Brain Cancer

Also called: Glioma, Meningioma

Cancer of the brain is usually called a brain tumor. There are two main types. A
primary brain tumor starts in the brain. A metastatic brain tumor starts somewhere
else in the body and moves to the brain. Brain tumors can be benign, with no
cancer cells, or malignant, with cancer cells that grow quickly.
Brain tumors can cause many symptoms. Some of the most common are

Headaches, usually worse in the morning

Nausea and vomiting
Changes in your ability to talk, hear, or see
Problems with balance or walking
Problems with thinking or memory
Muscle jerking or twitching
Numbness or tingling in arms or legs

Brain cancer facts

Brain cancer can arise from many different types of brain cells (primary brain
cancer) or occur when cancer cells from another part of the body spread
(metastasize) to the brain.
Causes of brain cancer are difficult to prove; avoiding compounds linked to
cancer production is advised.
Symptoms of brain cancer vary but often include weakness, difficulty
walking, seizures, and headaches. Other common symptoms are nausea,
vomiting, blurry vision, or a change in a person's alertness, mental capacity,
memory, speech, or personality.
Tests for brain cancer involve a history, physical exam, and usually a CT or
MRI brain scan; sometimes a brain tissue biopsy is done.
Treatments usually are directed by a team of doctors and are designed for
the individual patient; treatments may include surgery, radiotherapy, or
chemotherapy, often in combination.
Side effects of treatments range from mild to severe, and patients need to
discuss plans with their treatment team members to clearly understand
potential side effects and their prognosis (outcomes).
Depending on the brain cancer type and overall health status of the patient,
brain cancer frequently has only a fair to poor prognosis; children have a
somewhat better prognosis.
What is brain cancer?
Brain cancer is a disease of the brain in which cancer cells (malignant) arise in the
brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that
interferes with brain functions such as muscle control, sensation, memory, and
other normal body functions. Tumors composed of cancer cells are called
malignant tumors, and those composed of mainly noncancerous cells are called

benign tumors. Cancer cells that develop from brain tissue are called primary
brain tumors while tumors that spread from other body sites to the brain are
termed metastatic or secondary brain tumors. Statistics suggest that brain cancer
occurs infrequently and is likely to develop in about 23,000 new people per year
with about 13,000 deaths as estimated by the National Cancer Institute (NCI) and
American Cancer Society.
Not all brain tumors are alike, even if they arise from the same type of brain tissue.
Tumors are assigned a grade depending on how the cells in the tumor appear
microscopically. The grade also provides insight as to the cell's growth rate. NCI
lists the following grades:

Grade I: The tissue is benign. The cells look nearly like normal brain cells,
and they grow slowly.
Grade II: The tissue is malignant. The cells look less like normal cells than
do the cells in a grade I tumor.
Grade III: The malignant tissue has cells that look very different from normal
cells. The abnormal cells are actively growing and have a distinctly abnormal
appearance (anaplastic).
Grade IV: The malignant tissue has cells that look most abnormal and tend
to grow quickly.

What is metastatic brain cancer?

Cancer cells that develop in a body organ such as the lung (primary cancer tissue
type) can spread via direct extention, or through the lymphatic system and/or
through the bloodstream to other body organs such as the brain. Tumors formed by
such cancer cells that spread (metastasize) to other organs are called metastatic
tumors. Metastatic brain cancer is a mass of cells (tumor) that originated in
another body organ and has spread into the brain tissue. Metastatic tumors in the
brain are more common than primary brain tumors. They are usually named after
the tissue or organ where the cancer first developed (for example, metastatic lung
or breast cancer tumors in the brain, which are the most common types found).
Occasionally, an abbreviated name may be used that often confuses people; for
example, "small cell brain cancer" actually means "small cell lung cancer that has
metastasized to the brain." People should not hesitate to ask their doctor about
any terms they do not understand.
What causes brain cancer?
Metastatic brain cancer is caused by the spread of cancer cells from a body organ
to the brain. However, the causes for the change from normal cells to cancer cells
in both metastatic and primary brain tumors are not fully understood. Data
gathered by research scientists show that people with certain risk factors are more
likely to develop brain cancer.
Individuals with risk factors, such as having a job in an oil refinery, handlers of
jet fuel or chemicals like benzene, chemists, embalmers, or rubber-

