WorldBrainTumorDay

World Brain Tumor Day

Whether malignant or benign, many of the broad variety of brain tumor types will cause neurological symptoms and can be […]

Flavicone Icone TheKnowHow

Whether malignant or benign, many of the broad variety of brain tumor types will cause neurological symptoms and can be life-threatening. 

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World Brain Tumor Day: Together, We Can Make a Difference

Every year on 8th June, World Brain Tumor Day reaches out to promote global awareness about brain tumors. Introduced by the German Brain Tumor Association in 2000 it has progressively become a global campaign. This day is purposed to educate the population about brain tumors and their influence, encourage early detection & diagnosis, offer support for the patients, and endorse increased funding and research for enhanced treatment possibilities. Let´s make the theme for 2023 Together, We Can Make a Difference more than a slogan. 

Brain Tumors – Types and consequences

A brain tumor occurs when cells inside the brain start growing in an abnormal way and form a mass within the brain. A primary brain tumor originates from the brain cells themselves. A brain tumor is called “secondary”, when it is a metastasis derived from body cancer cells, like breast cancer or lung cancer, which have found their way into the brain through the blood stream.   

Certain brain tumor types, such as glioblastoma, astrocytoma, or oligodendroglioma, have the potential to spread into the surrounding brain tissue. The tumor cells disturb the normal function of the normal brain cells. In addition, their invasive character makes it difficult to remove them by surgery in total.  

Many other brain tumor types such as meningiomas or pituitary tumors do not invade the brain but squeeze and displace brain tissue. The enclosed space inside the skull is limited. Therefore, even when benign tumors grow, they start closing in the space and provoke irritation and damage to the brain. Therefore, whether invasive or not, whether malignant or benign, many of these brain tumor types will cause neurological symptoms and can be life-threatening and life-limiting. 

Brain tumors can occur in more than hundred types, each with a unique range of symptoms, treatment requirements, and prognoses Brain tumors can have profound effects on a patient’s physical, mental, and emotional well-being. 

Brain tumor symptoms – When to get alert

Clinical signs of brain tumors are highly variable based on the location, size, and type of the tumor. Most of the symptoms are unspecific and can also be caused by other conditions. Nevertheless, when you or your loved ones become aware of symptoms listed below, talk to your doctor about it. 

Brain tumor symptomes may includes:

Symptoms may start gradually over weeks to months or rapidly, potentially leading to an emergency visit at the hospital. 

How to diagnose a brain tumor

The Neuroradiologist: Dip into the brain

When a patient exhibits symptoms of nerve and brain dysfunction, a neurologist will do a physical neurological examination first. If the results point to an origin of symptoms within the brain, diagnostic imaging such as a CT scan (computerized tomography) or an MRI scan (magnetic resonance imaging) will be performed.  

These tests allow the neuroradiologist to “see” your brain to identify if there is a tumor. If so, it is important to determine where it is located, if it is demarcated off from brain tissue, and its size. You may then be referred to a neurosurgeon, who, if necessary, will recommend a biopsy or surgery.  

The Neuropathologist: Making an exact diagnosis

Biopsy or surgery are required to ascertain the origin and nature of the tumor. Is it primary or metastatic, from which cell types does it arise, is it growing slowly or aggressive? What other characteristics do the tumor cells display?  

The diagnostic activities of a neuropathologist include intraoperative consultations, histopathological evaluation, and the use of specific immunological markers. In addition, according to the new WHO 2021 classification of brain tumors, molecular genetic examinations have become essential for the exact diagnosis. Molecular genetics also give important information on the prognosis and help to predict the benefit of therapeutical interventions on an individual basis. 

Treatment options for brain tumors

The Neurosurgeon: Surgical removement of brain tumors

Surgery is the most common first line treatment for brain tumors, and often it may be the only treatment needed. There are numerous approaches neurosurgeons take to remove brain tumors depending on their size and location. 

In a craniotomy a piece of skull is temporarily removal to allow surgeons access to the brain. Neurosurgeons may also enter the brain through other parts of the body, like the nose, to better reach certain regions and minimize scarring. If the tumor is in a challenging position in the brain, a biopsy might be the initial choice to clarify it´s type by the neuropathologist. 

