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A brain tumor (brain cancer)

There are 2 main types of brain tumors depending on whether they are cancerous or not:

  • The benign (not cancerous). They form rather slowly and most often remain isolated from neighboring brain tissues. They do not spread to other parts of the brain or other organs and are generally easier to surgically extract than malignancies. However, some benign tumors remain unreliable due to their location.
  • The malignant ( cancerous) . It is not always easy to distinguish them from neighboring tissues. As a result, it is sometimes difficult to extract them entirely without damaging the surrounding brain tissue.

Examinations, such as magnetic resonance imaging (MRI) , PET scan (tomoscintigraphy by positron emission) and computed tomography (“CT scan”), make it possible to precisely locate the tumor. A biopsy ( removal of tumor tissue for analysis ) is essential for determining the benign (non-cancerous) or malignant (cancerous) nature of the tumor.

Brain tumors are also distinguished by their origin and location.

We distinguish :

  • The tumors brain primary , are those that originate in the brain. They can be benign (non-cancerous) or malignant (cancerous). Their denomination comes from the brain tissue in which they develop.

Among the most common malignant tumors are:

– Glial tumors, or gliomas (malignant tumors) representing 50 to 60% of all brain tumors. They are formed from glial cells, cells that act as a support structure for nerve cells (neurons).

– Medulloblastomas (malignant tumors), develop from the spinal cord in the embryonic stage. These are the most common brain tumors in children .

– Finally, among benign primary tumors, rarer than primary malignant tumors, we find hemangioblastomas, meningiomas, pituitary adenomas, osteomas, pinealomas, etc.

  • The secondary tumors or metastatic are malignant (cancerous) and from other organs where there is a cancer whose tumor cells have migrated to the brain and multiply. Tumor cells are transported by the blood and most often develop at the junction between the white matter and the gray matter of the brain. These secondary tumors are more common than primary tumors. Moreover, it is estimated that 25% of people who die of cancer of all kinds are carriers of brain metastases. Among the tumors most frequently causing brain metastases: breast cancer, lung cancer, skin cancer (melanoma), kidney cancer, colon cancer, etc.

Who is affected?

Each year in France, around 6,000 people are diagnosed with a primary brain tumor. They represent 2% of all cancers. In Canada, primary brain tumors affect 8 out of 100,000 people. Metastatic tumors affect about 32 out of 100,000 people. Large epidemiological studies show that the number of brain tumors in the West has been rising for several decades, with we really know why. However, the intensive use of the cell phone seems incriminated in the increase in the number of certain primary brain tumors as shown by numerous studies. In terms of mobile phone use, children are more likely to have brain tumors than adults.

When to consult?

Consult your doctor if you experience symptoms such as persistent, intense headaches, nausea, and vision problems .

Symptoms of a brain tumor (brain cancer)

The symptoms vary depending on the location of the tumor and its size. By enlarging, the tumor whether benign or malignant puts pressure on the neighboring brain formations, altering their functioning. Attention, some symptoms of brain tumor can be found also in case of stroke, brain abscess, intracerebral hematoma or in some arteriovenous malformations, thus risking misplacing the diagnosis.

Some of the most common brain tumor symptoms include:

  • Unusual, frequent and intense  headaches
  • Of nausea and vomiting
  • Vision Disorders  : blurred vision, double vision or loss of peripheral vision
  • Of numbness or loss of sensation on one side of the body
  • Paralysis or weakness of an arm or leg on one side of the body
  • Vertigo, problems of balance and coordination
  • Speech Problems
  • Memory Disorders and Confusion
  • A change in behavior or personality, mood changes
  • Hearing Disorders (especially in cases of acoustic neuroma, a tumor of the auditory nerve)
  • Seizures
  • A loss of consciousness
  • A loss of appetite

Risk factors

Although the causes of brain tumors are still poorly understood, some factors seem to increase risks.

