Few facts about brain tumours

Brain tumor refers to formation of  abnormal cells within the brain.  There are two main types of brain tumors: cancerous (malignant) tumors and indolent (benign) tumors.    

Warning signals

Tumours produce symptoms either due to compression or irritation of brain

• Headache occurring in later onset of life and gradually increasing in intensity. There can be a constant aching pain without any painfree period in between.  Usually Headache is maximum in the morning and the victim wakes up with severe headache
• Projectile vomiting mostly on waking up in the morning. Here the vomiting may not be preceded by nausea. Vomiting can offer temporary relief to the headache.
• New onset seizures with can be focal seizures ( More significant) involving only part of the body or it can be generalized seizures.
• Weakness or numbness- progressively increasing and can involve only one limb or one side of the body.
• Visual problems especially when it involves the optic Nerve(  nerve of vision) or pituitary gland.
• Cognitive problems occurring suddenly like memory problems,  behavioral changes, language problems , confusions etc
• Difficulty in speech, Sudden Gait disturbances, imbalance ,in coordination or weakness of facial muscles

Risk factors

Majority of brian tumours don’t have any specific causative factors. The best known environmental risk factor for brain tumors is radiation exposure. Impaired immune systems have an increased risk of developing  lymphomas  (cancers of lymphocytes ). In rare cases (5%) brain cancers run in families. Environmental factors such as exposure to solvents, pesticides, oil products, rubber, or vinyl chloride (a chemical used to manufacture plastics), petroleum products, and certain other chemicals have been linked with an increased risk of brain tumors..Exposure to aspartame (a sugar substitute) and infection with certain viruses ( Epstein Barr virus, human Cytomegalovirus, polyoma virus) are possible risk factors. Relation to Cell phone use, Head injury, Power lines, Diet, Smoking and alcohol remains controversial.

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Treatment

Tumours like Meningiomas , Certain Gliomas,   Pituitary adenomas ,Nerve sheath tumors , germ cell tumours, haemangioblastomas, cavernomas,  and certain Lymphomas are curable.

Survival rates in brain tumors depend on the

Type of tumor, size, area involved and early detection

Age and  health of the patient,

Extent of surgical tumor removal.

The primary and most desired course of action is surgical removal (resection) via craniotomy. Minimally invasive techniques is the trend in neurosurgery.  Endoscopic surgeries are also being done. With the availability of ultramodern operating microscopes, neuronavigation systems, Cavitron ultra sonic aspirator, endoscopes and other  sophisticated instruments along with better understanding of surgical techniques, the safety and success rate for brain tumour surgery has dramatically improved.

Radiotherapy is the most commonly used treatment for brain tumors. Radiosurgery is a treatment method that uses computerized calculations to focus radiation at the site of the tumor while minimizing the radiation dose to the surrounding brain. Types of stereotactic radiosurgery, include Gamma knife, linear accelerator and  Cyberknife.  

Chemotherapy: is a treatment option for cancer, and can improve survival in 20% brain cancers.

Role of pharmacological therapy is limited  except for anti epileptics(  controlling fits) and steroids( reduce brain oedema)

Extensive research and studies are going on for better understanding of the behavior of different brain tumours and more and more treatment modalities are being tried to fight this dreaded disease. Immunotherapy/ biological response modifier (BRM) therapy, Oncolytic virus therapy.  Targeted therapy of faulty genes or proteins, Gene therapy.  Hormonal therapy, photodynamic therapy and  Electric field therapy are some of the treatment modalities that may bring hope in the future.

Cell phone and brain tumours

Cell phones give off radiofrequency (RF) rays, a form of energy on the electromagnetic spectrum between FM radio waves and those used in microwave ovens, radar, and satellite stations., Till now it has not been proved that RF waves can cause brain tumours and at the same time it remains to be proved that RF waves are absolutely safe. It is ionizing radiations  that has been proved to cause cancer by damaging the DNA inside cells. Cell phones do not give off ionizing radiation. The  International Agency for Research on Cancer (IARC) classified mobile phone radiation as Group 2B – possibly carcinogenic. That means that there “could be some risk” of carcinogenicity, so additional research into the long-term, heavy use of mobile phones needs to be conducted.

Radiofrequency rays emitted from mobile phones has not been proved to cause brain tumours nor have they been proved to be absolutely safe. IARC hence recommends mobile phones to be used judiciously.

Dr Arun Oommen

MBBS,  MS ( Gen Surg),  Mch( Neurosurgery), MRCSEd,  MBA

Sr Consultant Neurosurgeon,

VPS Lakeshore Hospital, Kochi.