CONDITIONS

Brain Tumour

An abnormal, uncontrollable multiplication of cells leading to their growth in the brain is known as brain tumour. In India, the incidence of central nervous system (CNS) tumors in India ranges from 5 to 10 per 100,000 population.

What are the types and grades of brain tumour?

Brain tumours are graded according to the speed at which they grow and their chances to grow back post treatment.

Grade 1 and 2 tumours are low grade, and grade 3 and 4 tumours are high grade.

There are 2 main types of brain tumours:

  • non-cancerous (benign) brain tumours – also known as low grade (grade 1 or 2), since they grow slowly and are less likely to return after treatment
  • cancerous (malignant) brain tumours – these are high grade (grade 3 or 4) and these type either start in the brain (primary tumours) or spread into the brain from elsewhere (secondary tumours) because of some other cancer; the chances of these are higher to return and grow back after treatment

What are the symptoms of Brain Tumour?

Symptoms depend on the size and location of the brain tumour. General signs and symptoms caused by brain tumors may include:

  • Headache or pressure in the head worse in mornings.
  • Frequent and severe headaches
  • Nausea or vomiting.
  • Eye problems, such as blurry vision, seeing double or losing side vision.
  • Losing feeling or movement in an arm or a leg.
  • Trouble with balance.
  • Speech problems.
  • Extreme tiredness.
  • Confusion in everyday matters.
  • Memory problems.
  • Trouble following simple commands.
  • Personality or behaviour changes.
  • Seizures, especially if there is no history of seizures.
  • Hearing problems.
  • Dizziness or a sense that the world is spinning (vertigo)
  • Feeling very hungry and gaining weight.

Brain tumor headaches

  • Headaches – most common symptom of brain tumors.
  • Happen in about half of people with brain tumors due to a a growing brain tumor that encroaches on healthy cells around it.
  • Headaches may also occur due to swelling in the brain
  • Worse in the morning, but could happen anytime.
  • Sometimes, headaches are so severe that it wakes up from sleep.
  • Worsens when coughing or straining.
  • Headache feels like a migraine.
  • Brain tumors in the back of the head – neck pain.
  • Brain tumor in the front of the head – eye pain or sinus pain.

What are the causes and risk factors of Brain Tumour?

The cause of most brain tumours is unknown, but some factors may increase chances of developing a brain tumour. These factors are:

  • Age – increasing age increases the risk of getting a brain tumour (most brain tumours happen in older adults aged 85 to 89),
  • Radiation – although very rare, exposure to radiation may lead to brain tumours;
  • Family history and genetic conditions – genetic conditions may increase the risk of getting a brain tumour, including tuberous sclerosis, neurofibromatosis type 1, neurofibromatosis type 2 and Turner syndrome.

How is Brain Tumour diagnosed?

Upon suspecting brain tumour, doctor may conduct following tests:

A neurological exam – to check for vision, hearing, balance, coordination, strength and reflexes

Head CT scan – A computed tomography scan (CT scan), using X-rays to generate pictures and detect problems in and around the brain

Brain Magnetic resonance imaging (MRI): To detect brain tumors as it provides clearler images than do other imaging tests.

PET scan of the brain: To detect tumours that are growing quickly.

Brain biopsy:  A sample of brain tumor tissue is tested in the lab.

What are the treatment options for Brain Tumour?

The treatment for brain tumour depends on:

  • the type of tumour
  • location in the brain
  • size of the tumour and how far it’s spread
  • abnormality of the cells
  • a person’s overall health and fitness

Treatment might not be needed immediately if the brain tumor is small, noncancerous and non-symptom causing. In case the tumour is small and benign, with a slow growth rate, then, a brain MRI scan may be advised for a few times a year to keep a check for tumour growth. If however, the brain tumor grows more quickly than expected treatment might be needed.

Treatments for brain tumours include:

  • Surgery: goal of surgery is removal all of the tumor cells
  • Radiotherapy – By using powerful energy beams to kill tumor cells
  • Radiosurgery – aims beams of radiation from many angles at the brain tumor so that where the beams meet gets a very large dose of radiation that kills the tumor cells.
  • Chemotherapy – By using strong medicines to kill tumor cells
  • Steroids – to help reduce swelling around the tumour.

Medicines to manage symptoms like painkillers, anti-seizure medications.

What can be done for recovery post treatment for brain tumour?

Help may be needed regain function like moving, speaking, seeing and thinking depending on the part of brain with tumour.  The health care provider might suggest:

  • Physical therapy to help you regain lost motor skills or muscle strength.
  • Occupational therapy to help you get back to your typical daily activities, including work.
  • Speech therapy to help if speaking is difficult.
  • Tutoring for school-age children to help them cope with changes in memory and thinking.
  • People can also approach organizations to help with the management of brain tumour. The Brain Tumour Foundation and Brain Tumour Support Group in India are 2 organizations that works to improve the care and treatment available to people with brain tumour and their families; and provides a platform for people affected by brain tumour to connect, share their experiences, and receive support respectively.

References

  1. Dasgupta A, Gupta T, Jalali R. Indian data on central nervous tumors: A summary of published work. South Asian J Cancer. 2016 Jul-Sep;5(3):147-53.
  2. Brain Tumour. Mayo Clinic. May 2024. https://www.mayoclinic.org/diseases-conditions/brain-tumor/diagnosis-treatment/drc-20350088
  3. Brain Tumours. NHS UK. May 2024. https://www.nhs.uk/conditions/brain-tumours
  4. The Brain Tumour Foundation. May 2024. https://braintumorfoundation.in/
  5. Brain Tumor Support Group. May 2024. https://btsgfoundation.in/

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