BRAIN CANCER

Brain cancer is the disease of the brain where the abnormal cells grow to form a mass (tumor), which interferes with the functions of the brain like muscle control, sensation, memory and others. All tumors are not cancerous. Cancerous tumors are malignant and spread uncontrollably overpowering the healthy cells. They even take nutrients, blood and space from the healthy cells. Benign tumors are less serious than malignant tumors but still cause problems to the brain. Brain tumor is of two types.

• Primary brain tumor: This originates in the brain and grows within the limited space in the skull.

• Secondary brain tumor: This is also called as metastatic brain tumor and the tumor cells formed would have migrated from other parts of the body. Metastatic brain tumor indicates advanced stage of the of disease condition.

Occurence of brain cancer in different groups: Brain cancer is the leading cause of death from cancer in persons who are less than 35 years of age. Studies have indicated that the incidence rates of brain cancer have increased among the elderly and the children also.

The annual incidence of primary brain tumor ranges from 7 to 19.1 cases per 100,000 populations. Brain tumors are the second most common form of cancer seen in children, comprising 15–25% of all pediatric malignancies. It is also seen that 10–15% of people suffer from metastatic brain tumor.

Brain tumors can occur to anybody without any differentiation between race and gender. Metastatic brain cancers have the greatest risk when compared to other types of cancers. Males have a 0.66% lifetime risk of suffering from primary malignant brain tumor when compared to females who have 0.54% lifetime risk.

Recent epidemiological studies have linked the occurrence of brain tumors to the use of cellular phones.

                                       Sign and symptoms of brain cancer

Flow of cerebrospinal fluid is blocked due to the tumor formation in the brain. This leads to accumulation of cerebrospinal fluid and increases cranial pressure. Brain tumors may damage and condense the neurological pathways.

Symptoms depend on the location and size of the tumor.

The following are some signs and symptoms seen.¹

• Gradual loss of movement and loss of sensation

• Headache

• Altered mental status with memory loss and decreased alertness

• Ataxia

• Nausea and Vomiting

• Weakness

• Focal seizures

• Visual changes

• Speech deficits

• Sensory abnormalities

• Eating disorder

• Hearing loss

• Infertility

Apart from the above, some other symptoms, which are related to stroke can also be observed.
 
 
Diagnosis of Brain Cancer

Brain tumor is diagnosed based on the symptoms.¹

A detailed medical history, physical examination and neurological examination are conducted to assess the symptoms.

Based on this, a neurologist may suggest other diagnostic tests like:

• CT scan or computed tomography to know about the brain abnormalities

• MRI scan or magnetic resonance imaging to identify the tumors in the bones of the skull

• EEG or electroencephalography to measure the electrical activity in the brain

• X-ray done to know the deformities of the brain

• Brain scan to detect the abnormal cells in the brain

• MEG scan or magnetoencephalography to measure the magnetic fields produced by nerve cells and their electric current

• Digital holography is done to view the complete three-dimensional map of the tumor and surrounding the brain structures.

These tests help the physician to know the presence of tumor. Later, biopsy is conducted to know the kind of cells it contains.


Management of Brain Cancer
Primary brain tumor is difficult to manage, as it may occur without any cause.

Secondary brain tumor can be managed by:

• Good nutritional diet rich in fiber.

• Quit smoking.

• Avoid excessive use of alcohol.

• Avoid excessive exposure to sun.

• Frequent self-examination of breast and testicles, which can help in early detection of breast cancer and testicular cancer to avoid metastasis.

• Occupational therapy can be opted by patients and families to learn in approaching daily tasks.

• Physical therapy helps in the patients to maintain balance, express thoughts, speaking and swallowing.

• Those with incurable brain tumor, hospice care (a program or facility that provides medical and emotional support) may be preferred who can provide supportive environment to help the patients to deal with the pain.The procedure is called craniotomy and involves removal of the tumor without causing neurological damage. Different surgical techniques are conducted depending on the location, size and type of the brain tumor, such as:
  • Classic operation

  • Laser microsurgery

  • Ultrasonic aspiration
  Prior to the surgery the patient is given:
  
  • Steroids to reduce swelling of the brain tissue
  • Anticonvulsants to reduce seizures
  • Radiations to reduce the size of the tumor
  A benign tumor can be completely removed without additional treatment but periodic CT scan, MRI scan and neurological examinations may be suggested. In case of malignant tumors, surgeons cannot be sure that every bit of the tumor is removed and hence radiations and chemotherapy is suggested to eradicate the cells, which have escaped.
  
  Radiation Therapy
  External radiotherapy: Here, radiations are given externally to the tumor and the area surrounding it.
  
  Implant radiotherapy: Tiny pellets of radioactive material are left in the brain for a short period of time or permanently. The radiations released by these pellets are measured every day. This technique is also called brachytherapy.
  
  Stereoactive radiosurgery: Imaging techniques are used to determine the exact location of tumor cells. Gamma knife, adapted linear accelerator (LINAC) and cyclotron are the instruments used to release radiations. Different drugs like radioprotective drugs, radiosensitizers and radioenhancers are administered during radiation therapy to protect the brain cells.¹
  Side-Effects of Radiation Therapy:
  
  • Headaches, seizures and memory loss due to clustering of cells killed by radiation in the brain
  • Partial loss of eyesight and learning problems in children
  • Damage to the pituitary gland causing hindrance to normal growth and development
  
  Chemotherapy
  Anticancer drugs may be taken by orally, injected into the blood vessel or muscle or cerebrospinal fluid.
  Chemotherapy may be considered in case of following:
  
  • Radiation and surgery as a part of patient’s initial treatment
  • Treat tumors that recur in the same place or in another part of the body
  The commonly used chemotherapeutic drugs include procarbazine, CCNU or lomustine and vincristine.
  
  Other methods of delivering chemotherapy are interstitial chemotherapy, intrathecal chemotherapy, intra-arterial chemotherapy and electrochemotherapy.
  Side-Effects of Chemotherapy
  
  Chemotherapic drugs can cause the followining:
  • Damage to the kidneys

  • Tingling in the fingers

  • Ringing in the ears
  
  Other Treatments
  Some other drugs are prescribed if the brain tumor is not cured.
  They are as follows:
  
  • Anticancer drugs to limit tumor growth
  • Anticonvulsants to control seizures
  • Steroids to reduce swelling of the brain
  • Analgesics to relieve pain
  
  Alternate Treatment
  Alternate treatment is not recommended for brain cancer, as it cannot cure brain cancer. Complementary therapies can be used along with standard treatments to cope with the illness, side-effects of the treatment and may include the following:
  
  • Massage and meditation to help the patients to relax

  • Yoga to soothe body, spirit and mind

  • Hydrotherapy to improve circulation and relieve pain

  • Homeopathic and Chinese medicine focuses on diet and food supplements