industry workers, show higher rates of brain cancer than the general population.
Some families have several members with brain cancer, but heredity as a
cause for brain tumors has not been proven. Other risk factors such as smoking,
radiation exposure, and viral infection (HIV) have been suggested but not
proven to cause brain cancer. There is no good evidence that brain cancer is
contagious, caused by head trauma, or caused by cell phone use. Although many
lay press and web articles claim that aspartame (artificial sweetener) causes brain
cancer, the FDA maintains that it does not cause brain cancer and base their
findings on over 100 toxicological and clinical studies regarding the sweetener's
safety.
Do cell phones cause brain cancer?
There is an ongoing concern by a number of people that cell phones cause brain
cancer. Some in popular press and some web sites suggest that avoiding cell
phone use and using a macrobiotic diet will help avoid brain cancer. This situation
has been exacerbated by a recent ruling to put cell phones on a list of items that
"may" cause cancer by the International Agency for Research on Cancer (IARC).
This was done because the IARC suggested that an increase in gliomas may occur
with high use of cell phones. The IARC classified cell phones as group 2b
carcinogens; these substances are considered possibly carcinogenic, but evidence
is limited in both humans and experimental animals. The report does not say that
cell phones cause brain cancer.
Currently, many researchers are convinced there is no good evidence for these
cancer-causing claims. In December 2010, a large study of about 59,000 cell
phone users, with use times ranging over five to 10 years, indicates that no
substantial change in brain cancer incidence could be found in these individuals.
Investigators suggest that "high usage" of cell phones over long time periods is yet
to be investigated. With over 5 billion phones in use and no significant increase in
gliomas (the most frequent type of brain cancer) reported worldwide, many
investigators think that normal cell use likely causes no harm. However, for those
readers who want to minimize any electromagnetic radiation dose from cell
phones, the reader can consult the web for a list of phones that produce the
highest and lowest radiation levels (for example, In addition, the use of earphones
or the speaker function will allow usage without the phone having close proximity
to the brain.
What are the Signs and Symptoms of brain cancer?
Although there are few early signs, the most common symptoms of brain cancer
are weakness, difficulty walking, seizures, and headaches. Other common
symptoms are nausea, vomiting, blurry vision, or a change in a person's
alertness, mental capacity, memory, speech, or personality. These
symptoms can also occur in people who do not have brain cancer, and none of
these symptoms alone or in combination can predict that a person has brain
cancer. Cancer can occur in any part of the brain (for example, occipital, frontal,
parietal, or temporal lobes, brainstem, or meningeal membranes).

What tests are used to diagnose brain cancer?

The most frequently used test to detect brain cancer is a CT scan (computerized
tomography). This test resembles a series of X-rays and is not painful, although
sometimes a dye needs to be injected into a vein for better images of some
internal brain structures. Another test that is gaining popularity because of its high
sensitivity for detecting anatomic changes in the brain is MRI (magnetic resonance
imaging). This test also resembles a series of X-rays and shows the brain structures
in detail better than CT. MRI is not as widely available as CT scanning. If the tests
show evidence (tumors or abnormalities in the brain tissue) of brain cancer, then
other doctors such as neurosurgeons and neurologists that specialize in treating
brain ailments will be consulted to help determine what should be done to treat
the patient. Occasionally, a tissue sample (biopsy) may be obtained by surgery or
insertion of a needle to help determine the diagnosis. Other tests (white blood cell
counts, electrolytes, or examination of cerebrospinal fluid to detect abnormal cells
or increased intracranial pressure) may be ordered by the health-care practitioner
to help determine the patient's state of health or to detect other health problems.
What is the treatment for brain cancer?
Surgery, radiation therapy, and chemotherapy are the major treatment categories
for most brain cancers. Individual treatment plans often include a combination of
these treatments. Surgical therapy attempts to remove all of the tumor cells by
cutting the tumor away from normal brain tissue.
Radiation therapy attempts to destroy tumor cells by using high-energy
radiation focused onto the tumor to destroy the tumor cells' ability to function and
replicate. Radiosurgery is a nonsurgical procedure that delivers a single high
dose of precisely targeted radiation using highly focused gamma-ray or X-ray
beams that converge on the specific area or areas of the brain where the tumor or
other abnormality is located, minimizing the amount of radiation to healthy brain
tissue. Equipment used to do radiosurgery varies in its radiation source; a gamma
knife uses focused gamma rays, and a linear accelerator uses photons, while
heavy-charged particle radiosurgery uses a proton beam.
Chemotherapy attempts to destroy tumor cells using chemicals (drugs) that are
designed to destroy specific types of cancer cells. There are many chemical agents
used; specific drug therapies are numerous, and each regimen is usually designed
for the specific type of brain cancer and individualized for each patient. For
example, bevacizumab (Avastin) is a drug approved for treatment of
glioblastomas. Chemotherapy can be administered intrathecally (by a spinal tap or
through a surgically placed permanent reservoir under the scalp attached through
a sterile tubing placed into the fluid-containing chambers in the brain), by IV
administration, and biodegradable chemically impregnated polymers. All
treatments attempt to spare normal brain cells.
Other treatment options may include hyperthermia (heat treatments),
immunotherapy (immune cells directed to kill certain cancer cell types), or steroids

to reduce inflammation and brain swelling. These may be added on to other

treatment plans.