Table Of Content

Introduction

The brain and spinal cord comprise the central nervous system (CNS). The brain is an essential organ that plays a vital role in controlling thought, memory, emotion, touch, motor skills, vision, respiration, body temperature, hunger, and many other processes that regulate our body. It comprises three main parts: the cerebrum, cerebellum, and brain stem.

Brain cancer is an abnormal growth or mass of cells in or around your brain. It can be benign (non-cancerous) or malignant (cancerous). There are two types of brain cancer, primary and secondary. Cancer that begins in the brain is called a primary brain tumor, and a tumor that has spread to the brain from anywhere else in the body is called secondary brain cancer or brain metastases.

Types of Brain Cancer

Meningioma is the most prevalent primary tumor originating in the meninges that surrounds the brain and spinal cord. These tumors are benign (non-cancerous) and slow-growing and are commonly diagnosed in women between 30 and 50 years old.

Pituitary adenomas originate from the pituitary gland. They are not malignant but can disrupt normal pituitary function and cause certain medical conditions.

A craniopharyngioma develops near the pituitary gland, which secretes hormones to regulate many body functions. It grows slowly because it can affect the function of the pituitary gland and other surrounding brain structures.

Schwannomais a slow-growing and benign tumor that develops in the nervous system. It originates from Schwann cells, which support and protect the nerve cells. A vestibular schwannoma is the most prevalent type, and it develops in a nerve in the inner ear.

Nasopharyngeal angiofibroma is a benign (non-cancerous) tumor that develops beneath the nose. It is an aggressive and dangerous tumor known as juvenile nasopharyngeal angiofibroma.

A choroid plexus carcinoma is most common in children and develops near the brain tissue that secretes cerebrospinal fluid. A non-cancerous tumor of this region is called a choroid plexus papilloma.

Dysembryoplastic Neuroepithelial is a glieo-neuronal brain tumor containing glial and neuronal cells. Glial cells provide the structural support of the central nervous system (CNS), and neuronal cells act as a functioning component of the central nervous system. It occurs in the tissues covering the brain and spinal cord.

Neurofibroma is a benign nerve tumor that can grow on nerves anywhere in the body, and sometimes it develops in the brain, spinal cord, or cranial nerves. Multiple neurofibromas cause a symptom of a genetic disorder known as neurofibromatosis type 1 (NF1).

Hemangioblastoma is a benign tumor of the blood vessels that can form in the brain, spinal cord, or retina. Rarely, they can appear in multiple sites and cause symptoms of hereditary disease.

Chondroma is a rare benign tumor made up of cartilage, bones, or soft tissue. They can occur in the hands or feet. These tumors grow slowly, as it causes bone fracture by creating pressure on the brain.

Giant cell tumors are rare, aggressive benign bone tumors that affect the arm and leg bones. It is also found in the skull. The exact cause of these tumors is not known.

Osteomas are benign and slow-growing bone tumors that develop on the skull base and facial bones. These tumors are asymptomatic. Large osteomas that develop in certain brain regions may impair hearing, vision, or respiration.

Chordoma is slow-growing cancer that can occur anywhere along the spine. It is found near the tailbone (called a sacral tumor) or where the spine meets the skull (called a clival tumor). It is also known as notochordal sarcoma.

Chondrosarcoma is a rare type of malignant bone cancer that mainly affects cartilage. This tumor can begin cells in the thigh bone, arm, pelvis, knee, and spine. Some of these cancers can be aggressive.

Medulloblastoma is the most prevalently occurring malignant brain tumor in children. It commonly arises in the cerebellum, which is responsible for muscle coordination, balance, and movement.

Olfactory neuroblastoma is a rare malignant tumor that grows in the nasal cavity. It begins in the olfactory nerve, which transmits impulses related to smell from the nose to the brain. It is otherwise known as esthesioneuroblastoma.

Lymphoma mainly affects the lymphatic system, which is part of the body's immune system. Brain lymphomas can develop or spread from other body parts (primary central nervous system lymphomas).

Gliosarcoma is a rare histopathologic variant of glioblastoma that begins in the brain or spinal cord. It is the primary central nervous system (CNS) tumor, which is aggressive and can spread to other areas of the body.

Grades of Brain Cancer

Brain cancer is only graded because most tumors occur inside the brain and do not spread to other body regions. The world health organization has suggested different categories for brain tumors based on the nature of growth. The first tumor grades are benign and are referred to as low-grade brain tumors. Grades 3 and 4 show potent development and are referred to as high-grade brain tumors since most cells in high-grade tumors are malignant.

Grade I: This grade is the least aggressive because the tumor is slow-growing and rarely spreads to surrounding tissues. It might have the possibility of removing this tumor with surgery.

Grade II: These tumors grow slowly and spread into nearby tissues, but they are more likely to recur after treatment.

Grade III: These tumors are high-grade as they grow rapidly by destroying the surrounding tissues in the brain.

Grade IV: In this grade, tumor cells are actively dividing. The tumor also exhibits abnormal blood vessel development and areas of dead tissue. These tumors have grown and spread rapidly.

