diease

Brain Tumour


OVERVIEW OF Brain Tumour :

  The brain tumour is termed as the abnormal growth or mass of cells in the brain. The skull is an rigid structure and it encloses the brain. When any abnormalities such as cancerous or non cancerous tumours occurs develops in that restricted space it might leads to the cause of the brain cell tumour. The growth of the tumour creates pressure in the brain and eventually causes serious complications


CAUSES :

Causes:

Genetics

Age – increase in age increases the chances for brain tumour

Chemical exposure-cyproterone acetate, pesticides , excessive use of dyes.

Ionizing radiation

Epstein Barr infection


COMMON CLINICAL SIGNS AND SYMPTOMS :

The symptoms are based upon the site of the brain area involved:

Frontal lobe:

Change in personality

Aggressive nature

Loss of speech and vision

Loss of smell

Difficulty in walking

Weakness in one side of the body

Apathy

Temporal lobe:

Forgetting words

Short term memory loss

Seizures.

Parietal lobe:

Difficulty in speaking

Difficulty reading or writing

Loss of feeling inn one side of the body

Occipital lobe:

Vision impairement

Cerebellum:

Issue with co-ordination of the movements

Nausea

Uncontrolled eye movements

Dizziness

Neck stiffness

Brain stem:

 Eyelid or mouth drooping on one side

 Difficulty swallowing

     Difficulty speaking

Double Vision

Issues with co ordination

Spinal cord:

Pain

Numbness

loss bowel and bladder habits

difficulty is walking

weakness in legs and arms

Pituitary gland:

Lack of energy

Weight gain

Mood Swings

High blood pressure

Diabetes

Enlarged hands/feet

(Women) Irregular/Infrequent Periods

 Infertility / Impotence

Meninges:

Head ache

Feeling heaviness in head

Nausea

Sight pain

Neck stiffness

Signs:

Seizure

Tingling sensation

Depression

Memory loss


DIAGNOSTIC :

  • Physical exam and medical history: Your doctor will perform a general health exam, looking for signs of diseases or illnesses. Your doctor will also ask questions about past and current health conditions, surgeries and medical treatments and family history of disease.
  • Blood test: To check for tumor markers (substances secreted into blood by tumors) that are linked to certain types of tumors.
  • Biopsy: Through a small hole in the skull, a doctor uses a needle to take a sample of tissue from the tumor. A laboratory studies the sample to identify details from the tumor, including how fast it is growing and whether it is spreading.

          Biomarker: Biomarkers or genetic mutations found in the tumor may help  to determine the  prognosis. These include: IDH1IDH2MGMT, and 1p/19q co-deletion.

  • Imaging tests: CT scans, MRI scans  SPECTs and PET scans help doctors locate the tumor and determine if it is cancerous or benign. Your doctor may also look at other parts of the body, such as the lungs, colon or breasts, to identify where the tumor started.
  • Neurological exam: During a neurological exam, your doctor will look for changes in your balance, coordination, mental status, hearing, vision and reflexes. These changes can point to the part of your brain that may be affected by a tumor.
  • Spinal tap: A doctor uses a small needle to remove fluid from around the spine. A laboratory examines this fluid to look for cancer cells.


TREATMENT AND PROGNOSIS :

The following medications are used to treat the following brain tumour:

  • Steroids such as dexamethasone are used in the treatment of brain tumour. Intake of steroid result in increase chances for peptic ulcer hence famotidine and pantaprazole are used to treat the disease.
  • Furosemide and mannitol can be used to treat the brain edema and swelling. Anticonvulsants are used to treat or prevent the edema.  The most common cause include phenytoin,valproic acid and carbamazepine.

Surgery is the best treatment for brain tumour which might result in the reduced side effects and does not causing much side effects. Surgery can help to redefine the diseases and remove as much of the tumour as possible and it also releases pressure within the skull. A neurosurgeons performs the craniotomy to redefine the skull. In some cases only part of the tumour is reduced if the tumour is present nearer to the critical structures. A partial removal can result in relief to the symptoms.

Laser Interstitial Thermal Therapy:

This treatment is done with the help of heat which is tramitted from the laser. This heat initiates the process of dissolving the tumour and it is done by the guidance of MRI.

