what is a brain tumor?

A brain tumor or intracranial neoplasm occurs when abnormal

cells form within the brain. There are two main types of tumors:
malignant or cancerous tumors and benign tumors. Cancerous
tumors can be divided into primary tumors that started within the
brain and those that spread from somewhere else known as brain
metastasis tumors; this article deals mainly with primary tumors.
All types of brain tumors may produce symptoms that vary
depending on the part of the brain involved. These may include
headaches, seizures, problem with vision, vomiting, and mental
changes. The headache is classically worst in the morning and
goes away with vomiting. More specific problems may include
difficulty in walking, speaking and with sensation. As the disease
progresses unconsciousness may occur.

signs and symptoms

People with a brain tumor may experience the following
symptoms or signs. Sometimes, people with a brain tumor do not
show any of these symptoms. Or, these symptoms may be
caused by a medical condition that is not a brain tumor.Symptoms
of a brain tumor can be general or specific. A general symptom is
caused by the pressure of the tumor on the brain or spinal cord.
Specific symptoms are caused when a specific part of the brain is
not working normally because of the tumor. For many people with
a brain tumor, they were diagnosed when they went to the doctor
after experiencing a problem, such as a headache or other
changes.
General symptoms include:
Headaches
Seizures. Motor seizures, also called convulsions,
are sudden involuntary movements of a persons
muscles.
Single or multiple muscle twitches, jerks, spasms
Loss of consciousness and body tone
Loss of control of body functions
Change in sensation, vision, smell, and/or hearing
without losing consciousness
May cause a loss of awareness or a partial or total
loss of consciousness
May be associated with repetitive, unintentional
movements, such as twitching
Personality or memory changes
Nausea, vomiting and Fatigue

causes
Aside from exposure to vinyl chloride or ionizing radiation, there
are no known environmental factors associated with brain tumors.
Mutations and deletions of so-called tumor suppressor genes,
such as TP53, are thought to be the cause of some forms of brain
tumors

Although studies have not shown any link between cell phone
radiation and brain tumors, the World Health Organization has
classified mobile phone radiation on the IARC scale into Group
2B possibly carcinogenic. That means that there "could be
some risk" of carcinogenicity, so additional research into the longterm, heavy use of mobile phones needs to be conducted.

diagnosis
Neurologic exam: Your doctor checks your vision, hearing,
alertness, muscle strength, coordination, and reflexes. Your
doctor also examines your eyes to look for swelling caused
by a tumor pressing on the nerve that connects the eye and
the brain.
MRI: A large machine with a strong magnet linked to a
computer is used to make detailed pictures of areas inside
your head. Sometimes a special dye (contrast material) is
injected into a blood vessel in your arm or hand to help show
differences in the tissues of the brain. The pictures can show
abnormal areas, such as a tumor.
CT scan: An x-ray machine linked to a computer takes a
series of detailed pictures of your head. You may receive
contrast material by injection into a blood vessel in your arm
or hand. The contrast material makes abnormal areas easier
to see. Your doctor may ask for other tests:
Angiogram: Dye injected into the bloodstream makes blood
vessels in the brain show up on an x-ray. If a tumor is
present, the x-ray may show the tumor or blood vessels that
are feeding into the tumor.
Spinal tap: Your doctor may remove a sample of
cerebrospinal fluid (the fluid that fills the spaces in and
around the brain and spinal cord). This procedure is
performed with local anesthesia. The doctor uses a long, thin
needle to remove fluid from the lower part of the spinal
column. A spinal tap takes about 30 minutes. You must lie
flat for several hours afterward to keep from getting
a headache. A laboratory checks the fluid for cancer cells or
other signs of problems.

