What is a brain Tumor

• A brain tumor is an abnormal growth or mass

of cells in or around your brain. Together, 
spinal tumors and brain tumors are called
central nervous system (CNS) tumors.
• Brain tumors can be malignant (cancerous) or
benign (noncancerous). Some tumors grow
quickly, while others are slow growing.
 What is a brain tumor?

• Only about one-third of brain tumors are cancerous. But whether

they’re cancerous or not, brain tumors can impact brain function
and your health if they grow large enough to press on surrounding
nerves, blood vessels and tissue.

• Tumors that develop in your brain are called primary tumors.

Tumors that spread to your brain after forming in a different part of
your body are called secondary tumors, or metastatic brain tumors.
 What are the types of brain tumors?

• Researchers have identified more than 150 different

brain tumors.

• Healthcare providers categorize primary tumors as glial

(composed of glial cells in your brain) or non-glial
(developed on or in the structures of your brain,
including nerves, blood vessels and glands) and benign
(noncancerous) or malignant (cancerous).

• Many types of brain tumors can also form in your spinal

cord or column.
 Types of brain tumors that are usually benign include:

• Chordomas: These slow-growing tumors typically begin at

the base of your skull and the bottom part of your spine.
They’re mostly benign.

• Craniopharyngiomas: These tumors usually arise from a

portion of your pituitary gland. They’re difficult tumors to
remove because of their location near critical structures
deep in your brain.
Gangliocytomas, gangliomas and anaplastic gangliogliomas:
These are rare tumors that form in neurons (nerve cells).

Glomus jugulare: These tumors are typically located just under

the base of your skull at the top of your jugular vein (neck vein).
They’re the most common form of glomus tumor.

Meningiomas: These are the most common type of primary

brain tumors. Meningiomas typically develop slowly. They form in
the meninges, (P A D) the layers of tissue that protect your brain and
spinal cord. In rare cases, a meningioma can be malignant.
Pineocytomas: These slow-growing tumors form in your pineal
gland, which is located deep in your brain and secretes the hormone
melatonin.(Cell and neuro protection then regulating sleep patterns )
Pituitary adenomas: These tumors form in your pituitary
gland, which is located at the base of your brain. Your
pituitary gland makes and controls hormones in your
body. Pituitary adenomas are usually slow growing and
they may release excess pituitary hormones.
Schwannomas: These are common benign brain tumors in
adults. They develop from the Schwann cells in your
peripheral nervous system or cranial nerves. Schwann
cells assist the conduction of nerve impulses. Acoustic
neuromas are the most common schwannoma. These
tumors occur on your vestibular nerve (the nerve that
leads from your inner ear to your brain
 Cancerous (malignant) brain tumors

• Approximately 78% of cancerous primary brain tumors

are gliomas. These tumors develop in glial cells, which
surround and assist nerve cells. Types of gliomas
include:
• 1 Astrocytoma: These tumors are the most common
type of glioma. They form in the star-shaped glial cells
called astrocytes. They can form in many parts of your
brain, but most commonly occur in your cerebrum.
• 2. Ependymomas: These tumors often occur near the
ventricles in your brain 4 LLV,RLV,3rd, 4th . Ependymomas
develop from ependymal cells (called radial glial cells).
3.Glioblastoma (GBM): These tumors form in glial cells
called astrocytes. GBMs are the fastest-growing
astrocytoma.

4. Oligodendroglioma: These uncommon tumors begin in

cells that create myelin (a layer of insulation around
nerves in your brain).

