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Monday, August 30, 2010

What is a brain tumor?

A brain tumor is an abnormal mass of tissue in which the cells grow and multiply without restraint, apparently unregulated by the mechanisms that control normal cells. One factor that distinguishes brain tumors from other tumors is that they arise in the skull, an organ encased by bone, and there is very little room for expansion with the skull. They are also among the few types of tumors that generally do not tend to metastasize or spread to other parts of the body.
Whereas certain brain tumors occur almost exclusively during childhood and adolescence, others are predominantly tumors of adult life. The patient's age appears to correlate with the site where some tumors develop in the brain. Although most primary tumors attack member of both sexes with equal frequency, some, such as meningiomas, occur more frequently in women, while others, such as medulloblastomas, more commonly afflict boys and young men.
The prognosis for patients with a brain tumor is as individual as the patients themselves. Your doctors will help you understand the possible consequences of your specific tumor.

Tumor Types

There are several different types of brain tumors and this section describes most except the ones that are quite rare. We will help you locate the structures of the brain mentioned in these descriptions and will tell you in general terms the functional roles of each structure.
GliomasAstrocytoma and Glioblastoma Multiforme (GBM)
Other GliomasBrain Stem Glioma, Epdendymoma, Ganglioneuroma, Juvenile Pilocytic Astrocytoma, Mixed Glioma, Oligodendroglioma, and Optic Nerve Glioma
Chordoma, Craniopharyngioma, Medulloblastoma, Meningioma, Pineal Tumors, Pituitary Adenoma, Primitive Neuroectodermal Tumors (PNET), Schwannoma or Acoustic Neuroma, and Vascular Tumors
Other brain-related conditions CNS Lymphoma, Meningeal Carcinomatosis, Neurofibromatosis, Pseudotumor Cerebri, and Tuberous Sclerosis
Metastatic brain tumors
Any tumors that spread to the brain from other parts of the body.
Facts about Brain Tumors
o Each year approximately 190,000 people in the United States and 10,000 people in Canada will be diagnosed with a primary or metastatic brain tumor.
o Brain tumors are the leading cause of SOLID TUMOR death in children under age 20 now surpassing acute lymphoblastic leukemia (ALL), and are the third leading cause of cancer death in young adults ages 20-39.*
o Brain tumor patients, including those with certain "benign" brain tumors, have poorer survival rates than breast cancer patients.
o Metastatic brain tumors (cancer that spreads from other parts of the body to the brain) occur at some point in 10 to 15% of persons with cancer and are the most common type of brain tumor. The incidence of brain tumors has been increasing as cancer patients live longer.**
o In the United States, the overall incidence of all primary brain tumors is more than 14 per 100,000 people.
o There are over 120 different types of brain tumors, making effective treatment very complicated.
o Because brain tumors are located at the control center for thought, emotion and movement, their effects on an individual's physical and cognitive abilities can be devastating.
o At present, brain tumors are treated by surgery, radiation therapy and chemotherapy used either individually or in combination.
o Only 31 percent of males and 30percent of females survive five years following the diagnosis of a primary or malignant brain tumor.
o Brain tumors in children are different from those in adults and are often treated differently. Although as many as 69 percent of children with brain tumors will survive, they are often left with long-term side effects.
o Enhancing the quality of life of people with brain tumors requires access to quality specialty care, clinical trials, follow-up care and rehabilitative services. Improving the outlook for adults and children with brain tumors requires research into the causes of and better treatments of brain tumors.
o Complete and accurate data on all primary brain tumors are needed to provide the foundation for research leading to improved diagnosis and treatment and to investigations of its causes.
o The National Cancer Institute and the National Institute for Neurological Disorders and Stroke are working together to implement the brain tumor research priorities set by the research, clinical and advocacy community, as summarized in the Brain Tumor Progress Review Group Report.
o Symptoms of a brain tumor can include headaches (headaches that wake you up in the morning), seizures in a person who does not have a history of seizures, cognitive or personality changes, eye weakness, nausea or vomiting, speech disturbances, or memory loss. While these are the most common symptoms of a brain tumor, they can also indicate other medical problems.
Treatment of Brain Tumor
1.Which therapies are used to treat brain tumors?
2.Which medications are used for brain tumor patients?
3.What is radiation therapy?
4.What is stereotactic radiosurgery?
5.What is chemotherapy?
6.What are the newest chemotherapy drugs?
7.What is gene therapy?
1. Which therapies are used to treat brain tumors?
Surgery is the chief form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. Because a tumor will recur if any tumor cells are left behind, the surgeon's goal is to remove the entire tumor whenever possible. Radiation therapy and chemotherapy, in general, are used as secondary or adjuvant treatment for tumors that cannot be cured by surgery alone.
2. Which medications are used for brain tumor patients?
Steroids and anti-convulsants (to stop seizures) are the most common medications used for brain tumor patients. Steroids are given to reduce inflammation of tissues and control swelling of the brain, particularly before and after surgery. They do not kill tumor cells, but used alone or combined with other forms of treatment, can cause remarkable improvement in a patients condition. If used for only a few days, steroids generally cause no side effects, but used over a long time or withdrawn without monitoring, steroids may produce several side effects. You should discuss monitoring of the steroid and all possible side effects with you doctor.
Other drugs commonly used with brain tumor patients are anti-convulsants. Some are used to keep seizures from happening (prophylactic) while others cut short (abort) seizures that have already started. Some of the more common drugs now used to prevent seizures are Dilantin, Tegratol, Depakote, and Phenobarbital. It is important to remember that side effects of these drugs vary greatly from person to person. But if side effects are a serious problem, there are plenty of newer drugs that can be used, either alone or in combination with others. Newer drugs include Neurontin (gabapentin), Topomax (toiramate), Lamictal (lamotrigine) and Gabitril (tiagabine).
3. What is radiation therapy?
Radiation therapy is mainly used after surgery for tumors that cannot be removed completely, as well as for cases in which surgery would involve too great a risk to the patient. It may be given in a single dose each day, usually for 30 days with weekends off, or it may be "hyper fractionated" into two or more doses daily for the recommended course of treatment.
Standard radiation therapy delivers an external beam of radiation aimed at an entire region, such as the portion of the brain containing the tumor and typically delivers a daily dose of 1.8-2.0 Gy (Gray) to a total dose of 50-60 Gy over 5-7 weeks.
4. What is stereotactic radiosurgery?
Stereotactic radiosurgery is a non-invasive the****utic alternative for treating brain disorders. Instead of a scalpel, clinicians using stereotactic radiosurgery technology aim multiple"pencil-thin" beams or arced beams of high energy particles directly at the tumor site while sparing healthy tissue as much as possible. With stereotactic radiosurgery techniques, a higher dose of radiation is delivered to the specific site (or tumor) of 15-20 Gy and is usually given in one day. Both Gamma Knife and LINAC X Knife are types of stereotactic radiosurgery.
5. What is chemotherapy?
Chemotherapy works to destroy tumor cells with drugs that may be given either alone or in combination with other treatments. A key problem with chemotherapy has been the difficulty in delivering sufficient amounts of drug directly to the tumor while sparing normal brain cells. Another problem is the blood-brain barrier mechanism that normally serve to keep harmful substances out of the brain - unfortunately, this same blood-brain barrier can also work to keep potentially helpful drugs out of the brain. Although chemotherapy is usually given by mouth or injected in the vein, some new techniques of intratumoral chemotherapy use either small pumps or biodegradable wafers to place the drug inside the tumor.
6. What are the newest chemotherapy drugs?
There is currently a great deal of scientific activity focused on the area of the discovery of new chemotherapy drugs, many with novel or alternative mechanisms of action (how drugs work). Following is a brief list of the various categories of chemotherapies being used to treat brain tumors: Cytotoxic Agents, Anti-angiogenic drugs, Differentiating agents, Anti-invasion agents, Cell signal transduction modulators and Growth factor inhibitors.
7. What is gene therapy?
Currently for patients with malignant brain tumors who have a recurrence after surgery, radiation therapy or chemotherapy, gene therapy may provide an experimental option for treatment. Using gene therapy, researchers inject a substance into the brain tumor that changes the genetic makeup of the tumor cells.

