Brain Tumour

Introduction

  • A brain tumor is an abnormal growth of cells within the brain or its surrounding structures, which can be benign (non-cancerous) or malignant (cancerous).
  • Tumors are classified based on their location, type, and aggressiveness.
  • Early diagnosis and treatment are essential to improve survival and quality of life.

Types of Brain Tumors

  1. Primary Brain Tumors
    • Originate within the brain or spinal cord.
    • Examples:
      • Gliomas: Includes glioblastomas, astrocytomas, and oligodendrogliomas.
      • Meningiomas: Arise from the meninges, typically benign.
      • Pituitary Tumors: Affect hormone production.
  2. Secondary (Metastatic) Brain Tumors
    • Spread to the brain from other cancers like lung, breast, or melanoma.
  3. Benign Tumors
    • Non-cancerous but may cause pressure effects.
  4. Malignant Tumors
    • Cancerous, rapidly growing, and invasive.

Causes and Risk Factors

  1. Genetic Factors
    • Inherited conditions like Li-Fraumeni syndrome or neurofibromatosis.
  2. Environmental Factors
    • Exposure to radiation or carcinogens.
  3. Age
    • More common in older adults, though certain types (e.g., medulloblastomas) are seen in children.
  4. Immune System Disorders
    • Weakened immunity increases risk.
  5. Unknown Etiology
    • Many cases have no clear cause.

Symptoms of Brain Tumors

  1. General Symptoms
    • Headaches (worse in the morning or with activity).
    • Nausea or vomiting.
    • Seizures or convulsions.
    • Fatigue or drowsiness.
  2. Focal Symptoms
    • Motor Problems: Weakness or paralysis on one side of the body.
    • Vision Changes: Blurred or double vision, loss of peripheral vision.
    • Speech Difficulties: Slurred speech or difficulty understanding language.
    • Cognitive Changes: Memory loss, confusion, or difficulty concentrating.
  3. Hormonal Symptoms (Pituitary Tumors)
    • Changes in menstrual cycles, growth abnormalities, or increased thirst and urination.

Complications of Brain Tumors

  • Increased intracranial pressure (ICP) leading to brain herniation.
  • Neurological deficits (e.g., paralysis, vision loss).
  • Cognitive decline and personality changes.
  • Seizure disorders.
  • Hormonal imbalances (from pituitary tumors).

Diagnosis of Brain Tumors

  1. Clinical History and Examination
    • Assess neurological function and symptoms.
  2. Imaging Tests
    • MRI: Gold standard for detailed brain imaging.
    • CT Scan: Often used in emergency settings.
  3. Biopsy
    • Confirms tumor type and grade.
  4. Functional Imaging
    • PET Scan: Assesses metabolic activity.
    • fMRI: Maps brain functions before surgery.
  5. Lumbar Puncture
    • Evaluates cerebrospinal fluid (CSF) for tumor markers in certain cases.

Treatment Options for Brain Tumors

1. Surgical Intervention

  • Craniotomy: Removal of as much of the tumor as safely possible.
  • Minimally Invasive Techniques: Endoscopic or laser-assisted surgeries.
  • Goal: Relieve pressure, obtain biopsy, and remove tumor bulk.

2. Radiation Therapy

  • External Beam Radiation: Targets the tumor with high-energy rays.
  • Stereotactic Radiosurgery (SRS): Precise radiation delivery (e.g., Gamma Knife, CyberKnife).

3. Chemotherapy

  • Common Agents: Temozolomide (Temodar), Carmustine.
  • May be administered orally, intravenously, or directly into the brain (e.g., Gliadel wafers).

4. Targeted Therapy

  • Focuses on specific molecules involved in tumor growth.
  • Examples: Bevacizumab (Avastin) for glioblastoma.

5. Immunotherapy

  • Uses the immune system to attack tumor cells.
  • Examples: Immune checkpoint inhibitors, CAR T-cell therapy.

6. Symptomatic Treatments

  • Corticosteroids: Dexamethasone to reduce brain swelling.
  • Antiepileptics: Prevent or control seizures (e.g., Levetiracetam).
  • Pain Management: Opioids or NSAIDs for headache relief.

7. Palliative Care

  • Focuses on improving quality of life in advanced or inoperable cases.

Monitoring Parameters

  • Tumor Growth: Regular imaging to assess tumor size and recurrence.
  • Neurological Function: Monitor changes in strength, coordination, and cognition.
  • Side Effects: Manage complications from treatments (e.g., fatigue, nausea).

Patient Counseling Points

  • Educate patients and families about treatment options and prognosis.
  • Stress the importance of follow-ups and regular imaging.
  • Discuss lifestyle adjustments to reduce seizure risks (e.g., avoiding triggers).
  • Offer emotional support and connect with support groups.

Use in Children

  • Pediatric brain tumors often require specialized multidisciplinary care.

Use in Pregnancy

  • Balance maternal and fetal health; avoid certain treatments like chemotherapy during the first trimester.

Use in Elderly

  • Tailor treatment based on overall health and comorbidities.

FAQs About Brain Tumors

Q1: Are all brain tumors cancerous?

  • No, many are benign but can still cause symptoms due to their location.

Q2: How are brain tumors treated?

  • Treatment varies by type and grade but includes surgery, radiation, and chemotherapy.

Q3: What are the early signs of a brain tumor?

  • Persistent headaches, nausea, vision changes, and seizures.

Q4: Can brain tumors be cured?

  • Benign tumors can often be completely removed; malignant tumors may be managed but not cured.

Q5: How long can someone live with a brain tumor?

  • Survival depends on the tumor type, grade, and response to treatment.

Q6: Are brain tumors hereditary?

  • Some are linked to genetic conditions, but most are sporadic.

Q7: How are glioblastomas different from other brain tumors?

  • They are aggressive and fast-growing, requiring intensive treatment.

Q8: Can brain tumors recur?

  • Yes, especially malignant ones, requiring ongoing monitoring.

Q9: Is chemotherapy effective for brain tumors?

  • It depends on the tumor type; certain brain tumors are resistant to chemotherapy.

Q10: What is a brain biopsy?

  • A procedure to remove a small sample of the tumor for diagnosis.

Q11: Can lifestyle changes help with brain tumors?

  • While they don’t cure tumors, healthy habits can improve overall well-being and recovery.

Q12: What are the risks of brain tumor surgery?

  • Infection, bleeding, neurological deficits, and swelling.

Q13: Can brain tumors cause personality changes?

  • Yes, especially if they affect the frontal lobe.

Q14: What support is available for brain tumor patients?

  • Counseling, support groups, and palliative care services.

Q15: What is the role of immunotherapy in brain tumors?

  • Emerging treatments show promise, particularly for glioblastomas.