5. Medulloblastoma is another type of cancerous brain

tumor. These tumors are fast growing and form at the
base of your skull. They’re the most common cancerous
brain tumor in children.
Brain tumors effect - whether cancerous or not — can
cause serious problems. This is because your skull is rigid
and doesn’t provide room for the tumor to expand. Also, if
a tumor develops near parts of your brain that control vital
functions, it may cause symptoms, such as:
Weakness.
Difficulty walking.
Problems with balance.
Partial or complete loss of vision.
Difficulty understanding or using language.
Memory issues.
Brain tumors can cause problems by:
Directly invading and destroying healthy brain tissue.
Putting pressure on nearby tissue.
Increasing pressure within your skull (intracranial
pressure).
Causing fluid to build up in your brain.
Blocking the normal flow of cerebrospinal fluid (CSF)
through the spaces within your brain, causing those spaces
to enlarge.
Causing bleeding in your brain.
However, some people have brain tumors that never cause
symptoms or grow large enough to compress surrounding
tissues.
 What causes brain tumors

• brain tumors develop when certain genes on the

chromosomes of a cell are damaged and no longer
function properly, but they aren’t sure why this
happens. Your DNA in your chromosomes tells cells
throughout your body what to do — it tells them when
to grow, when to divide or multiply and/or when to die.
• When brain cell DNA changes, it gives your brain cells
new instructions. Your body develops abnormal brain
cells that grow and multiply faster than normal and
sometimes live longer than normal. When that
happens, the ever-growing crowd of abnormal cells
takes over space in your brain.
 What causes brain tumors
• When brain cell DNA changes, it gives your brain cells new
instructions. Your body develops abnormal brain cells that
grow and multiply faster than normal and sometimes live
longer than normal. When that happens, the ever-
growing crowd of abnormal cells takes over space in your
brain.
• In some cases, a person may be born with changes in one
or more of these genes. Environmental factors, such as
exposure to large amounts of radiation from X-rays or
previous cancer treatment, may then lead to further
damage.
In other cases, the environmental injury to the genes may
be the only cause.
There are a few rare, inherited (passed down from parent
to child) genetic syndromes that are associated with brain
tumors, including:
Neurofibromatosis type 1 (NF1 gene).
Neurofibromatosis type 2 (NF2 gene).
Turcot syndrome (APC gene).
Gorlin syndrome (PTCH gene).
Tuberous sclerosis complex (TSC1 and TSC2 genes).
Li-Fraumeni syndrome (TP53 gene).
Only about 5% to 10% of people with brain tumors have a
family history of a brain tumor.
 RISK FACTORS
• Age. Brain tumors are more common in children and older adults,

although people of any age can develop a brain tumor.

• Gender. In general, men are more likely than women to develop a brain

tumor. However, some specific types of brain tumors, such as

meningioma, are more common in women.

• Home and work exposures. Exposure to solvents, pesticides, oil

products, rubber, or vinyl chloride may increase the risk of developing a

brain tumor. However, there is not yet scientific evidence that supports

this possible link.

 Risk factors
• Family history. About 5% of brain tumors may be linked to hereditary

genetic factors or conditions, including Li-Fraumeni syndrome, 

neurofibromatosis, nevoid basal cell carcinoma syndrome, 

tuberous sclerosis, Turcot syndrome, and von Hippel-Lindau disease.

Scientists have also found “clusters” of brain tumors within some

families without a link to these known hereditary conditions. Studies

are underway to try to find a cause for these clusters.