Causes & Risk Factors of Brain Cancer

Age: Brain tumors can occur at any age, but they are most common in children and older adults. The age between 85 to 89 has the highest chance of developing a brain tumor.

Gender: Men are more prone to developing brain tumors than women. However, certain brain tumors, such as meningioma, are more common in women.

Overweight and obesity: Being obese or overweight raises the risk of developing some brain cancers, including meningiomas.

Radiation exposure: People who are exposed to ionizing radiation are more likely to develop brain tumors. Examples of ionizing radiation include atomic bomb radiation exposure and radiation therapy used to treat cancer.

Home and work exposures: Exposure to solvents, insecticides, oil products, rubber, or vinyl chloride may raise the risk of getting brain cancer.

Viruses: Exposure to some viruses, such as the Epstein-Barr virus and cytomegalovirus, may increase the risk of developing brain cancer.

Weak immune system: Individuals with weakened immune systems are at a higher risk of getting central nervous system (CNS) lymphomas.

History of cancer: People with a current or previous history of cancer are more likely to develop brain cancer.

Genetic disorders: Some inherited genetic conditions may raise the risk of brain cancer. Those includes:

  • Neurofibromatosis is caused by NF1 or NF2 gene mutation, which raises the risk of brain cancers, including schwannomas, gliomas, and meningiomas.
  • Li-Fraumeni syndrome is caused by TP53 gene mutation, which increases the risk of gliomas in the brain and other body areas, such as the breasts.
  • Von Hippel-Lindau syndrome is caused by mutations (changes) in the VHL gene, which raises the risk of benign and malignant tumors, including in the brain and spinal cord.
  • Turcot syndrome is caused by mutations in the APC, MLH1, or PMS2 genes, which raise the risk of brain cancers and gliomas.
  • Tuberous sclerosis caused by mutations in the TSC1 or TSC2 gene increases the risk of brain cancer.

Symptoms of Brain Cancer

  • Persistent headache
  • Nausea and Vomiting
  • Memory loss
  • Weakness or numbness in one side of the body
  • Hearing impairment
  • Visual disturbances
  • Lack of coordination in voluntary actions
  • Seizures or convulsions
  • Loss of balance, dizziness, or unsteadiness
  • Confusion and difficulty in concentrating
  • Trouble speaking with behavioral expressions

Brain Cancer Screening

There are no standard screening tests that are indicated to detect brain cancer before symptoms appear. The greatest approach for screening brain cancer is to be early detection. Therefore, let your physician know if you notice any abnormal lumps, growths, or other symptoms that could be a brain tumor. Screening is important to those at a higher risk of developing primary brain cancer.

Brain Cancer Diagnosis

A brain cancer diagnosis is usually made after symptoms or if screening tests indicate the cancer risk. The type of diagnostic tests varies depending on the type of cancer, signs and symptoms, age, general health, and the results of the previous medical testing.

Diagnostic procedures and tests for brain cancer include:

A neurological exam: It evaluates brain and nervous system functioning. It may include a variety of tests to evaluate neurological functions such as balance, hearing, vision, coordination, and reflexes. If you have symptoms of a neurological disease, you may benefit from this test.

Imaging tests: Various imaging tests can be done to diagnose brain cancer which includes:

  • Computed tomography (CT) scan creates more detailed images of your bone structures near the tumor and provides details on the size of the tumor. It can help to find bleeding and enlargement of the fluid-filled spaces in the brain, called ventricles.
  • Magnetic resonance imaging (MRI) uses magnetic fields to produce extremely clear images of your body. MRI is used to look for brain and spinal cord tumors. It is used to determine the size of the tumor.
  • A positron emission tomography (PET) scan creates images of tissues and organs within your body using certain substances, including sugar or proteins. A small amount of radioactive glucose is injected into a patient's vein. The PET scanner provides an image of the inside of your body.

Biopsy: Medical professionals remove a small amount of tissue and examine it under a microscope for cancer indications. It is the most accurate method for diagnosing brain cancer. A biopsy can be performed as a part of surgery to remove the whole tumor.

Cerebral arteriogram: It is an x-ray of the head, or a series of x-rays, depicting the arteries in the brain. X-rays are taken after a specific dye (contrast medium) is injected into the patient's head arteries. It is otherwise known as a cerebral angiogram.

Lumbar puncture or spinal tap: In this procedure, a medical professional uses a needle to collect a sample of cerebrospinal fluid (CSF) to examine for tumor cells, blood, or tumor markers. This technique detects whether the tumor has spread to the tissues covering your brain (meninges).

Myelogram: It uses a contrast dye and x-rays to determine whether the tumor has spread to the spinal fluid, spinal cord, or other brain areas. This test is also called myelography.

Electroencephalography (EEG): It is a non-invasive procedure that involves attaching electrodes to the outside of a person's head to assess electrical activity in the brain. It is used to identify brain disorders, particularly epilepsy or another seizure disorder.

