Term brain cancer usually means a malignant tumor inside the brain. Brain cancer is called primary, if it is started in the brain. Sometimes tumors can come from other parts of the body and lodge inside the brain. They are called secondary brain cancer. Brain tumors can be benign, without cancer cells or malignant, with cancer cells. Even benign tumors can be problematic, if situated near a vital structure.
*How to Diagnose*
Brain cancer is first suspected by symptoms and signs. Then necessary tests are carried out to confirm the suspicion and to create a treatment plan. Symptoms are mainly due to increased pressure inside the skull and tumor pressing on various parts of the brain.
*Symptoms due to increased pressure inside the skull*
1. Early morning headache: – This type of headaches is typically present on waking or may awaken the patient from sleep. Usually this is a very common presenting symptom in brain cancer. But this may not be a very severe headache. This type of headache is worsened by lying down. It is relieved by vomiting. Headache is less severe in evening.
2. Early morning vomiting: – This is usually associated with headache. Vomiting is marked in the morning and less severe in evening.
*Symptoms due to brain cancer pressing on other parts of the brain*
3. Mental changes: – Irritability, socially inappropriate behavior and personality change in a previously normal individual may signal a brain cancer.
4. Seizures (fits): – Any new seizure in an adult may indicate a brain cancer.
5. New weakness in any part of the body: – Brain cancers can cause weakness or incoordination in certain parts of the body. Weakness and disability can increase over time.
6. Numbness:- Some brain cancers can cause numbness in certain areas of the body.
7. Loss of vision or hearing:- Reduced vision and hearing can be due to a brain cancer.
If anyone has above symptoms, they should immediately seek medical advice. Then the doctor will do several clinical tests by tapping or moving patients body parts. After that the doctor will look inside patient’s eye using an ophthalmoscope. Increased pressure inside the skull can be detected by looking inside the eye.
*What are the tests*
Computerized tomography (CT scan) can detect most of the brain cancers. It is cheaper than MRI. But some cancers can be missed by the CT scan. Magnetic Resonance Imaging is a more sensitive scan, which can detect even smaller lesions. But it is usually an expensive test.
*What are the treatment options*
Treating brain cancer is usually a challenging task for doctors. They have to weigh risks and benefits very carefully before starting a treatment plan.
Some tumors can be removed completely by surgery. It is usually used in combination with other treatment options. But if a tumor is near a vital structure, surgery alone can do very little.
If a tumor is radio sensitive and surgically unreachable then radiotherapy can reduce the tumor bulk. Usually radiotherapy cannot cure a tumor by its own. Usually Patient can have side effects such as nausea and vomiting.
Giving cytotoxic drugs is the other option. These drugs can reduce the tumor bulk. Sometimes it can cure the patient. But it causes nasty side effects such as nausea, vomiting and hair loss.
Various palliative treatment options to increase the quality of life are available, if the brain cancer is not treatable. Drugs are given to prevent seizures. Steroids are given to prevent cerebral edema. Psychological counseling of the patient and care givers is part of the palliation as well.
Newer therapies like immunotherapy, antiangiogenesis, biologic therapy, second messenger inhibition and gene therapy are in experimental stage.