised tomography (CT) scan and positron emission tomography (PET).
If it’s suspected that the brain tumour may be a result of cancer that has spread from another area of the body, the doctor may recommend tests and procedures to determine where the cancer originated. One example might be a CT scan of the chest to look for signs of lung cancer.
A biopsy can be performed as part of an operation to remove the brain tumour, or a biopsy can be performed using a needle. The biopsy sample is then viewed under a microscope to determine if it is cancerous or benign. This information is critical to establish a diagnosis and prognosis and, most importantly, in guiding treatment.
Says Dr Pradyot Govil, Senior Onco Surgeon at Max Super speciality Hospital, Vaishali, Ghaziabad, “Headaches, nausea, vomiting, and dizziness are all possible symptoms of a brain tumour. Early symptoms can be subtle or obvious, depending on the type, size, and location of the tumour. However, just because a person has these problems, doesn’t mean he or she has a brain tumour.”
Adds Dr Govil, “Early symptoms of brain tumours can be vague or dramatic, depending on the tumour size, type, and location. No one knows what causes brain tumours; there are only a few known risk factors that have been established by research. “Children who receive radiation to the head have a higher risk of developing a brain tumour as adults, as do people who have certain rare genetic conditions such as neurofibromatosis or Li-Fraumeni syndrome. But those cases represent a fraction of the approximately 35,000 new primary brain tumours diagnosed each year. Age is also a risk factor – people over the age of 65 are diagnosed with brain cancer at a rate four times higher than younger people.
Treatment
Treatment for a brain tumour depends on the type, size and location of the tumour.If the brain tumour is located in a place that makes it accessible for an operation, the neuro- surgeon will work to remove as much of the brain tumour as possible. In some cases, tumours are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumours can’t be separated from surrounding tissue or they’re located near sensitive areas in your brain, making surgery risky. In these situations only the part of the tumour is removed which is safe.
Even removing a portion of the brain tumour may help reduce your signs and symptoms.Surgery to remove a brain tumour carries risks such as infection and bleeding. Other risks may depend on the part of the brain where your tumour is located. For instance, surgery on a tumour near nerves that connect to your eyes may carry a risk of vision loss.
Radiation therapy
Radiation therapy uses high-energy beams, such as X-rays or protons to kill tumour cells. Radiation therapy can come from a machine outside your body (external beam radiation), or, in very rare cases, radiation can be placed inside your body close to your brain tumour (brachytherapy).
External beam radiation can focus just on the area of your brain where the tumour is located, or it can be applied to your entire brain (whole-brain radiation). Whole-brain radiation is most often used to treat cancer that has spread to the brain from some other part of the body.Side effects of radiation therapy depend on the type and dose of radiation you receive. Common side effects during or immediately following radiation include fatigue, headaches and scalp irritation.
Radio surgery
Multiple beams of radiation is used to give a highly focused form of radiation treatment to kill the tumour cells in a very small area. Each beam of radiation isn’t particularly powerful, but the point where all the beams meet — at the brain tumour — receives a very large dose of radiation to kill the tumour cells.
There are different types of technology used in radiosurgery to deliver radiation to treat brain tumours, such as a Gamma Knife which is available in cancer institutions. Radio surgery is typically done in one treatment, and in most cases you can go home the same day.
Chemotherapy
Chemotherapy uses drugs to kill tumour cells. Chemotherapy drugs can be taken orally in a pill form or injected into a vein (intravenously). Chemotherapy side effects depend on the type and dose of drugs you receive. Chemotherapy can cause nausea, vomiting and hair loss.
Targeted drug therapy
Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can work.
Rehabilitation after treatment
Since brain tumours can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Your doctor may refer you to Physical therapy that can help you regain lost motor skills or muscle strength.Occupational therapy can help you get back to your normal daily activities, including work, after a brain tumour or other illness.Speech therapy with specialists in speech difficulties (speech pathologists) can help if you have difficulty speaking.
Primitive neuroectodermal tumours (PNETs) are rare, cancerous tumours that start in embryonic (foetal) cells in the brain. They can occur anywhere in the brain. Germ cell tumours may develop during childhood where the testicles or ovaries will form. But sometimes germ cell tumours move to other parts of the body, such as the brain.”
Dr Sonia Lal Gupta, Consultant Neurologist and Headache & Stroke Specialist at Metro Centre for Neurosciences, Noida
“Headaches, nausea, vomiting, and dizziness are all possible symptoms of a brain tumour. Early symptoms can be subtle or obvious, depending on the type, size, and location of the tumour. However, just because a person has these problems, doesn’t mean he or she has a brain tumour.”
Dr Pradyot Govil, Senior Onco Surgeon at Max Super Speciality Hospital, Vaishali