Treatment of brain tumors is often teamwork

Surgery is the most common first line treatment for brain tumors, and often it may be the only treatment needed. There are numerous approaches neurosurgeons take to remove brain tumors depending on their size and location. 

In a craniotomy a piece of skull is temporarily removal to allow surgeons access to the brain. Neurosurgeons may also enter the brain through other parts of the body, like the nose, to better reach certain regions and minimize scarring. If the tumor is in a challenging position in the brain, a biopsy might be the initial choice to clarify it´s type by the neuropathologist. 

The Radiation Oncologist: Radiotherapy of brain tumors

Radiotherapy is differentiated by how the radiation is applied: from outside the body or directly from within the tumor  

External beam radiation therapy (EBRT):

Usually, a computer uses imaging scans to match the radiation beams to the shape of the tumor from different angles. A machine sends the rays of energy from outside the body to the tumor according to this radiation plan. This treatment is usually repeated over several weeks.  

Stereotactic radiosurgery (SRS) is a variation of EBRT. This method can be used on small tumors. Despite the name, there isn’t any cutting involved. Radiation with a high energy dose is delivered to the tumor from many different angles. Gamma knife uses beams focusing on the tumor from hundreds of angles. In linear accelerator-based radiation the machine moves around the head to send the radiation beams to the tumor from different angles.   

Internal radiation (brachytherapy, interstitial therapy)

During surgery, tiny radiation seeds are inserted into or close to the tumor. The radiation produced by the implants has only little influence on the nearby healthy brain tissue. 

The Neuro-Oncologist: Chemotherapy for Brain Tumors

Chemotherapy drugs are rarely used as a stand-alone treatment for brain tumors but often used in combination with surgery or radiation. One of the most common chemotherapy drug for brain tumors is temozolomide. 

The various types of chemotherapy medicines can be taken as pills, given into a vein to the blood stream, or injected directly into the cerebrospinal fluid (CSF) around the brain (intrathecal chemotherapy). Your neurosurgeon might also place medication directly into the brain tissue after tumor removal: The chemotherapy drug inside a gel wafer slowly dissolves over 2 to 3 weeks.  

Side effects of chemotherapy depend on the type, number, and dose of medicines you take, and the length of your treatment. Because the drugs kill cells that divide quickly, they can also damage healthy cells that quickly divide such as bone marrow cells or cells in the mouth, skin, and digestive tract. 

Therefore, chemotherapy usually is applied in cycles. You receive medication for a certain amount of time and afterwards have time off to recover. This pattern will continue over the course of the treatment. 

Molecular matched targeted therapies for brain tumors

Targeted drugs” are medications that selectively attack specific tumor cell characteristics. Such tumor-specific features may be induced by mutations in the tumor cell genes and detected by molecular genetic diagnostics. Targeted therapies better spare healthy tissue and usually have fewer or milder side effects. While targeted therapies have been shown efficiency in some other advanced cancer types of the body, their use in brain tumors are still at an experimental stage.  

My prognosis: Can brain tumors be cured?

Brain tumor can be a frightening diagnosis. But the course they take can be very variable. 

Some brain tumors are found on a scan unexpectedly, they need to be observed through repeated scanning and they remain the same size. Some brain tumors require surgical removal and they do not regrow. Other brain tumors however may be aggressive and invasive. These tumors require a variety of treatments. They may come back over time. 

A successful outcome depends in many factors including:

Selecting the appropriate treatment course, whether it be surveillance, surgery, radiation therapy, or any other treatment, requires partnering with a medical team you can trust.

TheKnowHow Independent Second Opinion Service

Are you or a loved one suffering from a brain tumor and are unsure about the exact diagnosis or are concerned about your current treatment choices?  

The KnowHow Independent Second Opinion Service is not intended to take you away from your treating doctor, but rather provide an extra level of competence. Get an unbiased assessment from an international expert without having to travel or schedule appointments. Our impartial specialists conduct a record-based assessment of your current health state and all available treatment options, including their advantages and potential hazards.  Read more on PATIENTS and SECOND OPIGNION REQUEST

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