The brain is the center of thought, memory, emotion, speech, sensation and movement. Different types of tumors start in the brain and can affect a variety of functions. These tumors cause damage because as they grow they can interfere with surrounding brain tissue that performs vital functions. According to the American Cancer Society, 21,810 cases involving the brain and other areas of the nervous system, were diagnosed in 2008.
Most brain tumors occur for no apparent reason and there are no proven ways to prevent them.
Among the most common complaints leading to a diagnosis of a brain tumor that would require further evaluation are:
- Weakness and/or numbness on one side of the body
- Changes in vision, hearing or sensation
- Impaired speech
- Difficulty with walking, coordination or doing simple tasks
- Changes in personality and ability to think
- Loss of memory
If you experience any of the early signs of a brain tumor, your doctor will probably conduct some or all of the following tests:
- - General physical and neurological examination to evaluate your overall health and brain function
- - Imaging studies such as CT, MRI or PET scans to look for abnormal area
If studies indicate you might have a brain tumor, a small amount of tissue may be removed (biopsy) to make a diagnosis. This will depend on the appearance of the area on a scan and the location within the brain.
Types of Brain Tumors
- Primary brain tumor: one that starts in the brain. They can be benign (noncancerous) or malignant (cancerous). These rarely spread outside the brain.
- Metastatic brain tumor: one that is caused by a cancer that starts elsewhere in the body and spreads to the brain. These tumors are always cancerous. This process occurs in approximately 10 to 15% of cancer patients.
The treatment recommendations will depend on multiple factors including type of brain tumor, location, size, number of tumors and whether it is a primary brain tumor or a metastatic tumor.
Many times removal of as much of the tumor as possible is performed first in order to reduce pressure on the remainder of the brain. Reduction of this pressure can often relieve many symptoms. Commonly, radiation therapy or a combination of chemotherapy and radiation therapy follows this procedure.
- Chemotherapy: Drugs that kill cancer cells or make tumor cells more sensitive to radiation therapy are sometimes used to treat brain tumors.
- Radiation Therapy: Sometimes radiation therapy is started after surgery and other times it is used in place of surgery. In certain situations a combination of chemotherapy and radiation therapy will be suggested. The most frequent radiation therapy treatment options are
External beam radiation therapy and Stereotactic radiosurgery or Stereotactic fractionated radiotherapy. External beam radiation therapy involves a series of painless, daily (Monday through Friday) outpatient treatments delivered over several weeks. Your treatments may be started over a weekend or while you are hospitalized if your symptoms are serious and interfere with your ability to function. The three main techniques for delivering external beam radiation are:
- Whole brain radiation involving treatment to all the brain tissue. This is often used for metastatic disease to provide treatment to parts of the brain where disease may be present, but does not show up on scans.
- 3-dimensional conformal therapy (3-D conformal) refers to a method of treatment delivery that incorporates 3-dimensional computer planning and treatment systems to produce a high-dose area of radiation that conforms to the shape of the area to be treated. This technique allows the delivery of precise doses of radiation to the tumor through multiple treatment fields while sparing surrounding tissues.
- Intensity modulated radiation therapy (IMRT) which utilizes a more sophisticated system of shields within the machine allowing a higher dose of radiation to be delivered to the tumor from multiple angles, while minimizing the effects on surrounding tissue. This form of 3-D conformal radiotherapy allows a precise adjustment of radiation beams to the tissue within the target area. It is used when a high dose of radiation is necessary to treat the tumor and critical normal tissue can be spared.
- Stereotactic radiosurgery (Linac based or Gamma Knife®) is a type of external beam radiation therapy using a very sophisticated treatment delivery system that delivers a high dose of radiation directly to the tumor in a very precise manner minimizing the radiation delivered to normal brain tissue. Several weaker radiation beams are aimed from different directions and come together at the tumor to deliver a high radiation dose directly to the tumor. This technique is often used when surgical removal of the tumor would damage essential brain tissue or when the individual's overall medical condition does not allow surgery. In some cases only one treatment is given.
- Stereotactic fractionated radiotherapy may be an option for individuals with larger tumors who wish to avoid surgery or where the tumor is very close to critical normal tissue structures (i.e. optic nerves, optic chiasm). The technique is similar to the process described for "stereotactic radiosurgery" but each treatment is divided into smaller doses and is delivered over five to six weeks.
Treatment Side Effects
Side effects of the therapy can vary depending on your tumor and the type of treatment you receive. Possible effects include headache, skin irritation and scalp redness (similar to sunburn), fatigue, hair loss, change in appetite and unsteadiness. Some side effects may be treated with steroids (Decadron or dexamethasone) or other medications.
Call us today at 401.432.7446 to learn more about treatments and options. Our oncology team is ready to support you.