Brain Cancer: What is it, Symptoms, Diagnosis and Treatment

Brain cancer is the rapid and uncontrolled proliferation and growth of malignant tumor cells that occur in the brain. The cells that cause brain cancer have the ability to self-renew. Brain tumors can occur in the pituitary and pineal glands, the membranes on the surface of the brain, and the nerves. Secondary tumors that arise elsewhere in the body and spread to affect the brain are more common than primary brain tumors that arise directly in the brain. The most common cases of brain cancer arise from secondary brain tumors. It is known that in 2022, more than 1,900 people worldwide with an average age of 59 will be diagnosed with brain cancer.

What is Brain Cancer?

Tumors occurring in the brain are clusters of abnormally proliferating cells and negatively affect brain functions. Lump-shaped tumors can be benign or malignant. Tumors that grow slowly and do not spread to other parts of the body are benign, and benign tumors are not cancerous. Malignant tumors are cancerous cells that multiply rapidly and require urgent treatment. These tend to spread to other parts of the brain and body.

Brain cancers are not a common condition. Brain cancers, especially those that occur directly in the brain and do not spread throughout the body, are rare. Common brain cancers occur due to cancers that form in a different part of the body and spread to the brain. It is common for cancers to spread through metastasis, which causes secondary tumors.

What Causes Brain Cancer?

Various risk factors for cancers, including brain cancers, have been identified. Although genetic and environmental conditions often trigger cancer development, the impact of these factors for brain cancer is less clear than for other cancers. Major factors that increase the risk of brain cancer may include:

• Gender

• advancing age

• Genetic links and family history

• chemical exposure

• Prior radiation therapy

What are the Symptoms of Brain Cancer?

Brain cancer symptoms depend on the location and size of the tumor. Symptoms also depend on the grade, which indicates how fast the tumor is growing. Non-cancerous benign brain tumors cause symptoms that develop more slowly. These symptoms may be so minor or minor that they are not noticed at first. Additionally, symptoms may worsen over months or even years. Cancer-causing brain tumors are malignant tumors. These cause rapidly worsening symptoms. These symptoms often appear suddenly and worsen over days or weeks. Major symptoms of a brain tumor may include:

• Frequent and severe headaches

• Feeling of pressure in the head

• Nausea and vomiting

• Dizziness and balance problems

• Impairment of vision, hearing, smell or taste

• memory problems

• Weakness or loss of movement in a part of the body

• Irritability, drowsiness, fatigue

• Problems following simple commands

• Personality and behavior change

• seizures

How Are Brain Tumors Classified?

Brain tumors are a collection of cells that, unlike normal body cells, multiply and grow uncontrollably, abnormally. According to data, there are more than 150 different brain tumors. Brain tumors are divided into two main groups:

1. Primary brain tumors: The tumor starts in the brain and tends to stay there.

2. Secondary (metastatic) brain tumors: The tumor starts in another part of the body and spreads to reach the brain. Secondary brain tumors are more common. Kidney and breast cancer, skin and lung cancer are common cancers that spread to the brain.

Tumors are graded based on the level of abnormality of the cells. The rating gives an idea of ​​how quickly the tumor may grow and spread. Treatment planning is made accordingly.

• Grade: Tumor cells grow slowly, almost like normal cells. The patient has a high probability of long-term survival.

• Grade: Tumor cells appear slightly abnormal and grow slowly. The tumor may spread to nearby tissue.

• Grade: Tumor cells appear abnormal and are actively growing into the brain. These tumors tend to recur.

• Grade: Cells appear very abnormal. It grows and spreads rapidly.

In rare cases, some benign tumors can turn into malignant tumors, and a lower-grade tumor can turn into a higher grade.

Brain Tumor Types

Brain tumors vary in size. Some brain tumors can be detected even if they are very small; because it starts showing symptoms early. Other brain tumors reach large sizes before being detected. While some of these brain tumors turn into cancer, some do not. There are basically two types of brain tumors:

1. Benign brain tumors usually do not turn into cancer. Tumor cells multiply and grow more slowly. It is unlikely to spread to surrounding tissues and is easily removable. It rarely spreads to the entire brain tissue. It may cause problems due to pressure on certain parts of the brain. Depending on the part of the brain where it is located, it can be life-threatening.

2. Malignant brain tumors are cancerous tissues. Tumor cells often multiply and grow faster. Sometimes it can progress slowly. It can also invade nearby healthy brain tissue, as it has a high risk of spreading. It rarely spreads beyond the brain and spinal cord.

Benign and malignant tumors are discussed in more detail below.

Types of Benign Brain Tumors

Benign brain tumors, even if they are not cancerous, cause various symptoms and require treatment. There may also be a possibility of turning into malignant tumors. Benign brain tumors need close monitoring.