Radiation:

In this treatment high energy rays are used in the treatment of brain tumour. Radiation damages the tumour by interfering with replication of the DNA cells. The large tumours gets shrinked upon the exposure to radiation.

Lethal dose is applied to the tumour which does not affect the surrounding healthy tissue. This is done by external beam radiation.

External beam is done by exposing the tissue to higher energy waves such as gamma rays and xrays at the tumour site.

  • Stereotactic Radiosurgery: delivers a high dose of radiation during the single beam of rays.
  • Fractioned Radiotherapy:delivers lower dose of radiation over several period of duration. Patient might comes to the visit several weeks for the complete curable rate.
  • Proton beam therapy uses the accelerated source of proton to destroys the tumour cells. The main advantage of this therapy is that the ray is passed only at the tumour site.

Whole brain therapy leads to the passage of beams to the entire brain. This results in destroying the multiple tumours at the various sites and metasized tumours.

Internal radiation (brachytherapy) :

The beam is passed  from inside the body by radioactive seeds surgically placed inside the tumor.  The patient undergoes the craniotomy and the skull is opened and the site of the tumour is detected and implant which transmits the drug is placed. The size of the tumour is reduced and the surrounding tissues are not , much damaged.

Chemotherapy

Chemotherapy drugs work by interfering with the cell division. In chemotherapy the normal healthy cells are also damaged. But the time taken by the normal cells to repair and rejuvenate is of shorter duration.

Chemotherapy drugs can be taken orally as a pill, intravenously (IV), or as a wafer placed surgically into the tumor. The drugs most commonly used to treat brain tumors are temozolomide (Temodar) and bevacizumab (Avastin). The most common side effects are nausea, low blood counts, infections, fatigue, constipation, and headaches. Chemotherapy is also used to increase tumor cell death during radiation therapy.

Chemotherapy is used mainly for the gliomas and it is not indicated much for benign tumours.

Adjunct therapiess

  • Immunotherapy or biotherapy activates the immune system (T-cells and antibodies) to destroy tumor cells. Research is exploring ways to prevent or treat cancer through vaccines.
  • Gene therapy uses viruses or other vectors to introduce new genetic material into tumor cells. This experimental therapy can cause tumor cells to die or increase their susceptibility to other cancer therapies.
  • Hyperbaric oxygen uses oxygen at higher than normal levels to promote wound healing and help fight infection. It may also improve the tumor’s responsiveness to radiation and is being studied experimentally. Currently it is being used to help the body naturally remove dead tumor cells and treat radiation necrosis.

Tumor Treating Fields or TTFields

TTFields slows and reverses tumor growth by keeping cells from dividing. TTFields is used for the treatment of glioblastoma multiforme (GBM) in combination with temozolomide in adults who have been newly diagnosed. It is also approved for treatment of recurrent GBM after surgical and radiation options have been exhausted. Treatment involves wearing a device resembling a bathing cap that delivers electromagnetic energy to the scalp.

 


PROGNOSIS :

Some brain tumours grow very slowly (low grade) and cannot be cured. Depending on your age at diagnosis, the tumour may eventually cause your death. The extent of the tumour also plays a vital role in prognosis of the disease. Metastic tumour is critical to get the good prognosis in them.

  • Grade I. These tumors are slow growing and unlikely to spread. They can often be cured with surgery.
  • Grade IIThese tumors are less likely to grow and spread but are more likely to come back after treatment.
  • Grade III. These tumors are more likely to have rapidly dividing cells but no dead cells. They can grow quickly.
  • Grade IV. In a grade IV tumor, cells in the tumor are actively dividing. In addition, the tumor has both blood vessel growth and areas of dead tissue. These tumors can grow and spread quickly.


PREVENTION :

Avoid the exposure to environmental hazards

ckeck the blood pressure regularly

practises yoga

Avoid the exposure to ionizing radiation to an larger extent.


Medicines used in the Treatment :

Furosemide 

 Mannitol 

phenytoin

 valproic acid

 carbamazepine

 


REFERENCE :

https://www.indushealthplus.com/brain-tumour-types-causes-symptoms-prevention.html

https://my.clevelandclinic.org/health/diseases/6149-brain-cancer-brain-tumour

https://www.cancer.net/cancer-types/brain-tumor/grades-and-prognostic-factor

https://www.nhs.uk/conditions/malignant-brain-tumour/