Vegetables and lower breast cancer risk

Cruciferous vegetables may help lower the risk of developing breast cancer, particularly for women who carry a particular gene variant linked to the disease.

American researchers studied more than 6,000 women and found that those with the highest intake of cabbage and white turnips had a somewhat lower risk of postmenopausal breast cancer than those with the lowest intake. The findings add to evidence that compounds in cruciferous vegetables may help fight cancer. Cabbage, white turnips, broccoli, cauliflower and kale contain certain compounds that the body converts into substances called isothiocyanates, which are thought to have anti-cancer effects.

High consumption of cabbage and white turnips were linked to a moderately lower breast cancer risk. But the apparent benefit was stronger among women who carried two copies of a particular variant of a gene called GSTP1. Among these women, those with the highest intake of any cruciferous vegetables had about half the risk of breast cancer as those who ate the fewest.

GSTP1 is an enzyme that helps detoxify the body of potentially cancer-causing substances. Some studies have suggested that having a particular form of the gene - the Val variant - may raise a woman's risk of breast cancer. The current study found that women who carried two copies of the Val variant did, in fact, have a higher risk of developing breast cancer before menopause than women who had other variants in the GSTP1 gene. But the excess risk was cut substantially in those who ate the most cruciferous vegetables.

It's possible that people who carry two Val variants of the GSTP1 gene excrete the beneficial isothiocyanates more quickly, and eating more cruciferous vegetables helps counter this. However, more research is needed to better understand how cruciferous vegetables might modify breast cancer risk.

Loneliness and Cancer Risks

“Lonely women could be at greater risk of breast cancer,” the Daily Mail reported. It said that scientists have found that the stress and anxiety caused by social isolation can speed up the growth of cancers.

The news story is based on a laboratory study in genetically engineered mice and the results cannot be directly applied to humans. Although animal studies can be valuable for gaining a general understanding of how diseases develop, humans have a very different biology from mice. These findings cannot be interpreted to mean that being sociable protects you against breast cancer or any other cancer, or that being unsociable raises your risk, or gives you a worse prognosis or outlook.


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