• Astrocytomas: They occur with the uncontrolled proliferation of cells called astrocytes. It usually occurs in the cerebrum, the largest part of the brain. Astrocytomas often spread throughout the brain and can occur in varying degrees. It may cause behavioral changes and seizures in the person.

• Germ cell tumors: Germ cells are reproductive cells that develop into sperm and egg cells. Tumors that occur in reproductive cells are germ cell tumors. Germ cells are mostly found in the ovaries and testicles; However, it can sometimes occur in other parts of the body, including the brain. If a germ cell tumor occurs in the brain, it is usually located near the pituitary or pineal gland.

• Meningiomas: Meningiomas are tumors that form in the membranes (meninges) surrounding the brain and spinal cord. It is the most common primary brain tumor in adults. It is mostly benign and tends to grow slowly.

• Pituitary tumors: These are tumors that form in and around the pituitary gland located at the base of the brain. Pituitary tumors are usually benign.

• Nerve tumors: These are tumors that form in or around the nerves. The most common type occurring in the head is acoustic neuroma called “Schwannoma”. This benign tumor is located at the main nerve connection between the inner ear and the brain.

Types of Malignant Brain Tumors

Malignant tumors are more aggressive than benign tumors. Because they often spread and damage all brain tissue and spinal cord, they need to be treated as soon as possible.

• Gliomas: Glioma cells are found in the nervous system that surround and support neurons. Gliomas are tumors that occur in these glial cells.

• Embryonal tumors: These are tumors that occur in the cells left over from fetal development. Embryonal cells remain in the brain after birth. For this reason, it is common in infants and young children. The most common type of embryonal tumor is medullablastoma.

• Pineal tumors: These are tumors that occur in and around the pineal gland in the brain. The pineal gland is located in the center of the brain and produces the hormone melatonin, which regulates sleep and wakefulness. It can be benign or malignant.

• Ependymomas: They form in the fluid-filled spaces in the brain and the canal that holds the CSF fluid. These tumors spread throughout the CSF; however, it does not spread to normal brain tissue. Approximately half of ependymomas occur in children under three years of age; but it can also affect adults.

Brain Cancer Diagnosis Methods

If the presence of a cancer-causing brain tumor is suspected, some physical examination techniques are used for diagnosis. The functions of different parts of the brain are examined by checking conditions such as reflexes, muscle strength, balance and coordination, hot-cold discrimination, and feeling the prick of a needle. In addition, there are some cancer screening techniques for the diagnosis of brain cancer:

• Computed tomography (CT): Photographing the inside of the body using x-rays

• MRI (Magnetic resonance imaging): Photographing cross-sections of the body with the help of a computer

• MRS (Magnetic resonance spectroscopy): Examining the changes in the chemical structure of the brain and the chemical profile of the tumor

• PET Scan: Injecting and imaging a radioactive solution that cancer cells absorb faster than normal cells

• SPECT: Three-dimensional imaging of blood flow affected by the tumor in the brain

• Lumbar Puncture: The process of removing CSF fluid from the waist with a needle to detect cancer.

• Biopsy: Taking a cell, fluid or tissue sample from the relevant area

Brain Cancer Treatment

Brain tumor treatment is determined depending on the type, location and size of the brain tumor. Common brain cancer treatment includes surgery and radiation therapy. In addition, the degree of cancer, the patient’s general health condition and age factors affect the treatment.

• Surgery: It aims to remove the tumor without damaging the brain tissue, which is important for the patient’s neurological functions. It is possible to remove all cancerous tissue. In cases where it is not possible, symptoms can be alleviated and the size of surgery can be reduced.

• Radiation therapy: A treatment that uses high-energy x-rays to kill cancer cells and shrink tumors. If tumor cells remain in the area after the surgery, the aim is to eliminate the remaining tumor cells by applying radiotherapy. When surgery is not an option, only radiation therapy can be applied.

• Chemotherapy: It aims to kill cancerous cells by damaging their genes in their nuclei. Combining more than one chemotherapy drug in treatment means there is a better chance of killing more cancer cells. Some chemotherapy drugs are used to prevent tumor cells from growing rather than killing them. It is often administered orally and intravenously. Resistance to chemotherapy means that the tumor does not respond to the drug or the drug cannot pass from the bloodstream to the brain. In some cases, patients may be resistant to chemotherapy.

• Laser Interstitial Thermal Therapy (LITT): A new technique used to treat smaller tumors in harder-to-reach areas. It is a method in which laser is used to thermally cut the lesion into which a catheter is placed. Since it has recently started to be used in brain tumor treatments, its long-term effects have not been proven.

• Combined Treatment: Depending on the condition of the tumor, your doctor may also recommend combined treatments.

If you suspect brain cancer or have been diagnosed with cancer, you should consult a specialist doctor and follow your treatment plan. Early diagnosis of cancer is too important to be left in the background. Keep your regularly scheduled appointments and stick to your treatment plan.