  • Ethnicity. Brain tumors occur more often in individuals of Caucasian origin, except in the case of meningiomas (a generally benign tumor refers to the meninges, ie the membranes covering the brain), more common in individuals from Africa.
  • Age. Although brain tumors can occur at any age, the risks increase as you get older. The majority of tumors are diagnosed in people over 45 years old. However, some types of tumors however, such as medulloblastomas, occur almost exclusively in children.
  • Exposure to radiotherapy. Individuals who have been treated with ionizing radiation are at higher risk.
  • Exposure to chemicals. Although further research is still needed to confirm this hypothesis, some ongoing studies indicate that sustained exposure to certain chemicals, such as pesticides, for example, could increase the risk of brain tumors.
  • Family history. If the existence of a case of cancer in the immediate family is a risk factor for brain tumors, the latter is moderate.

Prevention

Since we do not know the precise cause of  primary brain tumors , there is no measure to prevent their occurrence. On the other hand, it is possible to prevent the appearance of other primary cancers causing cerebral metastases by reducing the consumption of red meat, weight loss, a sufficient intake of fruits and vegetables, the practice of regular physical activity (prevention of colon cancer), skin protection in case of exposure to sunlight (skin cancer), stopping smoking (lung cancer) etc …

Using the earpieces routinely when using mobile phones helps reduce the amount of waves directed to the brain that is beneficial in preventing certain types of tumors.

Medical treatments of brain tumor

Treatments vary depending on the type of tumor, its size and location. The malignant tumors are usually treated with combination therapies such as surgery , the chemotherapy and radiotherapy .

Relatively high in children, the survival rate is variable in adults and depends on the type of tumor, its size, its infiltration into the surrounding tissues and the general operability of each person.

Before starting a treatment , after the tumor has been precisely located ( MRI , CT scan, Pet Scan, cerebral angiography …), the doctor often performs a biopsy (removal of part of the tumor, for the purpose of ‘analyze it’ when the exact diagnosis of the type of tumor remains imprecise despite the additional examinations. This is used to determine the nature of the tumor and its benign or malignant (cancerous or not). The biopsy is performed by piercing a small hole in the skull bone, and is performed under local or general anesthesia.

Surgery

If the tumor is accessible, the first option is to extract it from the brain (excision). This is the major therapeutic way in the treatment of brain tumors. Surgery of excision also confirms the results of the biopsy because many tumors are heterogeneous (uneven dispersion of tumor cells within the tumor itself). In some cases, the tumor cells are easily detached from the surrounding brain tissue and the tumor can be extracted in its entirety. In others, the tumor is near critical or very sensitive areas, making surgery more risky. If the tumor is located near the optic nerve, for example, surgery may compromise vision. Whatever the case may be, surgeons always do their best to remove as much of the tumor as possible without reaching the essential areas of the brain.

radiosurgery

If the tumor is not accessible to traditional surgery, gamma knife radiosurgery may be considered. More precise and powerful than radiotherapy, this technique uses powerful radiant beams, directed at once and precisely and directly on the tumor, for a few minutes or hours. It does not require opening of the skull or trephine hole.

Radiotherapy

If the rays are less powerful than those used in radiosurgery, they can cover larger areas of the brain. In some cases, radiation therapy is directed to the tumor only. In others, the entire brain is irradiated, for example after surgery, to destroy the remaining tumor cells, or when several tumors are lodged in the brain (metastases) and can not be removed by surgery. Finally, radiotherapy is used for tumors that are not fully extracted.

Chemotherapy

Although brain tumors rarely metastasize outside the brain, chemotherapy is used to better control the disease. Some types of brain cancers respond to chemotherapy. Chemotherapeutic agents may be administered intravenously or orally. In some cases, they can be injected into the spinal cord to target the nervous system only.

Innovative approaches include introducing directly into the brain, after surgery, a small disk that diffuses chemotherapeutic agents into the brain tissue for a few weeks.

Followed

It is sometimes difficult to eliminate all brain cancer cells. If some of them remain in the brain, the tumor may reappear. Regular monitoring and surveillance is therefore essential.

Moreover, because of the possible neurological sequelae due to the tumor or its treatment because of the possible neurological sequelae due to the tumor or its treatment (control of the movements or the speech etc …), a period of rehabilitation is often necessary . It involves specialized practitioners with the help of specialized therapists (physiotherapist, occupational therapist, speech therapist, etc.).

Complementary approaches

Check out our Cancer fact sheet for all of the complementary approaches that have been studied in people with cancer, such as acupuncture, visualization, massage therapy and yoga. These approaches may be beneficial when used in addition to, but not substituting for, medical treatments.

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