Introduction

Brain tumors are not rare. Thousands of people are diagnosed every year with tumors of the brain and the rest of the nervous system. The diagnosis and treatment of brain tumors depends on the type of tumor, tumor grade and where it started.

This reference summary will help you understand how brain tumors are diagnosed and what options are available to treat them.

Cancer and Its Causes

The body is made up of very small cells. Normal cells in the body grow and die in a controlled way. Sometimes cells keep dividing and growing without normal controls, causing an abnormal growth called a tumor.

If the tumor does not invade nearby tissues and body parts, it is called a benign tumor, or non-cancerous growth. Benign tumors are rarely life threatening.

If the tumor invades and destroys nearby cells, it is called a malignant tumor, or cancer. Cancer can sometimes be life threatening.

Cancerous cells may also spread to different parts of the body through blood vessels and lymph channels.

Cancer treatments are used to kill or control abnormally growing cancerous cells.

Cancers in the body are given names, depending on where the cancer started. Cancer that begins in the breast will always be called a breast cancer, even if it has spread to another place such as the liver, bones, or lungs.

Cancer that starts in the brain, rarely, if ever, spreads outside the brain. It is likely to grow (sometimes rapidly) and crowd out or invade the surrounding healthy brain tissue and cause disability and death. Although doctors can usually locate where a cancer started, the cause of a cancer in a patient cannot usually be identified.

Cells contain hereditary or genetic materials called chromosomes.

This genetic material controls the growth of the cell.

Cancer always arises from changes that occur in this genetic material. When the genetic material in a cell becomes abnormal, it can lose its ability to control its growth.

The sudden changes in genetic material can occur for a variety of reasons. These changes may be inherited from parents. Changes in genetic materials may also occur because of exposure to infections, drugs, tobacco, chemicals, or other factors.

However, to date, the only known causes for brain tumors or cancers are:

1. Previous radiation therapy to the head area.

2. Exposure to some chemicals. These chemicals are formaldehyde used by

pathologists and embalmers, vinyl chloride used in the manufacturing of plastics and acrylonitrile used in the manufacturing of textile and plastics.

Exposure to the textiles and plastics themselves does not increase the risk of developing brain cancer.

A family history of brain cancers increases slightly the chance of developing brain cancer .The use of cell phones has NOT been linked to an increased incidence of brain cancers.

 Signs and Symptoms

brain1The symptoms of brain tumors depend on the tumor size, type, and location. Symptoms may be caused when a tumor presses on a nerve or damages a certain area of the brain.

The most common symptom of brain tumors is headaches, usually because of the pressure that the tumor places on the surrounding brain.

Seizures or convulsions can also occur because the tumor may irritate the brain.

 Other possible signs of brain tumors include:

• Speech problems

• Impaired vision

• Weakness in parts of the body

• Problems with understanding

• Nausea or vomiting

• Problems balancing or walking

• Numbness or tingling in the arms or legs

Primary Brain Tumors

There are two main types of brain tumors: primary and metastatic. Primary tumors start in the brain. Metastatic tumors start somewhere else in the body and move to the brain.

There are two kinds of primary tumors: benign and malignant. Benign tumors do not contain cancer cells. Malignant tumors do contain cancer cells.

brain2 The most common benign primary brain tumors are called “meningiomas.” They begin in the covering of the brain called the dura. They are more common in women than in men. In older patients, small meningiomas should be watched if significant symptoms are not occurring. Meningiomas that are bigger or show a tendency to get bigger may need to be removed surgically.

If the whole tumor is taken out, it is not likely that the meningioma will come back. Rarely, meningiomas can be malignant. In such a case, a second operation may be necessary, and possibly radiation therapy.

The most common primary malignant brain tumor is called a "glioma" because it originates from the glial cells. Gliomas can be classified using a grading system. The system uses 4 grades, from low grade (grade 1) to high grade (grade 4). The grade of a tumor refers to the way the cells look under a microscope. Cells from high grade tumors look more abnormal and generally grow faster than cells from low grade tumors.