 Biopsy: The removal of tissue to look for tumor cells is

called a biopsy. A pathologist looks at the cells under a
microscope to check for abnormal cells. A biopsy can show
cancer, tissue changes that may lead to cancer, and other
conditions. A biopsy is the only sure way to diagnose a brain
tumor, learn what grade it is, and plan treatment. Surgeons
can obtain tissue to look for tumor cells in two ways:

treatment
When a brain tumor is diagnosed, a medical team will be formed
to assess the treatment options presented by the leading surgeon
to the patient and his/her family. Given the location of primary
solid neoplasms of the brain in most cases a "do-nothing" option
is usually not presented. Neurosurgeons take the time to observe
the evolution of the neoplasm before proposing a management
plan to the patient and his/her relatives. These various types of
treatment are available depending on neoplasm type and location
and may be combined to give the best chances of survival:
Surgery: complete or partial resection of the tumor with the
objective of removing as many tumor cells as possible.
Radiotherapy: the most commonly used treatment for brain
tumors; the tumor is irradiated with beta, x rays or gamma
rays.
Chemotherapy: is a treatment option for cancer, however it
is seldom used to treat brain tumors as the blood and brain
barrier prevents the drugs from reaching the cancerous cells.
Chemotherapy can be thought of as a poison that prevents
the growth and division of all cells in the body including
cancerous cells. This causes the significant side effects
experienced by patients undergoing chemotherapy.

prognosis

The prognosis of brain cancer varies based on the type of cancer.

Medulloblastoma has a good prognosis with chemotherapy,
radiotherapy, and surgical resection while glioblastoma multiforme
has a median survival of only 12 months even with
aggressive chemoradiotherapy and surgery. Brainstem gliomas
have the poorest prognosis of any form of brain cancer, with most
patients dying within one year, even with therapy that typically
consists of radiation to the tumor along with corticosteroids.
However, one type, focal brainstem gliomas in children, seems
open to exceptional prognosis and long-term survival has
frequently been reported.
Glioblastoma multiforme
Glioblastoma multiforme is the deadliest and most common form
of malignant brain tumor. Even when aggressive multimodality
therapy consisting of radiotherapy, chemotherapy, and surgical
excision is used, median survival is only 1217 months. Standard
therapy for glioblastoma multiforme consists of maximal
surgical resection of the tumor, followed by radiotherapy between
two and four weeks after the surgical procedure to remove the
cancer, then by chemotherapy. Most patients with glioblastoma
take a corticosteroid, typicallydexamethasone, during their illness
to palliate symptoms. Experimental treatments include gammaknife radiosurgery, boron neutron capture therapy and gene
transfer.
Oligodendrogliomas
Oligodendroglioma is an incurable but slowly progressive
malignant brain tumor. They can be treated with surgical
resection, chemotherapy, and/or radiotherapy. For suspected lowgrade oligodendrogliomas in select patients, some neurooncologists opt for a course of watchful waiting, with only
symptomatic therapy. Tumors with the 1p/19q co-deletion have
been found to be especially chemosensitive, and one source

reports oligodendrogliomas to be "among the most

chemosensitive of human solid malignancies".A median survival
of up to 16.7 years has been reported for low
grade oligodendrogliomas.

pictures of brain tumor

Interview with a doctor

Dr. Naveen sivadas
(Neurologist)

Q. What is brain cancer?

A. Benign brain tumors do not contain cancer cells, but they can
press on sensitive areas in the brain and cause symptoms. They
are usually a collection of extra cells that cause a mass of tissue
called a "tumor." They typically have clear borders and do not
invade surrounding areas. They usually can be removed by
surgery and are not likely to grow back.
Q. What are the symptoms of brain tumors?
A. The symptoms depend on the size of the tumor and the
location. Symptoms are caused by damage to vital tissue and by
pressure from the tumor or swelling, which may happen if the
tumor blocks the flow of cerebrospinal fluid.

Headaches that tend to be worse in the morning

Seizures
Nausea and vomiting
Weakness or loss of feeling in arms and legs
Stumbling or lack of coordination in walking
Abnormal eye movements or changes in vision
Drowsiness
Changes in personality or memory
Changes in speech