 Risk factors

Exposure to infections, viruses, and allergens. Infection

with the Epstein-Barr virus (EBV) increases the risk of CNS
lymphoma. EBV is more commonly known as the virus
that causes mononucleosis or “mono.” In other research,
high levels of a common virus called cytomegalovirus
(CMV) have been found in brain tumor tissue. The
meaning of this finding is being researched. Several types
of other viruses have been shown to cause brain tumors
in research on animals. More data are needed to find out
if exposure to infections, other viruses, or allergens
increase the risk of a brain tumor in people. Of note,
studies have shown that patients with a history of
allergies or skin conditions have a lower risk of glioma
 Risk factors
Electromagnetic fields. Most studies evaluating
the role of electromagnetic fields, such as
energy from power lines or from cell phone
use, show no link to an increased risk of
developing a brain tumor in adults. Because of
conflicting information regarding risk in
children, the World Health Organization
(WHO) recommends limiting cell phone use
and promotes the use of a hands-free headset
for both adults and children.
 Risk factors
• Race and ethnicity. In the United States, white
people are more likely to develop gliomas but
less likely to develop meningioma than Black
people. Also, people from northern Europe
are more than twice as likely to develop a
brain tumor as people in Japan.
• Ionizing radiation. Previous treatment to the
brain or head with ionizing radiation, including
x-rays, has been shown to be a risk factor for a
brain tumor.
 Risk factors
• Head injury and seizures. Serious head trauma has long been
studied for its relationship to brain tumors. Some studies have
shown a link between head trauma and meningioma but not
between head trauma and glioma. A history of seizures has
also been linked with brain tumors, but because a brain tumor
can cause seizures, it is not known if seizures increase the risk
of brain tumors, if seizures occur because of the tumor, or if
anti-seizure medication increases the risk.
• N-nitroso compounds. Some studies of diet and vitamin
supplementation seem to indicate that dietary N-nitroso
compounds may raise the risk of both childhood and adult
brain tumors. Dietary N-nitroso compounds are formed in the
body from nitrites or nitrates found in some cured meats,
cigarette smoke, and cosmetics. However, additional research
is necessary before a definitive link can be established.
 Signs and symptoms of brain tumors

• Some people who have a brain tumor experience no

symptoms, especially if it’s very small.
• Signs and symptoms of a brain tumor vary depending on the
tumor’s location, size and type. They can include:
• Headaches that may be more severe in the morning or wake
you up at night. Seizures.
• Difficulty thinking, speaking or understanding language.
• Personality changes.
• Weakness or paralysis in one part or one side of your body.
• Balance problems or dizziness., Vision issues.
• Hearing issues., Facial numbness or tingling.
• Nausea or vomiting. Confusion and disorientation.
 Brain tumors diagnosis
• Diagnosing a brain tumor can be a complicated process and
may involve several specialists. In some cases, though,
healthcare providers may discover a brain tumor when
performing imaging tests for another medical issue.
• If you’re experiencing symptoms of a brain tumor, your
healthcare provider will perform a physical exam. They’ll
also ask questions about your:
• Symptoms.
• Past and current health conditions.
• Current medications.
• Surgeries and medical treatments.
• Family medical history.
They may also perform a neurological exam,
which involves looking for changes in your:
Balance and coordination.
Mental status.
Hearing.
Vision.
Reflexes.
These changes can point to the part of your brain
that may be affected by a tumor.
If your healthcare provider suspects you may
have a brain tumor, a brain scan, most often an
MRI, is usually the next step.
Brain MRI or CT scan: Magnetic resonance imaging
(MRI) is the best imaging test for identifying brain
tumors. Computed tomography (CT) is a good
alternative if you’re unable to undergo an MRI.
Before these tests, a substance that makes the
tumor easier to see called a contrast agent is
injected into one of your veins. These tests can
show the tumor’s size and exact position in specific
detail. Your healthcare provider may also look at
other parts of your body, such as your lungs, colon
or breasts, to see if the tumor has spread.
Biopsy: Healthcare providers usually need to do a biopsy
of the tumor (removal of a sample of the tumor for
examination under a microscope) to identify the type of
tumor and if it’s cancerous. A neurosurgeon may perform
a biopsy during surgery in which they remove all or part
of the tumor. If the tumor is difficult to reach, they may
perform a stereotactic biopsy, which involves creating a
small hole in your skull and using a needle to take a
sample of tissue from the tumor.
Spinal tap (lumbar puncture): For this procedure, your healthcare
provider uses a small needle to remove cerebrospinal fluid (CSF)
from around your spine. A laboratory examines this fluid to look for
cancer cells. Healthcare providers use this procedure when they
suspect that the tumor has invaded the layers of tissues that cover
your brain (meninges).
Specialized tests: Certain tests can sometimes help with the
diagnosis. For example, your healthcare provider may order tests
that check your blood and cerebrospinal fluid for substances that
certain tumors release called tumor markers. They can also test for
gene abnormalities that are characteristic of certain tumors
 MANAGEMENT AND TREATMENT

