Brain tumors are abnormal tissue growths that are in or around the brain. Brain tumors can be benign, slow growing. While others are malignant, called cancer, grow quickly and are aggressive.
Only about a third of brain tumors are cancerous. But cancerous or not, brain tumors can interfere with brain function if they grow large enough to press on nerves, blood vessels and surrounding tissue.
Tumors that develop in the brain are called primary tumors. Tumors that spread to the brain after forming in a different part of the body are called secondary tumors or metastatic tumors.
INCIDENCE
Brain tumors in about 85,000 people each year. Of these tumors, about 60,000 are benign, and about 25,000 are malignant.
Brain tumors are more common in men than women. Although most common among older adults, they can develop at any age. Brain tumors are the leading cause of cancer-related death in children under 14 years of age
TYPES and CLASSIFICATION
Types and classification of brain tumors based on the location where the tumor forms and the type of cells involved. Benign brain tumors that often occur, include:
- MENINGIOMA: this is the MOST COMMON type of primary brain tumor. Meningiomas develop slowly. They form in the meninges, the layers of tissue that protect the brain.
- Acoustic neuroma: This tumor occurs on the vestibular nerve (the nerve that leads from the inner ear to the brain). Acoustic neuroma is also called vestibular schwannoma.
- Pituitary adenoma: This tumor forms in the pituitary gland, located at the base of the brain. The pituitary gland makes and controls hormones in the body.
- Several other benign tumors such as chordoma, pinealositoma, craniofraingioma, and so on.
Malignant brain tumors that often occur, include:
- Glioma: These tumors develop from glial cells, which surround and support nerve cells. Glioma is not always malignant, but most types are malignant, called Glioblastoma Multiforme (GBM).
- Medulloblastoma: a fast-growing tumor that forms at the base of the skull. This is the most common brain cancer in children.
- All brain tumors have Grades I-IV, I indicating benign, and IV indicating malignant. In some cases there are benign brain tumors that can develop into malignant.
CAUSES and PREVENTION
The cause of most brain tumors has not been identified. Mutations (changes) or defects in genes can cause cells in the brain to grow uncontrollably, causing tumors. The only known environmental causes of brain tumors are exposure to large amounts of radiation from X-rays or previous cancer treatment. Some brain tumors can also occur when hereditary conditions are passed down among family members.
The easiest way to prevent it is by living a healthy lifestyle, avoiding carcinogenic substances, especially exposure to X-rays, and being alert to early detection if there is a family history of brain tumors, especially if you have clinical symptoms.
SYMPTOMS and CLINICAL
Some people with brain tumors may have no symptoms. When a brain tumor grows and presses on nearby nerves or blood vessels, it can cause symptoms. Signs and symptoms of a brain tumor vary depending on the location, type, and size of the tumor. Some of the symptoms include:
- HEADACHE is the earliest symptom and is most often experienced. Headaches in brain tumors are CHRONIC and PROGRESSIVE. meaning that the pain that is felt never goes away or can be improved for a while with medicine, but the longer it takes, the worse it gets.
- Changes in behavior or personality.
- Confusion.
- Difficulty with balance or coordination.
- Difficulty concentrating
- Nausea and vomiting.
- Numbness, weakness or tingling in one part or side of the body or face.
- Problems with hearing, vision or speech.
- seizures
- Unusual sleepiness
- Problems with memory, thinking, speaking or understanding language.
INSPECTION
Several tests were carried out to confirm the presence of a brain tumor. This test includes:
- Physical examination and medical history: general medical examination, past and current health conditions, surgeries and medical treatments, and family history of diseases will be carried out.
- Neurological exam: a series of tests to look for changes in balance, coordination, mental status, hearing, vision, and reflexes. These changes can indicate which parts of the brain may be affected by the tumor.
- Blood tests: to check for tumor markers (substances secreted into the blood by tumors) associated with certain types of tumors.
- Imaging tests: CT, MRI, angiography, and PET scans help find tumors and determine whether they are cancerous or benign. Other parts of the body, such as the lungs, colon or breast will also be examined if a metastatic process is suspected.
MANAGEMENT and THERAPY
Treatment of brain tumors depends on the location, size and type of tumor. Several combination therapies can be used to treat tumors:
- SURGERY : surgery is the MAIN THERAPY , especially in benign tumors, large, and located on the surface. In addition to removing the entire tumor and eliminating the effect of tumor suppression on the brain, tumor samples are also taken to determine a definite diagnosis of the type of tumor. If it is not possible to do surgery, a biopsy can be done.
- Radiotherapy: performed on tumor types that are sensitive to X-rays, and as follow-up therapy for benign brain tumors that are not completely removed during surgery or as adjunctive therapy for brain cancer. Some of the more sophisticated radiotherapy techniques have now been developed, such as the gamma knife, which uses gamma rays instead of X-rays.
- Chemotherapy: some types of brain tumors are sensitive to certain chemotherapy drugs, usually in brain cancer or as a follow-up therapy in brain cancer that has been through surgery.
- Waiting with vigilance/active monitoring: performed in conditions of relatively very small brain tumors, usually under 1 cm, minimal symptoms, and suspected to be benign. In some cases, brain tumors can grow very slowly or even regress spontaneously. Usually monitoring is carried out every 6 months or it can be adjusted earlier according to the patient's complaints.
- Several other therapies that are being developed include : stem cell therapy, genetic therapy, immunotherapy, cell targeted therapy, and so on.
PROGNOSIS and LIFE EXPECTATION
The end result of treatment for brain tumors varies widely. Factors that can affect prognosis include tumor type, grade, and location; total tumor removal, and age and overall health condition.
In Benign BRAIN TUMORS , usually in MENINGIOMA which can be TOTALLY RAISED, a person can return to a normal life, without or with minimal symptoms. Therefore, it is important to be aware of the symptoms and get checked out as early as possible before too much brain tissue is damaged.
In some cases, brain tumors can recur after treatment. Brain cancer requires follow-up treatment, including chemotherapy or radiotherapy, to prevent the tumor from growing or spreading. In cases like this, life expectancy is not very good.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgeon Specialist at EMC Hospital Tangerang).