Evoked potential test: It measures the electrical activity of nerves in the brain and spinal cord. These tests are used with other diagnostic tests to detect neurological disorders.

Brain Cancer Treatment

Depending on the individual's age, type of brain cancer, location, size of the tumor, general and overall health, the physician may recommend the treatment options. The major treatment types for brain cancer include surgery, radiation therapy, chemotherapy, and targeted therapy.

Surgery removes the tumor and surrounding healthy tissue. It is the most common treatment for brain cancer, and it is the only treatment needed for a low-grade brain tumor. There are numerous surgical approaches to removing brain tumors, depending on their size and location.

  • A craniotomy is the most common surgical procedure for treating brain tumors. If brain function needs to be evaluated during the operation, the person may be under general anesthesia (in a deep sleep) or awake for at least part of the procedure (with the surgical region numbed). A small portion of the skull is temporarily removed so the surgeon can remove the brain tumor.
  • Neuroendoscopy is otherwise known as keyhole brain surgery. In this procedure, your neurosurgeon will make a small hole in the skull or go through the nose or mouth. They will use a tiny camera that sends images to find and remove the tumor.
  • Awake brain tumor surgery referred to as intraoperative brain mapping, is a procedure carried out while the patient is awake but under anesthesia. This procedure allows the neurosurgeon to activate a part of the brain to identify important functional areas to avoid.
  • Biopsy is a surgery where medical professionals remove a small amount of brain tumor tissue and examine it under a microscope for cancer indications. It is the most accurate method for diagnosing and treating brain cancer.
  • Neuroplastic surgery protects and recovers the appearance and anatomy of the skull after invasive treatments.
  • MRI-guided laser ablation is a minimally invasive neurosurgical method for treating various diseases, such as brain tumors. Lasers are used during this procedure to target and remove the tumor and help to treat the most dangerous brain tumors, such as glioblastoma multiforme.

Radiation therapy uses high-energy x-rays and protons to damage the DNA of cancer cells and shrink tumors. This damage inhibits tumor cells from growing and spreading. It is typically given after surgery.
Various radiation therapy methods for brain cancer include:

  • External radiation involves using a device outside the body to direct a high-energy radiation beam at the tumor. The beam passes through the skin, skull, brain, and other tissue to reach the tumor.
  • Stereotactic radiosurgery (SRS) is used to treat functional abnormalities and small tumors of the brain. It uses smaller, targeted beams of x-rays to protect healthy surrounding tissue. When SRS is used to treat body tumors, it is called stereotactic body radiotherapy (SBRT).
  • Proton therapy can be used to treat brain tumors by precisely delivering high doses of radiation to tumors. The procedure reduces exposure to non-targeted, healthy tissue surrounding the brain and eliminates malignant cells.

Chemotherapy treatment involves using drugs to kill rapidly growing cancer cells, and it can be given by mouth or through an IV.
Targeted therapy can identify and target the genes or proteins involved in cancer cell proliferation and multiplication by preventing cancer growth. Some targeted treatments are only effective in individual whose cancer cells have specific genetic mutations.

Brain Cancer Prognosis:

Brain cancer prognosis depends upon various factors such as:

  • Age
  • Types of brain cancer
  • Grade, size, and location of the cancer
  • Stage of cancer
  • Recurrent tumor
  • Overall patient health and response to the treatment

Prevention of Brain Cancer

There is no way to prevent brain cancer, but a few risks can be avoided to reduce the chance of developing brain cancer. Several brain cancer prevention strategies include:

  • Avoiding exposure to carcinogenic chemicals
  • Limit exposure to radiation
  • Avoid exposure to pesticides and insecticides
  • Make lifestyle changes
  • Eating a healthy balanced diet
  • Exercise regularly
  • Quit smoking

Brain Cancer FAQs

1. Can you cure grade 4 brain cancer?

Grade 4 brain cancer is not curable because this tumor is very aggressive and has grown and spread quickly. Hence, there are certain treatments to help relieve the symptoms.

2. Is a craniotomy my only option to treat my brain tumor?

A craniotomy is the most common surgical procedure for treating brain tumors, but it is not the only option. During this craniotomy procedure, a small portion of the skull is temporarily removed so the surgeon can remove the brain tumor.

3. What is the most common brain cancer?

The most prevalent kind of brain cancer is Gliomas, which develop from the supporting cells of the brain, called the glia. It is caused by the accumulation of genetic alterations in the glial stem or progenitor cells, which leads to uncontrolled growth.

4. What are the treatment options for my brain cancer?

Surgery, chemotherapy, radiation therapy, and targeted therapy are the various treatment options for my brain cancer.

5. How can I prevent brain tumors?

There are no preventive measures for brain tumors, but you can reduce the risk of developing a brain tumor by avoiding exposure to radiation, carcinogenic chemicals, and pesticides.

6. Who is at risk for brain cancer?

Brain cancers are more common in children and older adults, although people of any age can develop a brain tumor. As compared to women, brain cancer commonly occurs in men.

References:

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