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Brain Tumor and Brain Cancer—Adult

Definition

A brain tumor is the presence of cancer cells in the brain.
There are 2 main types of brain tumors:
Brain Tumor
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Causes

Cancer occurs when cells in the body divide without control or order. If cells divide uncontrollably, they form a mass of tissue. The mass is called a growth or tumor. The term cancer usually refers to malignant tumors. These can invade nearby tissue and spread to other parts of the body. A benign tumor does not spread. But, it can continue to grow and press structures near it, causing symptoms.
The cause of most primary brain tumors is unknown, but it is probably a combination of genetics and environment. Secondary brain tumors are caused by cancer that spreads to the brain from another site in the body.

Risk Factors

Factors that increase your chance of a brain tumor include:
Any cancer in the body can spread to the brain. The most common tumors that may spread to the brain include:

Symptoms

Symptoms depend on the tumor's size and location. A growing tumor will often have fluid build-up around it. This is called edema. Edema puts pressure on the brain. Symptoms may develop gradually or rapidly.
Symptoms may include:

Diagnosis

You will be asked your symptoms and medical history. A physical exam will be done. You will have a neurological exam. It will test muscle strength, coordination, reflexes, response to external actions, and alertness. The doctor may also look into your eyes to check for signs of brain swelling.
Images of your bodily structures may need to be taken. This can be done with:
A sample of brain tissue may need to be removed for testing. This can be done with:
There are many different types of brain tumors. The doctor will classify the type. The type of brain tumor is important to determine the treatment approach.

Treatment

Treatment depends on the type, size, location of the cancer, and your overall health. Treatments may leave you with physical or mental limitations.
Before beginning treatment, you may take medications, including:

Surgery

Surgical procedures include:
  • Craniotomy—opening the skull to remove the tumor or as much of the tumor as possible
  • Shunt—implanting a long thin tube in the brain to direct fluid build up to another part of the body

Radiation Therapy

Radiation therapy uses radiation to kill cancer cells and shrink tumors. This is a common treatment for brain tumors. Radiation may be:
  • External —Radiation is directed at the tumor from a source outside the body. If you have a metastatic brain tumor, you will receive whole brain radiation therapy (WBRT). If you have a primary brain tumor, you will receive more focused radiation therapy. WRBT may also be used in people who have cancer in other areas of the body. The treatment is used to prevent brain tumors.
  • Internal—Radioactive materials are placed into the body near the cancer cells. This is used less often.
  • Stereotactic radiosurgery—Higher doses of radiation can be delivered to the affected areas of the brain. Nearby normal tissue can be spared. Special equipment, including MRI and CT scans, help to focus the radiation. This is most often used in metastatic brain tumors or in benign brain tumors, such as meningiomas.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It may be given in many forms, including pill, injection, or through a tube called a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. It may also be delivered directly into the cerebrospinal fluid, which bathes the brain tissue. This form of chemotherapy is called intrathecal. This is most often used when cancer has spread from elsewhere in the body to the fluid surrounding the brain and spinal cord.

Rehabilitation Therapy

Rehabilitation therapy includes:
  • Physical therapy to help with walking, balance, and building strength
  • Occupational therapy to help with mastering life skills, such as dressing, eating, and using the toilet
  • Speech therapy to help express thoughts and overcome swallowing difficulties

Prevention

There are no current guidelines to prevent a brain tumor because the cause is unclear.

RESOURCES

American Brain Tumor Association http://www.abta.org

American Cancer Society http://www.cancer.org

CANADIAN RESOURCES

Canadian Cancer Society http://www.cancer.ca

Cancer Care Ontario http://www.cancercare.on.ca

References

Astrocytoma and oligodendroglioma in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 9, 2014. Accessed September 5, 2014.

Brain cancer—for patients. National Cancer Institute website. Available at: http://www.cancer.gov/types/brain. Accessed September 5, 2014.

Brain tumors. American Association of Neurological Surgeons. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Brain%20Tumors.aspx. Updated June 2012. Accessed September 5, 2014.

5/28/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Tremont-Lukats IW, Ratilal BO, Armstrong T, Gilbert MR. Antiepileptic drugs for preventing seizures in people with brain tumors. Cochrane Database Syst Rev. 2008;(2):CD004424

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