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Brain Tumor and Brain Cancer -- Adult

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Definition

A brain tumor occurs when cells grow uncontrollably in the brain. Cancer occurs when cells in the body divide without control or order. If cells divide uncontrollably, they form a mass of tissue. The mass is called a growth or tumor. The term cancer usually refers to malignant tumors. These can invade nearby tissue and spread to other parts of the body. A benign tumor does not spread. But, it can continue to grow and press structures near it, causing symptoms.

There are two main types of brain tumors:

  • Primary brain cancer—This begins in the brain. It can be either malignant or benign. A small benign tumor in a bad location can cause significant problems.
  • Secondary or metastatic brain cancer—This has spread to the brain from another site in the body. All metastatic tumors are malignant.
Brain Tumor
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Causes

The cause of most primary brain cancer is unknown. Secondary brain cancer is caused by the cancer spreading to the brain from another site.

Risk Factors

Factors that increase your chance of developing brain tumors include:

  • Radiation
  • A condition that affects the immune system
  • Family history of certain types of cancer

Any cancer in the body can spread to the brain. The most common tumors that may spread to the brain include:

Symptoms

Symptoms depend on the tumor's size and location. A growing tumor will often have fluid build-up around it. This is called edema. Edema puts pressure on the brain. Symptoms may develop gradually or rapidly.

Symptoms may include:

  • Headache—Most headaches are not caused by brain tumors. Headaches due to brain tumors may have the following features:
    • Worsens over a period of weeks to months
    • Worse in the morning or causes you to wake during the night
    • Different than a normal headache
    • Worsens with change of posture, straining, or coughing
  • Seizures
  • Nausea or vomiting, especially early morning vomiting
  • Weakness in arms and/or legs
  • Loss of sensation in arms and/or legs
  • Difficulty walking
  • Hearing loss or vision loss, including double vision
  • Speech problems
  • Drowsiness
  • Memory problems
  • Personality changes

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. You will have a neurological exam. It will test muscle strength, coordination, reflexes, response to external actions, and alertness. The doctor may also look into your eyes to check for signs of brain swelling.

Your doctor may need pictures of structures inside your body. This can be done with:

Your doctor may need to remove a sample of brain tissue for testing. This can be done with:

There are many different types of brain tumors. The doctor will classify the type. The type of brain tumor is important to determine the treatment approach.

Treatment

After cancer is found, further tests may be done if there is concern that the cancer has spread. Treatment depends on the type, size, location of the cancer, and your overall health. Treatments may leave you with physical or mental limitations.

Before beginning treatment, you may take medicines, including:

  • Steroids to decrease swelling and fluid buildup
  • Anticonvulsants to prevent seizures

Surgery

Surgical procedures include:

  • Craniotomy—opening the skull to remove the tumor or as much of the tumor as possible
  • Shunt—implanting a long thin tube in the brain to direct built-up fluid to another part of the body

Radiation Therapy

Radiation therapy uses radiation to kill cancer cells and shrink tumors. This is a common treatment for brain tumors. Radiation may be:

  • External radiation therapy—Radiation is directed at the tumor from a source outside the body. If you have a metastatic brain tumor, you will receive whole brain radiation therapy (WBRT). If you have a primary brain tumor, you will receive more focused radiation therapy. WRBT may also be used in people who have cancer in other areas of the body. The treatment is used to prevent brain cancer.
  • Internal radiation therapy—Radioactive materials are placed into the body near the cancer cells. This is used less often.
  • Stereotactic radiosurgery—Higher doses of radiation can be delivered to the affected areas of the brain. Nearby normal tissue can be spared. Special equipment, including MRI and CT scans, help to focus the radiation. This is most often used in metastatic brain tumors or in benign brain tumors, such as meningiomas.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms, including pill, injection, or through a tube called a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. It may also be delivered directly into the cerebrospinal fluid, which bathes the brain tissue. This form of chemotherapy is called intrathecal. This is most often used when cancer has spread from elsewhere in the body to the fluid surrounding the brain and spinal cord.

Rehabilitation Therapy

Rehabilitation therapy includes:

  • Physical therapy to help with walking, balance, and building strength
  • Occupational therapy to help with mastering life skills, such as dressing, eating, and using the toilet
  • Speech therapy to help express thoughts and overcome swallowing difficulties

Prevention

There are no guidelines for preventing brain cancer.

Revision Information

  • American Brain Tumor Association

    http://www.abta.org

  • American Cancer Society

    http://www.cancer.org

  • Canadian Cancer Society

    http://www.cancer.ca

  • Cancer Care Ontario

    http://www.cancercare.on.ca

  • Brain tumor. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 28, 2013. Accessed June 4, 2013.

  • Brain tumors. American Association of Neurological Surgeons. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Brain%20Tumors.aspx. Accessed June 4, 2013.

  • Brain tumor. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/brain. Accessed June 4, 2013.

  • 12/20/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine.

  • 5/28/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert MR. Antiepileptic drugs for preventing seizures in people with brain tumors. The Cochrane Library. 2008; DOI: 10.1002/14651858.CD004424.pub2.