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Brain tumor

Brain tumor is abnormal cell accumulation, development and growth of which can not be controlled. In most other parts of the body are a matter of purity, or of malignancy of the tumor is vital. Benign tumors do not grow into nearby tissues and has not spread to distant areas of the body, i.e. do not carry any threat of life. However, the brain is a different story.

A brain tumor rarely metastasizes to other organs, but, even if benign, she as their growth can compress and damage normal tissue, which can lead to disability and even death. That is why the doctors usually say "brain tumor" and not "brain cancer". The main concerns of doctors about brain tumors are how quickly it can grow into surrounding neural tissue and whether it can be removed without danger of recurrence.

Symptoms of a brain tumor in the early stages

Signs of brain tumor may develop gradually and worsen over time, or to show severe paroxysmal States. Tumors of any part of the brain can increase intracranial pressure. This may be caused by the growth of the tumor itself, swelling of the brain, or blocking the outflow of cerebrospinal fluid. All this leads to the common primary symptoms of brain tumor:

  • headaches
  • nausea
  • vomiting
  • blurry vision
  • imbalance
  • behavioral disorders
  • epileptic seizures
  • loss of consciousness

Headache is the most characteristic symptom of a brain tumor, occurs in approximately half of the patients (of course, in most cases, headaches are not associated with a tumor). About half of patients with brain tumor suffers from seizures, the type of which depends on the location of the tumor. Sometimes it is the first sign of a brain tumor, but, in the end, less than one out of ten cases, a seizure caused by a brain tumor.

Tumors in different parts of the CNS causes a variety of symptoms that depend on where "up" the tumor.

A tumor in the part of the brain that controls movement and feelings can cause weakness and numbness of the corresponding parts of the body.

A tumor in the part of the brain responsible for speaking, can cause speech disorders and the misunderstanding of the interlocutor.

A tumor in the front part of the brain sometimes causes problems with thinking and identities.

The tumor in the basal ganglia causes abnormal motor responses and abnormal body position in space.

If the tumor developed in the cerebellum, the patient may have problems with movement or other everyday functions, e.g. food intake.

A tumor in the back part of the brain, near the pituitary or the optic nerve causing visual disturbances.

As you know, the brain controls many vital functions, including hormonal secretion, therefore, tumor of the body can cause many other symptoms not listed in this article.

Treatment of brain tumor

A brain tumor is difficult to treat and requires an integrated effort of the whole "team" of doctors in different specialties, which is headed by a neurosurgeon. His closest aides:

  • a neurologist (a doctor who treats diseases of the Central nervous system)
  • radiation oncologist (a doctor who treats cancer with radiotherapy)
  • medical oncologist (doctor who uses chemotherapy treatment of cancer and other pharmacological agents)
  • an endocrinologist (a specialist in glands of internal secretion)

The program of treatment of a brain tumor may include such methods as surgery, radiotherapy, chemotherapy, targeted therapy and adjuvant pharmacotherapy. Treatment is built depending on the type of tumor and many other factors, but it is rare to use only a single method of treatment: typically, this combination therapy.

Surgery

In most cases, the first step of a neurosurgeon is the removal of so large part of the tumor as can be safely for the normal functioning of the brain.

Surgery is subject to a sufficiently large number of tumors, including undifferentiated astrocytomas, ependymomas, craniopharyngiomas, and meningiomas ganglioglioma. The same tumors that tend to spread into the surrounding tissue, for example, aplastic astrocytomas or glioblastomas cannot be surgically removed. The only thing you can do is to remove part of the tumor and try to kill any remaining cancer cells to radiation or chemotherapy. However, surgery can treat some of the symptoms, especially caused by high intracranial pressure (headaches, nausea, vomiting, blurry vision and seizures).

Restrictive circumstances surgery may be the location of the tumor deep inside the brain or in such part that cannot be removed (e.g., brain stem). Sometimes surgery is impossible and for medical reasons.

