Brain tumour guide

31/07/2022

Icon editWhat is a brain tumour?

A brain tumour occurs when cells begin to grow abnormally and form a mass. A difference between a benign tumour and cancer is that the tumour grows relatively slowly in the brain.

Benign neoplasms of the brain tend to stay in one place and do not spread. Therefore, it usually does not return if the doctor removes the entire tumour during surgery.

What is a brain tumour?There are more than 100 types of tumours, each with its spectrum of manifestations, treatments, and outcomes. The difference between types depends on the type of cells from which they develop.

The most common types:

  • gliomas - tumours of the tissue that supports nerve cells and fibres;
  • meningiomas - neoplasms of the membranous layers surrounding the brain;
  • acoustic neuromas - tumours of the auditory nerve, known as vestibular schwannomas;
  • craniopharyngiomas - lump near the base of the brain, the most common neoplasm in children, adolescents and young adults;
  • hemangiomas - neoplasms of cerebral vessels;
  • pituitary adenomas - tumours of the pituitary gland, pea-sized glands on the lower surface of the brain.

Approximately 71% of all brain tumours are benign. However, 58% of formations are diagnosed in women and 42% in men. The median age at diagnosis is 61 years. The survival rate for all patients with a primary brain tumour is 75.7%.

Icon microscopeDiagnostic tests

The symptoms of a benign brain lump depend on its size and localization. Some slow-growing neoplasms may not cause any symptoms at the beginning.

Common symptoms include:

  • new emerging, persistent headaches;
  • convulsions, epileptic seizures;
  • constant malaise, nausea, drowsiness;
  • mental or behavioural changes, personality changes;
  • weakness or paralysis, problems with vision or speech (for example, difficulty finding words).

Most neoplasms are diagnosed by a general practitioner or neurologist after the onset of symptoms. The doctor may prescribe additional tests to assess the neoplasm's growth rate and spread to other body structures.

  • Blood tests - to check overall health and hormone levels in the body.
  • MRI scan- with the help of a powerful magnet and a computer, a detailed cross-sectional image of the head is created.
  • CT scan uses x-rays to take multiple images of the brain inside to compile them with a computer into a coherent and detailed picture.
  • MRS scanning (magnetic resonance spectroscopy) is a specialized type of MRI. It helps to receive information about chemical changes in the brain.
  • SPET or SPECT scan - shows blood flow in the brain. Areas with higher blood flow, such as a neoplasm, will appear brighter on the scan.
  • PET scan - a small amount of a radioactive solution is injected, which helps neoplasm cells appear brighter on the scan.
  • Surgical biopsy - if the scan reveals an abnormality that looks like a lump, the doctor may remove some or all of the tissue for examination. Sometimes, the neurosurgeon makes a small hole in the skull and inserts a needle to take a sample. In other cases, a biopsy is performed during surgery.

All the information obtained from testing helps the doctor plan treatment and adapt it to a specific disease.

Icon doctorTreatment methods

The goal of treatment may be to entirely remove the tumour, slow its growth, or relieve symptoms by shrinking it. Very often, the only necessary treatment is surgery.

Complete tumour removal - total resection or partial removal can be achieved with neurosurgery. Partial resection may be indicated in cases where the neoplasm is located near large blood vessels or important brain parts. The smallest damage can lead to paralysis or blindness.

For brain neoplasms, the following types of neurosurgical operations are used:

  • Removal of a brain tumour (craniotomy) is the most common surgery type. All or part of the lump is removed under general anaesthesia. The surgeon cuts a section of bone from the patient's skull to access the brain. The growth is removed, and the bone is put back in place. Currently, this operation is performed using a computer navigation system.
  • Removal of a pituitary tumour (endoscopic transsphenoidal surgery) is the most common operation for neoplasms near the base of the brain. The surgeon inserts a long, thin tube with a light and a camera (endoscope) through the nose and into the base of the brain.
  • Removal with a tubular retractor system is a new minimally invasive procedure. A retractor is an instrument that moves or holds tissue so the surgeon can reach a specific area. The value of the tubular retractor lies in the fact that it pushes the folds and delicate tissues of the brain with less risk of damage than other surgical methods - displaces the tissue rather than cuts it.

Icon plusNew treatments options

If it is impossible to remove the entire tumour, further treatment will be required. In addition, sometimes, the operation cannot be performed because the neoplasm is located in a place inaccessible to the surgeon or is close to vital structures. Such neoplasms are inoperable and unresectable, and their treatment requires new or alternative methods.

  • Radiosurgery (CyberKnife, GammaKnife) is an advanced radiation method that accurately delivers a high dose of radiation to a lump anywhere in the brain. A painless, non-invasive procedure, it does not use a real knife but is called "radiosurgery" because of its precision. This procedure is also called stereotactic radiosurgery. A particular device emits a narrow radiation beam from a robotic arm that moves around the patient's body, targeting the lump. Using brain scans taken before and during the procedure, the robotic arm automatically tracks and compensates for small movements. An accurate map of the tumour's location in the brain is constantly updated throughout the procedure. In addition, advanced radiosurgery techniques minimize radiation exposure to healthy tissue surrounding the tumour.
  • Endovascular embolization (for vascular tumours) is a procedure that cuts off the tumour's blood supply. As a rule, a brain neoplasm has relatively large vessels that feed it. During the procedure, a thin tube called a catheter is inserted into an artery in the leg and is guided through the blood vessels to the brain by X-rays. The catheter is then placed into one of the arteries that feed the brain lump. The next step is to inject an embolizing agent, such as a jelly-like substance or small particles, to block the vessel.

Icon chartStatistics and prognosis

The survival time after a brain neoplasm diagnosis depends on the patient's age, the type and extent of the tumour, and the symptoms present. However, the chances of survival have gradually improved over the past 30 years.

Despite a slight improvement from previous studies, the five-year survival rate for brain tumours is still only 12.5%, compared with 12% in previous years, according to the National Cancer Institute. At the same time, the five-year survival rate for women with breast cancer is 86%, and for men with prostate cancer - 87%.

Statistics and prognosis

Understanding statistics, the AiroMedical team is ready to provide all necessary information for patients to understand the importance of treating a brain lump as soon as possible.

  • Every two hours, someone is diagnosed with a brain neoplasm;
  • Only 12% of patients survive five years after diagnosis;
  • Brain tumours are the leading cause of cancer death in children and young adults.

References:

  1. BMJ: Brain tumours: incidence, survival, and aetiology
  2. AiroMedical: Examination (check-up) in Germany
  3. National Brain Tumor Society: Quick Brain Tumor Facts
  4. American Brain Tumor Association: Emotional impact of a brain tumour
  5. NHS: Treatment - Benign brain tumour (non-cancerous)
  6. Cancer.Net: Brain Tumor: Types of Treatment
  7. Cancer Council: Treatment for brain tumours