Brain cancer is defined as cancer that starts in the brain. Cancer that starts elsewhere in the body and then moves into the brain is called a metastatic brain tumor.
Brain cancer can change a person's behavior and can be quite deadly. Fortunately, many people will never suffer through this disease. According to the American Cancer Society, the chance of developing a malignant tumor in the brain or spinal cord is less than 1 percent, which means 1 in 140 men and 1 in 180 women may be affected by this disease.
Brain cancer is caused by abnormal cell growth in the tissue of the brain. Anaplastic astrocytomas and glioblastomas make up about one-third of brain tumors in adults, and astrocytomas are the most common type of brain tumor in children, according to the National Cancer Institute. Anaplastic astrocytomas, astrocytomas and glioblastomas develop from brain cells called astrocytes, which surround and protect other nerve cells. The types of brain cancer are differentiated by "grades." A grade is how normal or abnormal the cells look. Each type of these brain cancers are given a grade from I to IV.
Since the brain is the control room of the body, cancer located in this area can affect many different areas of the body. The most common symptoms of brain tumors are headache, seizure, weakness, numbness and behavioral change, according to Dr. Andrew E. Sloan, director at the Brain Tumor & Neuro-Oncology Center and a professor and vice chair at the department of neurological surgery at University Hospitals-Seidman Cancer Center in Cleveland, Ohio.
The Mayo Clinic also lists these symptoms of brain cancer:
- Speech difficulties
- Hearing problems
- A change in the pattern of headaches
- Unexplained nausea or vomiting
- Vision problems, such as blurred vision, double vision or loss of peripheral vision
- Gradual loss of sensation or movement in an arm or a leg
- Difficulty with balance
- Confusion in everyday matters
Headaches are often associated with brain cancer, but some people can go without having tell-tale headaches, said Sloan. That's usually not the case, though.
"Headache is a sign that the tumor is putting pressure on the normal brain and increasing the intracranial pressure," said neurosurgeon Dr. Charles Park, director of the Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore, Maryland. "So, it's true headache is present most of the time, if the size of tumor is sufficiently large enough. Also, location is very important. Depending on the area of brain affected, the symptoms can vary from weakness, numbness, seizure, memory, speech difficulties, etc."
There are some symptoms that many people may not associate with a tumor in the brain. "A tumor in the right parietal region of the brain (above and behind the right ear) can cause what's known as a 'dressing apraxia,'" said Dr. Michael Schulder, a neurological surgery specialist and director at the Brain Tumor Center at Northwell Health's Neuroscience Institute in Manhasset, New York. "People who have that may walk, talk and do everything else normally, but not be able to properly identify and wear clothing. An example would be someone putting his pants on his head."
If a medical professional suspects brain cancer, the patient is usually referred to a specialist. The specialist may check hearing, vision, coordination, balance, strength and reflexes to look for abnormalities that may point toward brain cancer. The specialist may also order a magnetic resonance imaging (MRI), computerized tomography (CT) or a positron emission tomography (PET) scan to find a possible tumor, according to the Mayo Clinic.
If a tumor is found, a biopsy will typically be ordered. A biopsy is the collection and testing of the tissue in question. Biopsies are used to determine if the tumor is cancerous or benign.
There are many ways to treat brain cancer. Treatment depends on where the tumor is located, how advanced the cancer is and the type of the tumor. Some options include surgery, chemotherapy, radiation treatment, radiosurgery and drug therapy, according to the Mayo Clinic. The survival rates of those diagnosed with brain cancer varies, depending on the type of cancer, its progression and several other factors.
Though many movies and television shows would have viewers believe that most brain cancers are inoperable, that just isn't true. Schulder explained that with almost no exception, it is possible to at least perform a biopsy on someone with brain cancer, if nothing else.
"In the future, imaging techniques such as MRI may take the place of biopsies, but that is far in the future, if ever," said Schulder. "However, using modern techniques of microsurgery, advanced imaging, intraoperative monitoring, and intraoperative imaging, most brain tumors can be surgically removed. Most of the time it is best to remove as much of a tumor as possible."
"Inoperable is defined differently by different surgeons," said Sloan. "Its estimated that the mean number of brain tumors the average neurosurgeon in the U.S. operates on is two to three per year. Subspecialists at major brain tumor centers like the UH-Seidman Cancer Center commonly operate on 60 to 100 brain tumors a year, and often certain individuals will subspecialize in various types. Thus while some complicated tumors might be truly 'inoperable' to a neurosurgeon in general practice who typically do many kinds of surgery, only rare tumors are truly 'inoperable' to subspecialists with specialized tools such as intra-operative MRI, stereotaxis, fluorescent imaging of tumors (i.e. 5-ALA), laser interstitial thermotherapy (LITT), etc."
For example, deep malignant tumors of the corpus callosum, also called "butterfly gliomas," have typically been considered inoperable, but with surgeons using LITT, they can now be treated using surgery.
One occasion where a brain tumor may be inoperable is if it's located in the "eloquent" or very important part of brain with vital functions, explained Park. In trying to remove the tumor, a surgeon can do more damage to the brain and the patient may either become comatose or a vegetable-like. In this case the risk would outweigh benefits of the surgery. "These are a very small percentage. However, most of these can be treated with radiosurgery," said Park.
Overall, the tumor's anatomy and pathology, patient's general medical condition, prognosis, expectations and quality of life are all carefully considered before operations are considered.