 

Grade 1 tumors are the least malignant and the slowest to grow. If they are totally removed surgically they can be associated with long-term remission.

Grade 2 tumors have more malignant cells in them than Grade 1. They grow somewhat faster and have a tendency to recur, often more cancerous than the first time.

Grade 3 and 4 tumors are very malignant and are often difficult to treat. Grade 4 tumors are also known as glioblastoma multiforme. These tumors usually require an operation to take as much of the tumor as possible, followed by radiation therapy and chemotherapy.

Even the most malignant gliomas tend to stay in the brain; they rarely grow outside the brain.

Metastatic Brain Tumors

Metastatic brain tumors start somewhere else in the body and move to the brain.

Cancers that commonly affect the brain are lung cancers, breast cancers, and skin cancers. Metastatic brain tumors are usually found AFTER the original cancer has been diagnosed. Metastatic brain tumors are usually treated with radiation therapy and possibly chemotherapy.

Patients with metastatic tumors usually only have surgery if:

• The original cancer is under control

• There are only a few brain tumors, usually not more than two close to each other

• The brain tumors can be accessed through surgery.

Sometimes a brain tumor may have to be taken out as a life-saving procedure. The outcome of patients with metastatic brain tumors usually depends on the stage of the original cancer.

Diagnosis

brain3 The diagnosis of a brain tumor is usually made after a careful history and physical examination are done, in addition to radiological tests.

CAT scans and MRI scans of the brain are very important in diagnosing brain tumors.

The appearance of the tumor on the CAT scan or MRI may help the doctor determine what kind of tumor the patient has.

Sometimes the CAT scan or MRI does not show the exact type of tumor. More radiological tests and sometimes surgery may be needed to make an exact diagnosis.

Proton Therapy for Brain Cancer Treatment

Proton therapy for brain tumors is generally recommended because of the tumor’s proximity to delicate and vitally important tissues and structures. What’s more, primary brain cancer tumors generally start – and stay – in the brain, making them even more eligible for proton therapy.

Because proton therapy is so precise, brain cancer treatment with proton therapy allows for potentially higher doses of radiation to target brain cancer, with less damage to surrounding tissues. Proton treatment for brain tumors can produce successful outcomes.

brain4

Brain cancers treated with proton therapy

Most brain tumors are not cured by surgery alone and may require radiation therapy to eradicate the remaining cancer cells. When radiation is indicated, proton therapy can be used with fewer side effects. Brain tumors treated include:

    • low grade gliomas
      • astrocytoma
      • oligoastrocytoma
      • oligodendroglioma
    • ependymomas
    • pineal tumors
    • embryonal tumors
      • medulloblastoma
      • CNS primitive neuroectodermal tumor (PNET)
      • atypical teratoid/rhabdoid tumor
    • sellar tumors
      • pituitary tumors
      • craniopharyngioma
    • meningiomas

proton

The gantry rotates 360 degrees around the patient to deliver treatment from different angles, allowing physicians to precisely target the tumor site. It is typically used to treat complex cases, such as those found in pediatric patients and hard-to-reach tumors in adult patients

What to expect

Each patient’s therapy is precisely tailored to their needs. Patients and clinicians collaborate closely to create a personalized treatment plan. The number and length of treatments will vary, based on the cancer. How patients respond depends on many factors, including the types of treatments they are receiving. Many people tolerate proton therapy well and continue to perform normal activities. However, individual responses vary.

Advantages of Proton Therapy for Brain Cancer

Although proton radiation treatment is relatively new, clinical trials for brain cancer have already shown excellent signs of disease control and minimal side effects compared with traditional forms of treatment. Proton therapy also offers a number of other compelling benefits:

    • Treatment is noninvasive and painless
    • Proton therapy is effective for treating early stage brain cancer
    • Treatment offers quicker recovery times with minimal side effects
    • It is more accurate and precise than other kinds of radiation
    • Treatment is provided in an outpatient setting
    • Proton radiation has little to no impact on patient energy level