The operation to open the skull is called a craniotomy or trepanation. This is the most common approach in the surgical treatment of brain tumors. The patient may be subjected to General anesthesia (deep sleep) or local, being conscious during the whole operation (it may be necessary to assess brain function).

Before the operation a number of instrumental investigations (CT, MRI, ultrasound) to determine the exact location of the tumor and its edges.

In most cases, a remote area of the skull back into place and attached to the skull with metal screws, spokes, plates, or special stitches.

If the tumor blocks the current of the cerebrospinal fluid, it can cause increased intracranial pressure. To divert the excess cerebrospinal fluid by using silicone tube shunt. The upper end is placed in the ventricle, the shunt runs under the skin across the neck and chest and ends in the abdominal cavity. Current spinal fluid is controlled with a valve, built-in shunt. This medical device can be, both permanent and temporary.

Radiation therapy

In most cases for cancer of the brain is used for remote radiation therapy: the patient is placed on a special table and irradiated under a pre-calculated, precise angles. Each session lasts 15 to 30 minutes, the whole complex of measures is carried out daily, 5 days a week for several weeks.

High doses of radiation can damage healthy brain tissue, so the oncologists try to, as accurately as possible, calculate the maximum allowable dose. Fortunately, a number of modern techniques allows to focus the radiation on a strictly malignant neoplasm:

  • 3D conformal radiation therapy. This method uses the results of MRI, with which the computer creates a precise map of the location of the tumor. Then, from different points on the tumor served radiation beam, each beam individually carries a low radiation dose that minimizes side effects, but when all the beams converge on the tumor, the total dose high enough to kill cancer cells
  • Radiation therapy with intensity modulated (IMRT). This is an advanced form of 3D conformal radiation therapy. As the radiation source here is a computerized medical linear accelerator. The radiation intensity can be adjusted during the procedure to limit radiation exposure to the most sensitive tissues and organs
  • Conformal proton radiation therapy. Similar to 3D conformal therapy, but instead of x-rays it uses a beam of protons that are less harmful to health. Copes well with meningiomas
  • Stereotactic radiosurgery. In this method for focusing radiation on tumors using such innovative devices as Gamma knife, CyberKnife, X-knife
  • Brachytherapy. Internal radiation therapy, when a radioactive substance is injected directly into the tumor or close to it
  • Craniospinal irradiation. Is used if the tumor has spread along the sheath of the spinal cord or into the cerebrospinal fluid. Shown in ependymomas and medulloblastoma

Chemotherapy

As you know, chemotherapy is a systemic cancer treatment in which a drug is injected into the body injection or orally, and one way or another, penetrates into all organs and tissues. All, but not in the brain: many chemotherapy drugs are not able to penetrate the body. In some cases, the drug may be administered directly into the cerebrospinal fluid, brain or spinal cord through the ventricular catheter.

Usually chemotherapy is used when fast-growing tumors, such as medulloblastoma and lymphoma, who respond well to this method of cancer treatment. Standard practice is the use of chemotherapy together with surgery and/or radiation therapy.

Targeted therapy

Targeted drugs do not play a decisive role in the treatment of brain tumors, but some are against certain types of tumors can be quite useful. For example, Bevacizumab (Avastin) copes well with glioblastomas, reducing their size, and Everolimus (Afinitor) works in subependymal giant cell astrocytomas, slowing the growth of these tumors.

Auxiliary pharmacotherapy

Some drugs not directly affecting the growth and development of tumors, help relieve symptoms caused by either the tumor itself or its treatment:

  • Corticosteroids, e.g., Dexamethasone (Decadron) is often prescribed to relieve swelling in the area of tumor localization. It helps to relieve headaches and alleviate other symptoms
  • Anticonvulsant medications. They are used for prevention of seizures that often accompany a brain tumor
  • Hormonal agents. If the tumor itself or its treatment (e.g. surgery or radiotherapy) has caused damage to the pituitary gland, you may need hormone replacement therapy
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