• Brain tumor treatment depends on several

factors, including:
• The tumor’s location, size and type.
• The number of tumors.
• Your age.
• Your overall health.
 MANAGEMENT AND TREATMENT
• Brain surgery (craniotomy): When possible,
neurosurgeons remove the tumor. They work very
carefully, sometimes performing surgery when you’re
awake (you won’t feel pain), to minimize damage to
functional areas of your brain.
• Radiation therapy: High doses of X-rays destroy brain
tumor cells or shrink the tumor in this type of treatment.
• Radiosurgery: This is a type of radiation therapy that
uses very focused beams of radiation (gamma rays or
proton beams) to destroy a tumor. It’s not actually
surgery because it doesn’t require an incision (cut).
Brachytherapy: This is a form of radiation therapy. It
involves surgically placing radioactive seeds, capsules or
other implants directly in or near the cancerous tumor.

Chemotherapy: This therapy consists of anticancer drugs

that kill cancer cells in your brain and throughout your
body. You might receive chemotherapy through an
injection into a vein or take it as a pill. Your healthcare
provider may recommend chemotherapy after surgery to
kill any cancer cells left behind or to prevent remaining
tumor cells from growing.
Drugs Approved for Brain Tumors
Afinitor (Everolimus) 10 MG PER DAY
Belzutifan. 120 mg PO qDay
BiCNU (Carmustine) The recommended dose of BiCNU as a single
agent in previously untreated patients is 150 to 200 mg/m2
intravenously every 6 weeks. This may be given as a single dose or
divided into daily injections such as 75 to 100 mg/m2 on 2
successive days. When BiCNU is used in combination with other
myelosuppressive drugs or in patients in whom bone marrow
reserve is depleted, the doses should be adjusted accordingly.
16,000
Immunotherapy: Immunotherapy, also called biological
therapy, is a type of treatment that uses your body’s
immune system to fight cancer. The therapy mainly
consists of stimulating your immune system to help it do
its job more effectively. Example : Durvalumab, avelumab
Targeted therapy: With this treatment, drugs target
specific features in cancer cells without harming healthy
cells. Your healthcare provider may recommend targeted
therapy if you have trouble tolerating the side effects of
chemotherapy, such as fatigue and nausea.
Shunts: If the tumor causes pressure within your skull to increase,
you may need to have a shunt (a thin piece of tubing) surgically
placed in your brain to drain excess cerebrospinal fluid.
Drugs such as mannitol and Corticosteroids: These medications
can help reduce pressure within your skull. They reduce swelling
around the tumor.
Palliative care: This is a specialized form of care that provides
symptom relief, comfort and support to people living with serious
illnesses. It also provides support to caregivers and those impacted
by a loved one’s condition.
 NURSING DIAGNOSIS
1. Hyperthermia related to illness as
evidenced by increase in body temperature
above normal range.

2. Pain related to disease condition as

evidenced by verbalization of headache.

3.Imbalanced Nutrition:less Than Body

Requirements Related To Inability To Ingest
Food As Evidenced By Vomiting.
 NURSING DIAGNOSIS
4. Impaired physical mobility related to
neuromuscular impairment as evidenced by loss
of balance.

5. Disturbed sleep pattern related to sensory

alterations as evidenced by irritability.

6.Risk for deficient fluid volume related to

excessive losses as evidenced by diuresis with the
use of diuretics.
 NURSING DIAGNOSIS

7. Delayed growth and development related to

effects of disorder following surgery as
evidenced by inability to perform self-
control activities appropriate for age
behaviour.