Brain Cancer

Brain tumors can be benign, with no cancer cells, or malignant, with cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are secondary or metastatic, and they start somewhere else in the body and move to the brain; these tumors are named after the part of the body in which they started. Brain cancer includes malignant tumors that start in the brain, near the brain, or in the spinal cord. Secondary brain tumors are more common than primary brain tumors.

There are several types of brain tumors and they can occur in children and adults. The chance of recovery and treatment options vary depending on the location of the tumor, its size, how fast it is growing, and the patient’s age.

The most common symptoms of brain tumors include:

• Headaches, often in the morning
• Nausea and vomiting
• Changes in vision, speech, or hearing
• Problems with balance or walking
• Problems with thinking or memory
• Feeling weak or sleepy
• Changes in personality, mood, or behavior
• Seizures

Surgery common in the treatment of brain cancer. Other treatments may include chemotherapy and radiation therapy.

The signs and symptoms of a brain or spinal cord tumor vary greatly and depend on the tumor's size, location, and rate of growth. General signs and symptoms caused by brain tumors include:

• New onset or change in pattern of headaches
• Headaches that gradually become more frequent and more severe
• Unexplained nausea or vomiting
• Vision problems, such as blurred vision, double vision, or loss of peripheral vision
• Gradual loss of sensation or movement in an arm or a leg
• Difficulty with balance
• Speech difficulties
• Confusion in everyday matters
• Personality or behavior changes
• Seizures, especially in someone who does not have a history of seizures
• Hearing problems

Primary brain tumors originate in the brain itself or in tissues close to it, such as membranes that cover the brain (meninges), nerves in the brain and face, the pituitary gland, or the pineal gland.

Many different types of primary brain tumors exist. Each gets its name from the type of cells involved. Examples include:

• Gliomas. These tumors begin in the brain or spinal cord and include astrocytomas, ependymoma, glioblastomas, oligoastrocytomas, and oligodendrogliomas.
• Meningiomas. A meningioma is a tumor that arises from the membranes that surround your brain and spinal cord (meninges). Most meningiomas are benign.
• Acoustic neuromas (schwannomas). These are benign tumors that develop on the nerves that control balance and hearing leading from your inner ear to your brain.
• Pituitary adenomas. These are mostly benign tumors that develop in the pituitary gland at the base of the brain. These tumors can affect the pituitary hormones with effects throughout the body.
• Medulloblastomas. These are the most common cancerous brain tumors in children. A medulloblastoma starts in the lower back part of the brain and tends to spread through the spinal fluid. These tumors are less common in adults, but they do occur.
• PNETs. Primitive neuroectodermal tumors (PNETs) are rare, cancerous tumors that start in embryonic (fetal) cells in the brain. They can occur anywhere in the brain.
• Germ cell tumors. Germ cell tumors may develop during childhood where the testicles or ovaries will form. But sometimes germ cell tumors move to other parts of the body, such as the brain.
• Craniopharyngiomas. These rare, noncancerous tumors 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.

In most people with primary brain tumors, the cause of the tumor is not clear. But some factors that may increase your risk of a brain tumor. Different types of tumors have different risk factors, but some general risk factors include:

• Age. Your risk of a brain tumor increases as you age. Brain tumors are most common in older adults. However, a brain tumor can occur at any age, and certain types of brain tumors 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 tumor. 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 cellphones and microwave ovens, have not been proved to be linked to brain tumors.
• Family history of brain tumors. A small portion of brain tumors occur in people with a family history of brain tumors or a family history of genetic syndromes that increase the risk of brain tumors.

There are no widely recommended tests to screen for brain and spinal cord tumors. Most brain tumors are diagnosed after a person sees a doctor because of signs or symptoms they are experiencing.

Tests and procedures used to diagnose bone cancer may include a neurological exam and imaging tests, such as computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or X-rays.

Your doctor may recommend a biopsy – a procedure to remove a sample of tissue from the tumor – for laboratory testing. This testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. Testing will also reveal the cancer's grade, which helps doctors understand how aggressive the cancer may be.

If you have or have had brain cancer, you can take steps to manage the stress that accompanies the diagnosis:

• Learn about brain cancer so you can make informed decisions about your care.
• Have a schedule of follow-up tests and go to each appointment.
• Take care of yourself so that you are ready to fight cancer. This includes eating a healthy that includes plenty of fruits, vegetables and whole grains, exercising for at least 30 minutes most days of the week, and getting enough sleep so that you wake feeling rested.
• Accept help and support from family and friends.
• Talk with other cancer survivors or attend support groups.

The treatments for brain cancer are based on the type of cancer, the stage of the cancer, your overall health, and your preferences. Brain cancers can be treated with surgery alone, radiation therapy, radiosurgery, chemotherapy, and targeted drug therapy. Some patients receive combinations of treatments.

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. The most common chemotherapy for brain tumors is temozolomide (Temodar).

Targeted drug treatments focus on specific abnormalities within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. One targeted drug therapy used to treat a type of brain cancer called glioblastoma is bevacizumab (Avastin).

Brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, so rehabilitation may be a necessary part of treatment. You may need services such as physical therapy, occupational therapy, speech therapy, or tutoring.