Q. What are the causes of brain tumors?

A. The causes of brain tumors are not known. Brain tumors are
not contagious. They can occur at any age, although they are

most common in children 3-12 years old and adults 40-70 years
old. Risk factors include working in industries such as oil refining,
rubber manufacturing and drug manufacturing; other studies show
chemists and embalmers have higher incidence of brain tumors.
Q. How is a brain tumor diagnosed?
A. The doctor does a complete physical exam with special
attention to neurological examination. This includes checks for
alertness, muscle strength, coordination, reflexes and response to
pain. The doctor also examines the eyes for swelling caused by a
tumor pressing on the nerve that connects the eye and the
brain.The doctor may request a CT (or CAT) scan or an MRI. A
CT scan is a series of detailed pictures of the brain. The pictures
are created by a computer linked to an X-ray machine.
Sometimes dyes are injected into to help show differences in the
tissue of the brain.
Q. What are the types of brain tumors?
A. There are primary and secondary brain tumors. Tumors that
begin in brain tissue are known as primary tumors. Secondary
tumors are when cancer spreads from another site to the brain,
which is called metastasis. Brain tumors are classified by the type
of tissue in which they begin. The most common brain tumors are
gliomas.
Types of gliomas:

Astrocytomas
Brain stem gliomas
Ependymomas
Oligodendrogliomas

There are other types of brain tumors that do not begin in glial
tissue. Some of the most common are:
Medulloblastomas

 Meningiomas
Q. What are the treatments for brain tumors?
A. The doctor develops a treatment plan to fit each patient,
depending on the patients age and general health and the type,
location and size of the tumor. Brain tumors are treated with
surgery, radiation therapy and chemotherapy. Before treatment
most patients are given steroids to reduce swelling. They may
also be given anticonvulsant medications to prevent seizures.
Surgery is the usual treatment for most brain tumors.
Radiation therapy uses high-powered rays to damage
cancer cells
and stop them from growing
Stereotactic radiosurgery is another way to treat brain
tumors.
Chemotherapy is the use of drugs to kill cancer cells.
Q. What are the side effects of treatment?
A. Surgery may damage normal brain tissue, and edema may
occur. Seizures, weakness, coordination problems, personality
changes and difficulty in speaking or thinking may result. Most
side effects of surgery lessen or disappear with time.Radiation
may cause fatigue and hair loss, which may be temporary or
permanent. Skin reaction in the treated area is common. The
scalp and ears may be red, itchy or dark; these areas may feel
and look sunburned. Patients should not use lotions without
doctor advice. Sometimes radiation may cause headache,
memory loss or seizures because the brain cells killed by
radiation may form a mass that causes pressure. Doctors may
suggest surgery or steroids to relieve these problems. Patients
may have fatigue and lose their appetite four to eight weeks after
radiation; this may last for several weeks, but it will usually go
away. Children who have radiation treatments may have learning
problems and partial loss of eyesight, or they may not grow or
develop normally. Chemotherapy side effects depend on the

drugs used. Patients may experience lower resistance to

infection, loss of appetite, nausea, vomiting, mouth sores, less
energy and hair loss. These side effects usually go away after
treatment. Some chemotherapy causes sterility. Some
chemotherapy can cause kidney damage, so patients may be
given large amounts of fluid while taking these drugs. Patients
may also have tingling in fingers, ringing in ears or difficulty
hearing. These problems may not clear up after treatment.
Steroids reduce swelling in the brain and may cause increased
appetite, weight gain or swelling of the face and feet. Steroids can
also cause restlessness, mood swings, burning indigestion, acne
and elevated glucose. The steroid treatment must be gradually
stopped so the body can adjust.

Conclusion
For patients diagnosed with brain cancer, new antiangiogenic
treatments are dramatically altering the way this disease is being

treated. While bevacizumab is presently the only FDA approved

angiogenesis inhibitor for brain cancer, other drugs are in late
stage clinical trials and some are being used in the clinic in
patients who have stopped responding to front-line treatments.
Improved outcomes with antianiogenic therapies are now
common, compared to the harsher, less effective treatments of
the past. Therapies that block the growth of tumor blood vessels
give patients reason for hope and optimism.
It is important for patients and their families to remember that
clinical trials are an important opportunity to gain access to even
newer cutting edge cancer therapies. Clinical trials also contribute
to the advancement of medical knowledge that can benefit future
generations.

Bibliography

www.wikipedia.com
Neurology and neurosurgery
by Kenneth and Ian Bon

INDEX
What is a brain tumor?
Signs and symptoms
Causes
Diagnosis
Treatment
Prognosis
Interview with a doctor
Pictures of brain tumor
conclusion
Bibliography